11/23/22 Health Advisory: Pediatric Respiratory Illness Increasing

Health Advisory: Pediatric respiratory illness increasing in Western Washington

Published Nov. 23, 2022.

Situation update

• Western Washington pediatric hospital ED volumes are 200%–300% of capacity, with record high wait times and waiting room volumes.
• A significant increase in flu activity in Western Washington is compounding pediatric respiratory surge/capacity issues. King County has reported the first pediatric flu death in Washington State since the 2019-20 flu season.
• Several facilities report record high levels of pediatric behavioral health patient boarding, a worsening trend.
• Oseltamivir (Tamiflu) supply is constrained nationally, particularly the pediatric suspension

Information for healthcare providers

• Multiple respiratory viruses that impact children are circulating in Washington. No FDA-approved vaccine against RSV exists. Vaccinating against flu and COVID-19 is the best available strategy to ease the burden of respiratory illness on our overstrained healthcare system.
• To better prepare families for treating bronchiolitis at home, Seattle Children’s Hospital developed a Bronchiolitis Care Packet for providers to share with families.
• Seattle Children’s has a Bronchiolitis Care Pathway for providers.
• Proactively share information with patients about the surge in respiratory illness. Encourage appropriate levels of care—i.e., at home vs. primary care vs. emergency department. Emphasize the importance of children getting up to date on vaccines. You can use this template letter to communicate with patients.
• When evaluating children for respiratory illness, consider using a multiplex panel to better inform isolation and quarantine, and prevent further spread of illness.
• Consider reserving oseltamivir for patients who are diagnosed within 48 hours of onset of symptoms or at risk of severe illness.
• Encourage adults to get flu and COVID-19 vaccine to help stop the spread to children.
• Jefferson County Public Health has pediatric flu vaccine available and offers flu vaccine to adults who are receiving other vaccines, including COVID boosters. Families can call (360)385-9400 for an appointment.
• DOH convened the Health and Medical Multi-Agency Coordination Group including local health jurisdictions (LHJs), Tribal partners, healthcare coalitions, Washington State Hospital Association, healthcare providers and other state agencies to coordinate strategies for mitigating this pediatric RSV surge.
• Washington Medical Coordination Center (WMCC) is activated and working closely with healthcare facilities on pediatric load balancing. Harborview Pediatric ICU team is helping with triage. WMCC is working with regional “non-pediatric” hospitals with pediatric capacity to manage and receive appropriate transfers in support of the region.

Nurse advice lines

Additional resources

• Pediatric surge annex, Northwest Healthcare Response Network.
• Flu information for public health and healthcare, DOH.
• Weekly flu surveillance report, CDC.
• Communicable disease surveillance data, DOH.
• Kitsap Public Health District Respiratory Illness Report – Week 46