Arkansas doctors see flu, RSV uptick in light of pandemic

Arkansas has seen an uptick in cases of influenza after only a month of the typical flu season, although so far the state has not seen as many or as severe cases as neighboring states, medical professionals say.

Additionally, the prevalence of respiratory syncytial virus (RSV) has spiked after the usual season for the virus shifted from winter to summer and fall this year and last year. The virus is seen most often in children, and Arkansas Children’s Hospital has seen “significant volumes” of RSV patients this year, chief clinical officer Dr. Rick Barr said.

October is the usual beginning of the yearly flu season, the five to seven months per year with the highest rates of influenza-like illness (ILI), or any respiratory illness that includes fever and a cough or sore throat but has not been confirmed as influenza with a laboratory test.

Hospitalizations and deaths of the flu are required to be reported to the Arkansas Department of Health, but flu cases that do not result in hospitalizations are not always recorded, though some health care providers consistently do so, said ADH senior physician specialist Dr. Joel Tumlison.

“We have seen many more cases reported to us at this point in the year than we would see in a normal October,” he said in a Monday interview.

The Department of Health recorded 140 flu cases in the week from Oct. 23 to 29, an increase of 42 cases compared to the previous week.

Since Oct. 2, the state has seen 326 cases, 47% of them —156 cases — in people under 18, according to the department’s weekly influenza report. People 65 and older accounted for 36 reported cases.

The state saw four deaths linked to the flu from Oct. 2 to 29, the weekly report states.

Neighboring states worse

Overall, Arkansas has had low ILI rates so far in 2022, according to the Influenza Division of the U.S. Centers for Disease Control and Prevention. As of Oct. 22, four states bordering Arkansas — Texas, Louisiana, Mississippi and Tennessee — had much higher ILI rates, according to the CDC.

A hospital in Mount Pleasant, Texas, an hour west of Texarkana, sent some children with the flu to hospitals in Arkansas and Louisiana because it did not have enough beds for them, according to the Texas Tribune.

Medical experts agree that COVID-19 prevention measures, such as masking and social distancing, led to fewer flu infections in the 2020-21 and 2021-22 flu seasons. Currently, fewer people are practicing COVID-19 prevention measures, either entirely by choice or because there are fewer rules in place, Tumlison said.

“This year, many fewer kids are wearing masks in school, and in society at large a lot fewer people are wearing masks,” he said. “Maybe some of those other things like hand-washing, etc., have declined down to their more normal rates because people aren’t as conscious of it right now.”

There were fewer COVID-19 protections in place during late 2021 than a year earlier, but there were still more in 2020, when flu season “never got above the baseline,” Tumlison said.

The influenza virus mutates and is slightly different every year, so scientists adapt the flu vaccine accordingly, Barr said. He added that the flu is “just starting to take hold” in Arkansas.

“This flu virus that’s circulating this winter is going to cause more hospitalizations and ER visits, and I think it’s going to be a tough flu season,” he said. “That being said, the vaccine is really good this year. The match of the vaccine and the virus is pretty good, so we’re trying to get the message out there to get vaccinated.”

UAMS sees more cases

Even though flu season just started, the University of Arkansas for Medical Sciences has seen more flu cases this year than last year, said Dr. Bala Simon, an associate professor in the Department of Family and Preventive Medicine.

UAMS has overall seen an uptick in both children and older adults with flu-like symptoms recently, Simon said.

RSV usually causes a cold but can be followed by bronchiolitis or pneumonia and can be severe enough to require hospital care.

There is no publicly available RSV vaccine, but scientists are working to develop one, Simon said.

RSV infections were few in the winter of 2020 because of COVID-19 prevention measures, and the resurgence of the virus in July 2021 coincided with the surge of the COVID-19 delta variant, Barr said.

“The past two summers and early falls, we’ve seen an unusual RSV season,” he said. “There’s lots of speculation as to what caused that — is it that we’ve shifted immunity? It’s popping back up when people are taking off masks and haven’t seen RSV in a year or two. RSV is one of those viruses that doesn’t cause lasting immunity.”

RSV is “the poster child virus for hand-washing” since it is transmitted through droplets on the skin, usually the hands, Barr said. Influenza is more often airborne, but doctors still recommend hand-washing in addition to vaccination to prevent the spread of the flu.

Nearly 7.7% of students were absent from public schools during the week ending on Oct. 29, a slight decrease from nearly 8% the previous week, according to the report. Tumlison said the average for the year has been roughly 6%, even though absences could be due to any illness or other reasons.

There were 576 emergency room visits from patients with ILI symptoms in the week from Oct. 9 to 15, and 602 in the week from Oct. 16 to 22, according to the health department’s weekly report.

Nationwide, between 3% and 10% of emergency room and outpatient clinic visits are influenza-related during the height of flu season, which usually ends around March, Simon said.

“We’re dealing with flu, RSV and COVID all at the same time, so we’ll have to see how the entire season pans out,” he said.