Hawaii health officials are contending with a spike in the count of children in the islands contracting respiratory illness not related to COVID-19, following a nationwide trend.

Hospital emergency rooms across the state are seeing an increase in rhinovirus and respiratory syncytial virus, or RSV, cases, said Health Care Association of Hawaii President Hilton Raethel at a media briefing held Thursday at Kapiolani Medical Center for Women &Children.

“They’re all seeing an increase in pediatric RSV cases,” Raethel said, with RSV and other respiratory diseases affecting both “locals and visitors.” Additionally, hospitals are seeing a bump in adult respiratory illness cases, although that increase is small compared with the rise in pediatric cases, he said.

While the Healthcare Association of Hawaii has yet to record the number of patients that have been admitted due to RSV or rhinovirus (RV), Raethel said, “Our hospitals continue to be very full,” Raethel said.

Dr. Jessica Kosut, Hawaii Pacific Health division chief of pediatric hospitalists, said that generally, children are able to fight off RSV and rhinovirus at home. She said although many children are turning up in emergency rooms, few are actually being admitted to the hospital.

“I just want to emphasize to families, there isn’t a reason to panic. These are viruses that we’re used to. These are things that our pediatricians see every day,” Kosut said.

Many of the recent pediatric cases require patient care “that families can handle at home, in conjunction with their pediatrician,” she said, adding, “Of course, we want them to come to our ER when they’re concerned.” Among the symptoms in children that should prompt concern: rapid breathing, inability to drink, and not acting like themselves. While assessing symptoms, calling a pediatrician is “always the first best step,” Kosut said.

While doctors typically see an increase in these types of viruses around December, January and February, this year the spike is earlier and more severe, Kosut said.

Children particularly at risk are those under age 2 as they’re are too young to blow their noses or cough up mucus and are still drinking from a bottle. However, this year Kosut said he’s seeing illness affecting children up to age 4.

One possible reason for the increase in cases: Children who stopped wearing masks and dropped social distancing protocol when pandemic-related public health restrictions were lifted are now being exposed to more illness.

“When children are little we really predict that they’re going to have five to six respiratory illnesses per season, especially those ones who are in school. … The first year that they go to school, they get so many of those” illnesses, she said. “And did we kind of reduce that exposure (when pandemic restrictions were imposed)? Probably, to a degree. I would say their immune systems, except for those who are super young, are really robust.”

Kosut said older children are able to do well fighting RSV at home, fully recovering within about two weeks. One apparent difference this year, however, is that the illness is hitting its peak at days five to eight instead of days three to five.

With Kapiolani’s pediatric unit currently at capacity, Hawaii Pacific Health has plans to move patients to different units. Moreover, the hospital is able to expand space when needed. Kosut maintained that the hospital is not overwhelmed. However, she encouraged parents to get their children vaccinated, wash their hands and keep them home when sick to curb the spread of illness.