HONOLULU(KHON2) — RSV cases are continuing to rise, filling many local pediatric intensive care units. Here’s what parents need to know and what officials are planning to do if things get worse.

RSV cases are surging and Healthcare Association of Hawaii President Hilton Raethel said kids 2 years old and younger are getting hit the hardest.

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“RSV is particularly acute for those very young children with narrow airways where the airway gets inflamed because of the infection and blocked and they have difficulty swallowing — they have difficulty breathing,” Raethel explained.

According to Raethel, that’s putting a strain on hospitals

“Pediatric intensive care beds in the state are full right now,” said Raethel.

And he said the nursing shortage doesn’t help.

“Pediatric intensive care is a very specialized type of care we have been bringing some staff in from the mainland to help support our hospitals,” said Raethel.

Kapiolani Medical Center for Women & Children said they admitted more kids for RSV in October than in the past six years.

And a spokesperson for Kaiser Permanente Hawaii said 90% of their admits have RSV, with most just a few weeks old to age three.

Raethel said they plan to bring in medical staff to assist whenever necessary.

Many of the symptoms of RSV are similar to a cold including runny nose, decreased appetite, coughing, sneezing, fever and wheezing.

Pediatric intensive care unit nurse Adriane Flower said this is the worse RSV surge she’s seen in over 20 years as a nurse especially since there are so many sick infants

“It’s very serious because infants breathe through their nose,” Flower said. “If it is clogged and you’re either breastfeeding or bottle feeding, it can lead to dehydration and other things. And you know they can’t clear their secretions like you and I can with coughing and sneezing, they need us as adults to help them.”

Flower said a nasal aspirator can be used to help clear mucous from a baby’s nose to help them breathe. And while there are many different kinds of thermometers, she said using a regular digital thermometer to take a baby’s temperature under their arms is much more accurate.

Raethel said parents also need to pay attention to how much their child is eating.

“We want to make sure that they can eat and also take liquids because there’s a very real risk,” said Raethel. “If they can’t swallow, it could be very painful to swallow — that they won’t get sufficient liquids or nutrition.”

If your child is having a hard time breathing or eating, Raethel said you should call your pediatrician or take them to the emergency room just in case, especially for infants.

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He said the best way to prevent the spread of RSV is by washing your hands, wearing a mask, and avoiding close contact with others.