Doctors say the emergency rooms and pediatric wards at some Baltimore-area hospitals are thronged with children suffering from respiratory illnesses, with the traditional peak of the winter flu season still several weeks away.
"This has been the worst winter I've seen in a long time," said Dr. Nancy Braverman of Sinai Hospital, adding that Sinai's staff recently had to send a child to another hospital because its pediatric floor was full.
The number of sick children has "skyrocketed" in the past three weeks, she said, leading to the longest waiting times she can recall in the hospital's pediatric emergency room.
"We usually don't see the beds this full around Christmas, and we certainly are seeing it now," said Dr. John A. Boscia, assistant chairman of pediatrics at the Greater Baltimore Medical Center.
Dr. Boscia said his young patients are suffering from the flu, from cold-aggravated asthma and, increasingly, from respiratory syncidial virus, or RSV -- a common ailment that can become life-threatening, especially for infants younger than 6 weeks or babies with congenital heart or lung problems.
Almost four of five people get RSV at some point in their lives, Dr. Boscia noted, and most experience it as a very bad cold with a cough.
But tiny infants and vulnerable children can get much sicker. "When a baby has one of these problems with RSV, breathing can be so tiring they develop respiratory failure," he said.
The state Department of Health and Mental Hygiene does not track many common respiratory illnesses, but statewide data on influenza cases show "it's happening a lot earlier in the season than it usually does," spokeswoman Tori Leonard said.
Last winter, she said, the first documented case of the flu occurred in January; this year, it came Dec. 2. Partly as a result of the flu, she said, 54 schools statewide reported absentee rates of 10 percent or more the week before Christmas.
Vivienne Stearns-Elliott, a spokeswoman for GBMC, said that in November, less than a quarter of the 40 children admitted to GBMC's pediatric unit had respiratory illnesses. So far this month, she said, 32 of the 57 children admitted have had respiratory problems.
Sarah Frisch, a 2-month-old from Towson, was one of several children brought to GMBC in recent weeks with RSV. Her mother, Laurie Frisch, said Sarah developed a cough a week ago that escalated into wheezing within 24 hours.
"I took her to the pediatrician and he diagnosed her with bronchiolitis," she said, a narrowing of the small air passages in the lungs that is usually caused by RSV. The doctor sent Sarah home with a prescription and directions that she rest next to a vaporizer.
But by Monday morning, when her mother took her back to the pediatrician, tiny Sarah was working hard just to breathe. Her complexion was pale. The doctor sent her straight to GBMC's emergency room.
Sarah was put in a special tent that kept the air she breathed filled with cool water vapor and oxygen, and she was hooked to an intravenous feeding tube.
"I'm a pediatric intensive-care nurse," said Laurie Frisch, 33, "so I didn't flip like somebody else would. But it's not nice seeing your child go through that. I must admit I drove rather fast to the pediatrician's office, the whole time saying [to Sarah], 'Breathe! Breathe!' "
By yesterday afternoon, Sarah was doing much better -- her color had returned and she was eating again. "She's actually pink and smiling and doing all the normal baby stuff she wasn't doing on Sunday," her mother said.
Dr. Braverman of Sinai said parents should consider flu vaccinations for their children with pre-existing lung diseases. And, she said, they should try to shield their infants from other sick children.
The physician added that she is concerned that the surge in flu and other viral infections may be followed, as it often is, by serious bacterial infections.
Dr. Gerald M. Loughlin of the Johns Hopkins Hospital pediatrics department said he had not seen an increase in the number of RSV cases and other respiratory infections at Hopkins.
But he thinks that this year's RSV cases seem more severe than those in recent years -- in other words, the same number of children are getting ill, but they may be sicker.
However, there may be sharp differences between the children admitted to Hopkins and those elsewhere, since children treated at Hopkins tend to be those with congenital or other serious underlying illnesses.
Dr. Braverman said the children she has treated are not any sicker. "There are just more of them."