Kids are pouring into N.J. hospitals. A spate of respiratory illness cases is filling pediatric beds.

New Jersey hospitals are filling up with kids coughing and struggling to breathe.

But it’s not COVID-19. Or even influenza.

An outbreak of viral respiratory infections is sending children to emergency rooms throughout the state. The biggest culprits are enteroviruses and rhinoviruses as well as a few cases of RSV (respiratory syncytial virus), all of which usually produce cold-like symptoms.

But in severe cases, they can cause respiratory distress.

“Some of the ICUs are at capacity,” said Dr. Uzma Hasan, division director of pediatric infectious disease at Cooperman Barnabas Medical Center in Livingston, part of RWJBarnabas Health.

Another school year just began, helping the viruses spread, and already the spate of respiratory illness cases are filling pediatric hospital beds. The surge in infections has also been aided by the relaxation of masking and other measures against COVID-19, experts say.

Doctors at RWJ Barnabas Health are seeing a sharp rise in pediatric enterovirus and rhinovirus cases. Typically, these viruses cause only mild symptoms. But they can occasionally be severe, particularly for those with asthma and certain underlying conditions.

“We are starting to see our ERs and our floors and our pediatric ICUs (with) a large number of these kids within the last few weeks,” Hasan said Wednesday.

She said it appears to be a national trend. In fact, the Centers for Disease Control and Prevention issued an alert earlier this month warning of enterovirus D68, a rare but serious respiratory infection in children that can cause shortness of breath and develop into acute flaccid myelitis, a neurological condition that can result in muscle weakness and even paralysis.

The state Department of Health also issued an advisory last week to pediatricians and hospitals warning of higher enterovirus and rhinovirus activity in recent weeks. It asked doctors to be on the lookout for AFM, which is often preceded by an enterovirus D68 illness.

“The good news is that the vast majority will have mild illness,” Hasan said. “The ones who get hospitalized seem to get better pretty quickly.”

Cooper University Hospital in Camden also reported an uptick in pediatric respiratory cases, a spokeswoman said.

Enterovirus seems to spike every couple of years, according to Hasan.

“And this year, we are seeing a significant surge,” she said.

Hasan noted that 2020 was an outlier with particularly low respiratory infection numbers due to the pandemic preventive measures in place — measures that are now largely gone.

“The state is monitoring and watching hospitalizations and Pediatric Intensive Care Unit census daily throughout the state,” a spokeswoman for the New Jersey Department of Health said Wednesday in a statement. “The Department is also planning a call with hospitals to assess pediatric capacity.”

Despite the wave of cases, much was learned from the pandemic, according to Hasan.

“We are planning to deal with these surges, coming up with sort of flow-through plans for accommodating the larger number of kids,” she said.

While several respiratory viruses are circulating, enteroviruses seem to be the main driver of new cases.

“Enterovirus is what’s sort of the predominant virus right now,” Hasan said. “We are starting to see a little uptick in RSV. Flu — we haven’t seen overwhelming numbers.”

But that could change in the coming weeks and months. She noted that Australia’s flu season — a possible precursor to the US season — showed an unusually high number of cases.

“So we anticipate that the flu numbers are going to be high this year,” she said.

Hospitals want to get the message out to parents — and encourage proper hygiene measures and vaccinations — as Hasan emphasized that some kids are at higher risk.

“There are some high-risk populations that we know are going to be at risk for severe illness,” she said, “and those are the kids who have asthma, the kids who have underlying chronic lung disease. The neurologically impaired children will often have severe illness. The children who have congenital heart disease can have severe illness — so they are already on our radar.”

At Cooperman, she said some kids are entering the emergency room struggling to breathe.

“The kids who are coming into the ER setting, yes, they do have signs of respiratory difficulty, which is why they wind up getting treated with breathing treatments,” Hasan said. “Sometimes they are put on steroids if they’re asthmatics, and typically they will wind up requiring hospitalization and sometimes ICU admission if they are in severe distress.”

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Spencer Kent may be reached at [email protected].

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