DOH: Respiratory virus infections, flu on the rise

State Epidemiologist Sarah Kemble said Thursday doctors are “seeing a lot of sick kids with respiratory viruses right now.”

“We’re in frequent communication with our hospitals,” Kemble said during a press conference to discuss increased rates of respiratory syncytial virus, or RSV, and influenza in Hawaii. “We’re hearing from them, as well, that there are really high numbers of sick kids with respiratory illness of various kinds. They are managing the load. They have the capacity, but they do also encourage everyone to please take preventive measures, simple measures that can prevent you from getting sick.”

RSV is a common respiratory virus that usually causes mild, cold-like symptoms.

Most people recover in a week or two, but children under the age 5, and in particular infants, are at highest risk for severe RSV infections, according to the state Department of Health.

Older adults, especially those with underlying medical conditions, also can experience severe illness.

“Most people who are infected with RSV recover completely at home with just supportive care,” said Caroline Pratt, the DOH’s Disease Investigation Branch chief, during the same press conference. “There’s a small number of cases, mostly the very young and older adults with other medical conditions, who may require hospitalization — and that’s mostly just to support their breathing.

“Just like any other respiratory illness, if you do have concerning symptoms, like difficulty breathing or prolonged fever for several days, you should see your medical provider.”

In 2020 and 2021, RSV and influenza cases declined sharply, because COVID-19 mitigation measures also prevented the spread of these viruses. Since these measures were relaxed, RSV cases have been rising.

RSV cases typically increase in the fall and peak in winter. This year’s total testing volume (positive and negative tests) and percent positivity are both increasing quickly early in the season. Out of an average of 1,858 RSV tests performed per week statewide in recent weeks, 23% were positive.

This indicates there is a high level of both detected and undetected RSV infection in the community.

“Even though our (RSV) numbers are high, they are consistent with the western region of the mainland,” Pratt said. “Case numbers rose earlier on the East Coast and are already beginning to come down there, so hopefully, that’s going to happen on the West Coast and in Hawaii, as well.”

Flu activity in Hawaii remains low but also is increasing, the DOH reported.

Out of 3,886 specimens tested for influenza statewide in the week of Oct. 16 to Oct. 22, 5.8% were positive. During a similar timeframe, statewide COVID-19 test positivity was 6.4% out of 14,927 tests performed. COVID-19 test positivity declined to 5.3% in the current week.

People concerned about the flu or other respiratory viruses can take simple preventive measures like staying away from others who are sick, staying home if they’re sick, washing their hands, covering their cough and wearing a mask.

“RSV testing is not always necessary, especially for somebody who is not in a high-risk group,” Pratt said. “It should really be more emphasized in very young children and nursing home residents.”

Pratt urged vaccination for flu and COVID. She said there’s no vaccination for RSV as there is for flu and COVID, but added “washing your hands is really, really important for RSV, especially. It can be spread by touching surfaces that somebody else who’s been sick has touched, so washing your hands frequently is important. And masking still works. Just like it works for COVID, it works for respiratory viruses, as well.”

Email John Burnett at jburnett@hawaiitribune-herald.com.