Virus season hit Hawaii early this year, with cases of flu and respiratory syncytial virus, or RSV, increasing in October and November.
As a result, the state Department of Health is urging the use of several prevention tools to keep families safe during the holidays.
“Masks work terrifically, so if you’re going to be indoors and there are large crowds, wear your mask. Better yet, take the party outside,” said DOH Director Libby Char during a livestreamed interview with the Honolulu Star-Advertiser on Friday. “We don’t want to live in fear, but we also want to be reasonable. We need to be extra careful around (the elders) in our family and make sure they’re protected, vaccinated, boosted and in good health.”
Hospitals in Hawaii have reported an increase in RSV and flu cases, according to the DOH, and case rates are higher than the seasonal average.
“They’re seeing a lot of admissions, and admissions to the intensive care units,” said State Epidemiologist Sarah Kemble earlier this month. “There’s some concern the illness may be a little more severe this year, but it’s still early in the season to see how that will play out.”
Both the flu and RSV are respiratory ailments, with RSV causing cold-like symptoms such as runny noses, sneezing, coughs and a fever. In kids under 5, it can cause increased irritability and a decreased appetite.
“RSV affects children more than it affects adults in terms of the negative effects,” said Char. “We’re concerned, because hospitals have been very full in Hawaii. More kids are being hospitalizations for RSV than in prior seasons.”
The increase could be tied to the mitigation measures during the height of the COVID-19 pandemic, which helped stifle the last two RSV and flu seasons, according to the DOH.
“By the time you’re about 2 years old, you’ve been exposed to RSV and probably had an infection or two,” said Char. “The rates of the flu and RSV were really low the past few years, and I think some of the kids that would have been exposed have not been exposed yet, and that may be a factor playing into this.”
Statewide, the DOH reports that there have been roughly 2,070 confirmed cases of RSV this season, although the number is estimated to be higher due to undiagnosed cases.
“Right now, about one-in-four tests being done for RSV are coming back positive, and we are seeing a higher number of positives earlier than we usually do,” said DOH Disease Investigation Branch Chief Caroline Pratt during a livestream on Nov. 10. “This does suggest a higher level of detected cases, and there’s probably undetected RSV infections in the community.”
A PCR test can be used to diagnose RSV, but there are no vaccinations for the illness.
“Although there is no specific treatment for RSV, there are things we can do to prevent it,” said Pratt, mentioning washing hands, masking and staying home when sick. Other symptomatic treatments include ibuprofen to reduce pain and fevers, as well as acetaminophen and a nasal aspirator.
“The little kids, when they end up in the hospital, sometimes it has to do with breathing problems, so they may need support for breathing up to and including being on a ventilator and certain anti-inflammatory medicines,” said Char of severe cases. “But for most of us, RSV will make you sick, but it’s just like riding out a cold.”
While pediatric flu cases in the nation have hit a 10-year high according to CDC data, Hawaii remains in the “low” category for its total number of ILI, or Influenza-like illnesses, as of November.
COVID also continues to remain a concern this holiday season, with test positivity rates hovering between 5% and 6%, according to DOH data.
“If anybody’s sick or not feeling right, or you have a little bit of the sniffles or a cough, people have been really good about staying home so that we don’t expose aunties and uncles to germs,” Char said. “When it’s crowded or when we’re indoors, we wear masks. But I think it’s reasonable that if we’re sitting out on the lanai, we don’t have to wear our masks, and we can all have a good time and socialize with each other.
“It really is just finding that balance between the risk and the benefit.”
Email Grant Phillips at gphillips@hawaiitribune-herald.com.