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Update: ASG fights RSV — daycare and care homes closed this week

Dr. Maria Guyapa (left)  Dr. Aifili J. Tufa
Child care providers encouraged to thoroughly clean and disinfect their facilities

Pago Pago, AMERICAN SAMOA — At last Friday’s Health Department news conference, the territory lead Epidemiologist, Dr. Aifili J. Tufa, confirmed that DOH is working in collaboration with the Human and Social Service Department (DHSS) this week to shut down child care centers in efforts to “curb the increase” in the number of Respiratory Syncytial Virus (RSV) cases in the territory.

DoH’s health advisory, dated Jan. 28, alerted the public regarding “a recent outbreak of respiratory illnesses in the territory due to RSV, which is a common respiratory virus that usually causes mild, cold-like symptoms” — such as runny nose, decrease in appetite, coughing, sneezing, fever, wheezing.

Late last week, DHSS issued a notice about the temporary closure of all daycare centers and family child care homes from Monday, Feb. 7 to Friday, Feb. 11, in an effort to slow down or minimize the spread of RSV, especially among young children.

DHSS asked parents to make alternative care arrangements for their child. Child care providers and staff are encouraged to use this time to thoroughly clean and disinfect their facilities.

During the DoH news conference, LBJ Medical Center, Chief Pediatrician Dr. Maria Guyapa in an update on the RSV, which she says is mostly “affecting the age group of the young ones and the senior [citizen] population.”

In the previous two-weeks, she said the incidents of this virus coming into LBJ’s Pediatric clinic is “affecting 85-90% of our cases, mostly with respiratory syndrome.”

“There is a high [infection] rate, among the ages, less than 2 years old,” she said, and explained that symptoms of children “who have RSV, or afflicted by RSV are shortness of breath, poor oral intake, or a failed outpatient management — when we give them some medication, and apparently their symptoms are getting worse.”

She advised parents to only come into the Pediatric Clinic if their child has signs of shortness of breath or poor oral intake. “If your kids have more than three days of respiratory problems, with high fever, with decrease appetite — [then it’s] an indication for you to bring your children to the Pediatric Clinic or the Emergency Room.”

However, if children “have only simple complaints of one-to-two days of fever, cough or running nose, but remains active, good oral intake — please stay home, hydrate your children, give Tylenol or fever relievers,” she further advised parents and legal guardians.

If there’s any doubt, she suggested calling the Pediatric Clinic, where they have six pediatricians to take the phones calls.

“Remember, RSV is transmitted by respiratory droplets,” she said and explained that LBJ is aiming to divert patients away from the hospital, “because this disease is highly contagious.”

“We are trying to avoid other people — like adults, who are sick in the Emergency Room” from being exposed to children affected by RSV by having extended hours for the Pediatric Clinic on Mondays and Fridays — from 4p.m. to 8p.m and on Saturdays — from 12noon to 4p.m., with two physicians to accommodate the patients.

This extended clinic is called “Respiratory Clinic only” to address respiratory problems among the children. Other conditions, involving children go to the Emergency Room.

To assist the LBJ’s extended Respiratory Clinic, DoH will also have after-hour clinics on Tuesdays and Thursdays from 4p.m. to 8p.m at the DoH Tafuna primary clinic “specially for RSV cases both children and seniors.”

For answers to any questions call LBJ Pediatric Clinic 633-1222 ask for Pediatric Clinic or DoH command post 219.

Responding to a media question on whether LBJ or DoH has any specific data on the number of RSV infected patients, Dr. Guyapa said they do not, and “we lost count.”

She explained that there are a high number of cases coming in. She noted that there are patients who come in with a simple sore, and the next day they would come in with symptoms of RSV. “That’s how contagious the disease is,” she said, adding that LBJ is trying to inform the public not to come to the hospital, “if you only have mild symptoms of flu”.

“We can accommodate phone consultation, just to bridge the gap of coming in physically to the clinic,” she said and noted the clinic is looking at the data, but “we are just overwhelmed at this point.”

Dr. Tufa added that there’s a “very high” volume of people coming into the Emergency Room and Pediatric Clinic at LBJ.

As for the data, he said: “We can... look at how many people who are now being hospitalized. Now that number compared from last year, it has really, really increased in just a short period of about two months. We’re counting more than 65 being hospitalized for RSV at various wards.”

With the high number of young children — 2 years and younger infected with RSV, he said this is the reason why “we’ve put out a directive, asking DHSS to please help us out” with the closing of day care centers for one-week, starting today, “to see if that’s going to curb the increase in the number of cases.”

Responding to a query from Rep. Andra Samoa, who is a member of the COVID-19 Task Force and attended the press conference, Dr. Tufa said there is no known vaccine for RSV, and there are several companies — according to the U.S Center for Disease Control and Prevention — working towards that.

“RSV is a very contagious diseases that can be pass-around quickly. It is very common. Actually we get RSV on island, probably at least, two or three times a year,” Dr. Tufa explained. “It’s just that this time around, it has reached a certain level that we’re considering it beyond what we normally [have] seen in previous months or previous years.”

“So that’s why we’re call it an outbreak and the reasons why, is because we want to protect LBJ for those who get RSV — those one year or less with higher risk of hospitalization.”

“And even amongst the adults with a compromised immune system, [they] might need hospitalization. So if the virus is spreading towards a big portion of our population, the number of those who might require hospitalization rises,” he noted.

“So we don’t want that to happen at LBJ and also when we’re preparing for possible introduction of COVID-19 virus into the population,” he added.

In its Jan. 28 health advisory, DoH explained that there is “no specific treatment for RSV infection, but you can take steps to relieve the symptoms.”

DoH advises that anyone with flu-like symptoms should avoid going in public — including going to school or reporting to work — and should stay home until symptoms subside.

“If you are at risk for a severe respiratory infection or if you interact with older adults,” DoH offers the following recommendations for individuals to do:

• Wear a mask, or cover coughs and sneezes with a tissue

• Avoid close contact with others when one is symptomatic

• Wash your hands with soap for at least 20 seconds and

• Frequently clean touched surfaces