 And joining us now to talk about your health, Dr. Steven Zinn, Director of the University of Maryland Children's Hospital and Chair of Pediatrics at the University of Maryland School of Medicine. Doctor, thank you for joining us. We're seeing reports of children's hospitals around the country facing a surge in cases of RSV. What are you seeing there? Well, I think our experience is very similar to what others have reported in the news media. We are seeing a very significant increase in RSV at a point in time when we generally don't see RSV. So we're about two months ahead of when we would have expected to see RSV. And we are struggling to manage our bed situation so that we can take care of all the children that need our services in the state of Maryland. And at this point, I think we're doing an outstanding job with our partners of making sure that every child who needs a bed can get a bed. Are we close to a critical situation? Certainly hope not. Well, no one anticipated RSV occurring so early. And we also didn't anticipate for RSV to occur at the same time that flu is occurring and the same time that rhino virus which is the common cold is occurring. And we're also seeing some enterovirus. So we are definitely having some difficulty but what I would say is one of the things we learned in COVID is that communication is really important. And I really appreciate that the hospitals in the state of Maryland that have pediatric wards that take care of children, we've managed to communicate very well almost daily now to get an idea of which hospital has what sort of pediatric beds. And so we've sort of established an incident command of sorts to make sure that we know exactly what beds are available down at the University of Maryland versus Johns Hopkins Sinai Hospital, GBMC and others. And we are working very closely and very well to make sure that we can put the right patients in the right hospitals. And for right now, it's allowing us to really, I think, stretch our resources in a way that's very helpful to the families of Maryland. Well, what is this virus RSV? It's not something new, correct? Correct. RSV is a common virus, respiratory-sensitial virus. It is something that we see every year. We generally see it peak later in the year, I would say more towards December, January. Interestingly, we haven't seen much RSV during the COVID pandemic. So for the last two years, we have seen very little RSV and we are suddenly seeing significantly increased numbers of kids coming down with that virus. And the theory is that now the world is pretty much wide open and you have people who were previously unexposed to it. All of a sudden, everybody's getting exposed. Well, there are a lot of theories that are being discussed, but I think the one that you articulated perhaps makes the most sense. So if you think about RSV, it is, for adults, it's a pretty routine viral infection, not very serious, but the newborns zero to six months are at significant risk from this virus and so are the six to 12-month-old populations. So generally, there's a subset of the kids in the first year of life that get RSV every year, but for the last two years, that hasn't happened. So we now have zero to one, one to two and two to three-year-olds who've never seen RSV and now that we're no longer socially distancing now that we're no longer wearing masks and everything's trying to get back to normal, I think what we're seeing is two or three times the number of kids who've never seen RSV suddenly get it at once. And so I don't think the virus has become more virulent. I don't think the immune systems of children has been changed, but I think what we're seeing is two or three years worth of kids who've never seen RSV suddenly come down with it. Why is it that most children handle it and get past it as if it was a common cold, as I understand it? And some children become critically ill. Can you forecast who is gonna be susceptible to having a really serious case of it? Right. Well, the at-risk population is zero to six months and six months to a year. So if you look at children under a year of age, they are the ones most at risk. And one of the reasons is that this is a respiratory infection. It enters the body primarily through the ears, nose, mouth and it causes a lot of mucus. So running noses in babies, in very young babies, particularly babies that are breastfeeding or even bottle feeding, they become obligate nose breathers. So when they're feeding, they can only breathe through their nostrils. Their nostrils are very small, much easier to just run into some obstruction, get clogged with mucus and have trouble breathing. So that's the population. Now, why some kids do better than others even in the first year of life? Again, there might be a subset of kids who do have an underlying immune issue, but generally it's kind of just luck of the draw. If you can keep your baby relaxed, calm, if you can make sure they're hydrated so that those secretions don't become so tenacious, so sticky, then you have a really good chance of weathering this at home and not coming into the hospital. Advice for parents, how do they know, at what point do they start to get worried and how do they decide when and where to turn for care? So this is a very difficult time period because we have rhinovirus, sort of the common cold, which is generally not very serious. We do have RSV, we have flu, there may be some residual COVID and there's also a blip of enterovirus. So all of these viruses can cause symptoms very similar. RSV is the one that's causing the most havoc. And so as a parent, I think number one, you have to pay attention, of course, which all parents do, and monitor how your child is breathing. If you have any concerns about how your child is breathing, that should trigger a phone call to your caregiver, your pediatrician, nurse practitioner, family practitioner or a visit to the Urgent Care Center. So I would definitely know exactly where the closest Urgent Care Center is. And if you believe your baby's having trouble breathing, you really need to get in touch with a health caregiver very quickly or make the decision to go to Urgent Care. That's the one thing that you have to pay attention to. But if you can keep your baby calm, if you can keep them hydrated and they're doing okay, then I think it's fine to try stay at home. But if you have any concerns, a trip to your pediatrician or to Urgent Care would be indicated. Coming to a pediatric emergency room is not a bad idea, but I will say that we are inundated with families coming down to the emergency room. So you might do better by calling your pediatrician or caregiver first to get some guidance. And science that the baby's or the young child is really laboring to breathe, not getting enough oxygen, that's an emergency. Correct, correct. So if it looks like they're struggling, if you're getting a sense that they're wheezing or making any kind of noise is trying to breathe in or breathe out. If you see chest movements that you've never seen before, that's the indication to get help. And again, in an extreme case, call 911. What do you do for young patients at the hospital? The treatment for RSV is generally supportive. So the key is to make sure the baby's getting enough oxygenation. So giving the baby oxygen through a number of different ways is a big help. That helps slow down their breathing, makes them more comfortable and intervene its fluids. So it is critical that these kids stay hydrated. If you become dehydrated and you're having trouble breathing, that's a recipe for serious problems. So when these families do come into the hospital with their kids, we do use little cannula, little tubes, we put in around the nose to help the baby's breather. We'll put a mask on. And in many cases, we need to put an intravenous line in to hydrate the baby. But then it's supportive. It takes a number of days. But generally, the type of cure you can get in the state of Maryland for your child generally results in a very positive and good outcome. Lastly, anything we should all be doing from a prevention standpoint as we head into what looks like it may be a serious flu season and so forth. Yeah, great question. And I think that's an important question. So I appreciate you raising it. You know, we've been so focused on COVID and most people have probably gotten COVID at this point. A large number of the population have been vaccinated. And so there's no one's wearing masks. No one's concerned. We're trying to get back to normal. But it's hard for people to remember that during the winters, during flu seasons, there are some common sense things that we still have to do. So if you have a cold, try stay away from people. Consider wearing a mask. If you sneeze or cough, make sure that, you know, you cover your mouth. If you have a child who's got a running nose or not feeling well, don't send them to daycare or to play groups. So a lot of the things that was routine and common two years ago before COVID have kind of fallen by the wayside because we're just, I think just so exhausted from COVID. But we have to go back to doing the routine things we used to do. If you have a fever, stay home. If you're feeling sick, stay home. Don't send your kid to school but they're not feeling well. Again, you know, wear a mask or isolate yourself from other, you know, friends or family if you're not feeling well. And I think those types of things can make a very dramatic difference and decrease what we're struggling with right now. Decrease numbers of cases of these viral infections in kids and adults. And I would also say the flu vaccine is very effective. And that is something that this would be the time to get it. If you haven't got your flu vaccine, if your child hasn't been vaccinated, this is the time to get it because it will be effective in a couple of weeks. And I think we are going to be entering a very, very serious flu season as well. Steven Zinn at the University of Maryland Children's Hospital. Sir, thank you very much. Thank you so much. Your health segments are a co-production of Maryland Public Television and the University of Maryland Medical System.