Many different respiratory viruses are circulating throughout the United States, but the flu is responsible for a "significant proportion" of that circulation, according to CDC, all while many hospitals are dealing with surges of pediatric respiratory syncytial virus (RSV) patients.

Flu cases continue to surge

According to CDC, 15 states reported very high activity of influenza-like illnesses (ILI) for the week ending in Nov. 5, while eight states reported high activity and six states reported moderate activity.

In addition, for the week ending in Nov. 5, 6,465 lab-confirmed flu patients were hospitalized, according to CDC, and the current percentage of outpatient provider visits for an ILI was 5.5%, above the national baseline of 2.5%.

So far this season, CDC estimates there have been at least 2.8 million flu cases, 1.4 million flu medical visits, 23,000 flu hospitalizations, and 1,300 flu deaths.

Three pediatric flu deaths occurred during the week ending in Nov. 5, bringing the total number of pediatric flu deaths for the 2022-23 season up to five.

While flu cases may be surging early, Lynette Brammer, an epidemiologist who leads CDC's domestic influenza surveillance team, said there's no evidence yet that the flu virus circulating is causing more severe cases than normal.

"The picture is pretty consistent across our different pieces of surveillance. There's nothing there that makes me think that this virus is really different and causing more severe disease than we see typically with flu," she said. "Flu can cause severe outcomes, but it's not out of proportion this year compared to previous years. It's not like we're seeing a lot of hospitalizations without a lot of illness."

In addition, Samuel Scarpino, director of life sciences at the Institute for Experiential AI at Northeastern University, said this year's flu vaccine, "is a good match, which isn't the case every year." So, if considering whether or when to get a flu shot, "Now is a great time to do that," he added.

Hospitals deal with surges of RSV patients amid rising flu cases

As the flu surges nationwide, many pediatric hospitals are dealing with surges of RSV patients. According to federal data, more than 75% of pediatric hospital beds and pediatric ICU beds have been in use for the past few weeks, up from an average of roughly two-thirds full over the past two years.

Brian Cummings, medical director of the Department of Pediatrics at Mass General for Children, said they've seen around 2,000 RSV cases in October and more than 1,000 in the first week of November.

"It's been escalating and been quite severe," he said, adding that, as of Thursday, his hospital's pediatric ICU is full and seven patients are waiting to be transferred in.

Most RSV infections have been treated in urgent care facilities and the ED and patients are sent home, Cummings said. "But even if just 10% of those need hospitalization, it creates a lot of stress on health care facilities, and so what we are seeing is we've had over 250 hospitalizations for RSV alone on top of the other circulating viruses."

Many doctors' offices have started asking parents to treat their sick children at home if they're otherwise healthy.

"The things that would lead to us encouraging a family to come in would be the very young children, particularly under the age of 2, specifically under the age of 6 months with high fevers," said Rhonda Patt, from Atrium Health. "If the child is lethargic, isn't able to eat or drink very well, or if they see any signs the child is having a hard time breathing."

Patt added that families should visit their doctor if a child gets better and then spikes with another fever or starts having other symptoms.

"With the flu, there's a risk for secondary infection, meaning ear infections or pneumonia or things that would need antibiotics," she said. (McPhillips, CNN, 11/11; Leshner, WCNC, 11/10; Hibbert, News @ Northeastern, 11/10)