Dr. Katherine Harrod examines 2-year-old Arielle Dinsmore while her mother, Felicia, holds her at SMHC Pediatrics in Sanford on Friday. Felicia Dinsmore said her daughter’s daycare had a child with RSV and her daughter developed a cough and a high fever, so she wanted Harrod to examine her. Gregory Rec/Staff Photographer

Maine hospitals and pediatrician’s offices are treating high numbers of children infected with RSV, a common respiratory virus that tends to cause more severe illness in infants and young children.

RSV, or respiratory syncytial virus, is widespread across the United States, driving a surge in infections earlier than the typical midwinter peak.

“It’s the worst I’ve seen in a while,” said Dr. Katherine Harrod, a pediatrician with Southern Maine Healthcare in Sanford. Appointments are filled with children sick with RSV, and the nurse who answers the phone and fields questions from parents has been swamped the past two weeks, Harrod said.

Combined with concerns about an early and severe influenza season and a possible increase in COVID-19 hospitalizations this winter, public health experts are fretting about a “tri-demic” where RSV, influenza and COVID-19 strain the health care system at the same time.

“It’s concerning. We don’t want to see a wave of RSV on top of a wave of influenza on top of a wave of COVID-19,” said Dr. James Jarvis, incident command leader for Northern Light Health, the parent organization of Eastern Maine Medical Center in Bangor and Mercy Hospital in Portland.

The best way to avoid illness is to practice good hygiene, stay home when sick, and get your flu shot and COVID-19 vaccination. Wearing a mask in crowded areas also can help prevent illness.

Influenza is currently hitting the Southeast and is starting to travel up the Eastern Seaboard, public health officials say. Maine has so far had only 21 reported cases of influenza, but the disease typically moves south to north in late fall, winter or early spring.

While immunizations are available for COVID-19 and the flu, scientists have so far failed to develop a vaccine for RSV. Federal officials on Friday said they hope to have an RSV vaccine within the next two years.

Dr. Mary Ottolini, chair of pediatrics at The Barbara Bush Children’s Hospital in Portland, said treatments for RSV are not effective, other than comfort treatments such as over-the-counter pain medicine or, in more severe cases, supplemental oxygen.

“We don’t have a good anti-viral medication for RSV like we do for the flu, and in some cases for COVID,” Ottolini said.

Ottolini said the COVID-19 pandemic likely contributed to the early onset of RSV, as this is the first winter since 2019-20 without COVID-19 restrictions such as mask mandates and limits on gathering sizes that suppressed many respiratory infections.

“RSV didn’t percolate like it usually does the last couple of winters, so there’s more people whose immunity is down,” Ottolini said. And some children were born during a time of lockdowns, child care closures and few large gatherings, resulting in their immune systems being much less likely to have been as exposed to viruses.

RSV symptoms mimic those of the common cold – runny nose, cough and congestion – but can be more severe in infants and very young children, causing bronchiolitis, an inflammation of the small airways in the lungs, and pneumonia. Severe cases can cause difficulty breathing, and if breathing problems are acute enough can result in hospitalization. RSV is most dangerous for infants under a month old. Ottolini said parents of very young children should be careful about interacting with others.

SIMILAR TO COMMON COLD

When older children and adults contract RSV, symptoms are very similar to the common cold. Seniors, like infants, also can be sickened with a severe case of RSV, but typically toddlers and infants suffer the worst from the virus.

Dr. Katherine Harrod examines 2-year-old Arielle Dinsmore, while her mother, Felicia, holds her at SMHC Pediatrics in Sanford on Friday. Gregory Rec/Staff Photographer

At Harrod’s practice in Sanford on Friday, Felicia Dinsmore brought in her 2-year-old daughter, Arielle, who was sick with RSV. Dinsmore said Arielle had been spiking a 103-degree fever, was extremely fatigued and had some difficulty breathing. Because Arielle also has asthma, Dinsmore wanted to bring her in to make sure she was OK.

“We just wanted to stay on top of it, and just to make sure we are doing everything right,” said Dinsmore, of Limerick. She believes Arielle caught RSV at day care, because other children at the day care also have fallen ill from RSV, as well as children of people she knows.

While doctors know RSV is widespread, case counts are unreliable. The absence of vaccines or medication for RSV leads to spotty testing, Ottolini said.

“We tend not to test as much for RSV because it doesn’t change how you treat the patient,” Ottolini said. Patients who test positive for influenza or COVID-19, on the other hand, can be prescribed anti-viral medications.

But there are many indications RSV is sweeping through the population.

At Eastern Maine Medical Center in Bangor, the pediatric intensive care unit is full, with four patients, three of whom have RSV. Of the tests that are being conducted for RSV at Northern Light Health, positive results have doubled during the past two weeks, from 7% to 14%, Jarvis said.

At Barbara Bush Children’s Hospital in Portland, nine patients on a recent October day were admitted for RSV.

“Forty-five percent of admitted children were there with a respiratory illness (including non-RSV respiratory diseases),” said Caroline Cornish, a Maine Medical Center spokeswoman. “This is very unusual. In mid-October 2019, just under 5% of our admitted pediatric patients were there with respiratory illness.”

FLU SEASON EARLY, SCARY

Ottolini said that over the past few weeks the Portland hospital has taken care of a handful of pediatric RSV patients from Massachusetts because the Massachusetts hospitals were full.

Also on Friday, the Maine CDC reported an outbreak of RSV at Dike Newell School in Bath. It was not clear Friday how many cases there were at the elementary school, but when cases reach 15% or higher of the student population, the Maine CDC considers it an outbreak.

While perhaps not related to RSV, Cape Elizabeth High School closed on Friday due to a number of illnesses that sickened about 21% of students, including COVID-19 and other viruses.

Meanwhile, flu season is shaping up to be potentially “scary,” said infectious disease experts, possibly the worst since the H1N1 flu epidemic of 2009.

“The data are ominous,” William Schaffner, medical director for the nonprofit National Foundation for Infectious Diseases, told the Washington Post. “Not only is flu early, it also looks very severe. This is not just a preview of coming attractions. We’re already starting to see this movie. I would call it a scary movie.”

As of Friday, the U.S. CDC reported about 880,000 cases influenza, 6,900 hospitalizations and 360 flu-related deaths.