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AAP: How to manage the surge of respiratory infections


In a recent statement, the American Academy of Pediatrics discussed how patients with respiratory infections can be managed, along with guidance on RSV treatment.

The American Academy of Pediatrics (AAP) has given guidance to pediatrician offices, urgent cares, and hospitals dealing with an influx of pediatric patients.

Respiratory infections have surged among the pediatric population in the United States. Respiratory syncytial virus (RSV) is one of these infectious diseases, and children are at high risk of suffering from complications after infection. The AAP released a set of guidelines on RSV prevention, along with management for the surge of infected pediatric patients.

The current surge has been compounded by an ongoing mental health crisis in youths, leading the AAP to offer guidance that helps avoid interruptions to continuous care for both physical and mental health in children within inpatient and outpatient settings.

Special attention was given to children with special health care needs, including those with medical complexity, who are often the most significantly impacted by surge events. The current surge includes influenza, COVID-19, and RSV, along with increasing mental health concerns.

To prevent RSV infections, the AAP recommends that infants in regions with high RSV circulation are given over 5 doses of palivizumab if eligible. The 2022 to 2023 RSV season began earlier than usual and will last longer than prior seasons. Palivizumab can be administered to eligible infants during the RSV season to prevent severe lung infection.

RSV can also be prevented by avoiding large groups, infected individuals, and smoking, as well as frequent and thorough hand washing. There is currently to medicine available for curing RSV.

According to Sean O’Leary, MD, MPH, FAAP, chair of the AAP Committee on Infectious Diseases, RSV and other respiratory illnesses can be safely managed at home, with most children recovering without external help. When children are struggling to breathe, O’Leary told parents to call their pediatrician immediately.

O’Leary also recommended families get vaccinated against influenza and COVID-19, as this will prevent most cases of severe infection and hospitalization.

For additional guidance, the AAP stated that routine pediatric care, chronic disease management, and immunizations should not be delayed. Medical staff treating adults can also be trained for treating younger patients.

The AAP also noted that during a surge, children should only be referred to hospitals in cases of severe illness or associated medical disorders. This will prevent hospitals from overcrowding, keeping wait times manageable.


American Academy of Pediatrics offers guidance on RSV prophylaxis, handling surge of pediatric patients with respiratory infections. American Academy of Pediatrics. November 18, 2022. Accessed November 22, 2022. https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-offers-guidance-on-rsv-prophylaxis-handling-surge-of-pediatric-patients-with-respiratory-infections/

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