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Surge in RSV adds to pediatric hospital pressures. Here’s what to do

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Pediatricians have suggestions for parents and caregivers coping with coughing and sneezing children as some children’s hospitals in Canada report a surge in respiratory infections.

Symptoms of respiratory syncytial virus (RSV) resemble those of colds and flu, such as coughing, runny nose, fever and loss of appetite.

In its most recent update for the week ending Oct. 15, the Public Health Agency of Canada reported a rise in RSV cases in many parts of the country, based on limited testing.

Dr. Kashif Pirzada, an emergency department physician in Toronto, says he’s seeing a large number of sick children, mostly from viruses.

One of Pirzada’s own children was recovering at home last week after feeling miserable and lethargic.

“We’ve been through four colds in the last six weeks,” he said. “I’m sending my child back to school … with a mask welded to his face because we can’t keep getting sick like this.”

Much of the burden is from RSV, which Pirzada says hits children under 12 months especially hard. If so, they may need to go on oxygen at a hospital.

Warning signs for parents to watch

Dr. Ayisha Kurji, a pediatrician at a Saskatoon hospital, is also seeing lots of kids with viral illness in the emergency department and some end up being admitted. Children’s hospitals in other provinces and states have reported a similar trend.

Kurji says as temperatures drop and we spend more time inside, germs tend to spread and more kids get infected.

To prevent illnesses and to help out busy children’s hospitals, Dr. Ayisha Kurji, a Saskatoon pediatrician and assistant professor at the University of Saskatchewan, reinforced hygiene measures from the COVID-19 pandemic. (Submitted by Ayisha Kurji)

“Really it’s about symptoms,” Kurji said. If a child is breathing really quickly, or is tired out from breathing, that’s cause for concern.

“If they are stopping breathing or turning blue, of course that’s an emergency.”

Sometimes when young children work hard to breathe, it hinders their ability to eat and dehydration can also be a concern, Kurji said.

“They’re crying and there’s no tears coming out there, their mouths are really dry and their colour is different, they’re really sleepy, they’re really irritable, then it’s time to come into the hospital.”

Babies younger than three months with a fever should always be taken to the ER, the Canadian Paediatric Society advises, or if they are unable to suck or drink.

For those a bit older, the society says symptoms that warrant a doctor’s attention include having a fever for more than 72 hours, vomiting or loss of appetite, or coughing to the point of choking or throwing up.

To prevent illnesses and to help out busy children’s hospitals, Kurji reinforced familiar advice:

  • Wash your hands regularly.
  • Wear a mask if you’re inside, especially in a crowded place.
  • Stay home if you’re sick to prevent spreading to others.
  • Keep up to date on COVID vaccinations and get an annual flu shot.

Dr. Antonio D’Angelo, head of the pediatric emergency department at Montreal’s CHU Sainte-Justine, says it’s key to maintain hydration and comfort. For babies, it’s especially important to clear out the nose because they rely on a liquid diet and have to breathe while drinking and swallowing.

“If they’re completely congested, what happens is they’ll take a lung full of air from their mouth and while they’re breathing they can choke,” he said.

He suggests clearing a baby’s nose with saline so they’re able to drink properly. The drops can provoke a cough, which can help clear secretions.

Doctors also recommend a “snot sucker” for kids under six months who are very congested. If clearing the nose and expelling secretions doesn’t help, consult your primary care provider.

For babies at very high risk of severe infection, a monthly injection of a monoclonal antibody called palivizumab can be given during RSV season to help cut the risk of hospitalization.

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Whooping cough is at a decade-high level in US

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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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