Soaring RSV rates in parts of Quebec lead national cases, strain hospital staff

Dr. Antonio D’Angelo, head of the pediatric emergency department at Sainte-Justine hospital, in Montreal is shown in this handout image. Soaring cases of respiratory syncytial virus in Quebec have pushed the positivity rate to 15 per cent in Montreal and Quebec City. Sainte-Justine hospital/The Canadian Press

Soaring cases of respiratory syncytial virus in Quebec have pushed the positivity rate to 15 per cent in Montreal and Quebec City.

Weekly provincial surveillance data show positivity rates of the childhood illness hover near 14 per cent provincewide, with slightly higher rates in the two cities and wide variation among smaller communities.

It’s several times the most recent federal positivity rate of 3.5 per cent, although that data is a week behind and covers the week ending Oct. 15.

The head of the pediatric emergency department at Sainte-Justine hospital in Montreal says his emergency rooms “are completely jammed with patients” with respiratory viruses, largely driven by RSV.

Dr. Antonio D’Angelo says such numbers are not typically seen until later in the fall and winter, but that a similarly early RSV season last year has shifted viral patterns.

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He says RSV seems to be hitting more than just babies and toddlers this year to include three- and four-year-olds who are getting the virus for the first time because they had been shielded by now-lifted pandemic precautions.

“There’s just so much more — a larger wave with sicker patients, therefore more hospitalizations and our hospitals are just full to the brim,” D’Angelo said Tuesday.

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“In the emergency rooms, well, they’re just all over the place — they’re in our respiratory unit in the emergency room but they’re also in sort of a makeshift corridor for a temporary unit there. And then we had to open up another corridor with patients with respiratory cases that needed treatments.

“And that’s very, very unusual. In fact, we’ve never had it this bad.”

D’Angelo said he expected similar rates to emerge in other Canadian centres, although acknowledged that other hospitals are already seeing increasing numbers of respiratory patients, as well as strained resources and staff.

The national figures show a positivity rate of two per cent in Ontario and 3.4 in Atlantic Canada. The lowest rates were 1.4 per cent in British Columbia, one per cent on the Prairies and two per cent in the Territories.

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Ottawa pediatric hospital CHEO said for the week ending Oct. 15, out of 298 RSV tests 30 were positive _ about 10 per cent.

A CHEO spokesperson said 12 patients were hospitalized for RSV last month — the same record-high number as last year, and much higher than the pre-pandemic average of about one to two hospitalizations for September.

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D’Angelo said RSV typically spreads by community, and does not generally emerge at the same time across the country.

“It often happens where there’ll be one sort of epicentre where everything sort of starts to occur, and then it sort of spreads out,” he said.

While only a small percentage of RSV cases result in hospitalization, the illness is common among children. By age two, 90 per cent of kids will have had an RSV infection, says Dr. Jesse Papenburg, pediatric infectious disease specialist at the Montreal Children’s Hospital of the McGill University Health Centre.

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However, some infants are at greater risk of severe illness and that’s when it’s important to be have a predictable viral season, he said.

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The RSV season typically runs from November to March but Quebec experts noticed a five per cent positivity rate in August, said Papenburg.

He said that prompted the province to move a preventive campaign for high-risk babies to mid-September, instead of the usual November.

A monoclonal antibody injected monthly to very high risk infants can cut their risk of hospitalizations by half, he said. These may include children younger than one year of age who were born very prematurely, or who have congenital cardiac disease or chronic lung conditions.

with files from Cassandra Szklarski in Toronto

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