We come to you this week talking about the recent outbreak of RSV and many other childhood viruses in the US.
Winter is typically when cold and flu season spikes, but not this year. Although this may be surprising to most people, us pediatric nurses and doctors are not at all surprised. This winter many children’s hospitals had empty beds where RSV patients once filled them in year's past. The strict pandemic social distancing and mask rules helped these other viruses diminish.
However, with the country's mask policies being lifted in most states, common colds and RSV has risen drastically. Please see the article below from Yahoo! detailing what pediatricians are saying about these recent surges.
Respiratory syncytial virus (RSV) is nothing new to the pediatric world. The illness, which causes symptoms such as runny nose and cough, typically spikes in the winter months. But in the aftermath of the first waves of the COVID-19 pandemic, doctors are reporting an unexpected surge of the virus among infants and toddlers, and parents are taking to social media to share photos of their little ones battling the virus.
Thankfully, Dr. Jason Terk, a pediatrician at Cook Children’s Pediatrics in Keller, Texas, says that the vast majority of those who get RSV — including those below the age of 2 — recover from the virus without much need for treatment. “We’ve seen many, many, many children with RSV and a very, very small minority of those kids end up getting into trouble that requires hospitalization,” Terk tells Yahoo Life.
Still, he admits that the current increase in cases is a major deviation from the standard cycle of RSV. “It’s unprecedented,” says Terk. “If you look at typical RSV, it’s a type of illness that we see usually starting in late fall into the wintertime and then goes away usually by late winter, early spring.”
As the RSV virus continues to spread nationwide, here’s what you need to know.
Southern states are experiencing particularly high cases.
The Centers for Disease Control and Prevention issued a warning in June about the rise in RSV cases, particularly in Southern states. Dr. Diana Peterson, a pediatrician at Ochsner Hospital for Children in New Orleans, confirms that her department is seeing a spike. “Since mid-April, Louisiana has seen a progressive rise in RSV cases,” says Peterson. “We typically see RSV in the winter months along with other cough and flu-like illnesses, which makes the RSV pattern we are experiencing now very unusual.”
Dr. Stan Spinner, chief medical officer and vice president of Texas Children’s Pediatrics and Urgent Care, agrees. “We are seeing a large number of RSV cases, and that’s something we’ve never really seen in the summer before,” says Spinner. “I think it came as a surprise to all of us.” Dr. April Palmer, professor and chief of pediatric infectious diseases at the University of Mississippi Medical Center, says the same. “Like the rest of the country, we are seeing a spike in cases.”
COVID-19 precautions likely played a role in the current spike
While no one can say for certain why the respiratory virus is spiking off-season, all the experts implied that the COVID-19 pandemic played a role. “Our practices were virtual ghost towns through the winter of 2020-21, so because we were not having any significant viral transmission to speak of — based upon the public health measures that we were undertaking — those individuals who normally might have been exposed to RSV at that time were unexposed,” says Terk. “And it probably provided an opportunity for that virus to take hold and create a little mini spike here that we’re seeing right now.”
Peterson elaborates on how the COVID-19 precautions likely contributed. “During the COVID-19 pandemic, the community was very diligent with masking, physical distancing and careful school precautions,” she says. “These measures were associated with a very large decrease in other non-COVID-19 respiratory illness, which includes RSV. As these precautions were relaxed, we are seeing RSV and other respiratory illnesses circulating outside of their normal seasonal pattern.”
Hospitalization and death with RSV is incredibly rare
It’s true that RSV can be more dangerous for infants and young kids than adults, with the potential to cause a severe lower respiratory infection called bronchiolitis. But Terk reinforces that these serious cases are rare. “Most of the time RSV causes an illness that is entirely manageable at home with use of the usual things that we recommend for viral respiratory infections — nasal saline, suctioning and humidification,” he says. “If there’s a worsening of the respiratory status or they have a hard time breathing, then they need to be seen by their physician.”
Spinner adds that RSV can often be so mild that it’s assumed to be the common cold, though doctors can use a test to determine which it is. “It’s one of the most common viruses; every child will have been infected with RSV at some point during their childhood,” says Spinner. “A lot of times you get a runny nose, a cough, you get drained... You can’t tell that it’s RSV versus a common cold, but you deal with it the same way. It’s symptom relief. There’s no cure for it. It just runs its course. And even in a lot of younger kids and a lot of babies, that’s all it might do. It may just be a cold.”
As with many illnesses, Spinner says, the most at risk are the very young (babies under three months) and those with underlying medical conditions. For those with remaining questions, contact your health care provider or visit the CDC’s information page.
For more information about RSV, please check out our previous RSV blog post here. Stay safe, and wash your hands!
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Jeri Ford, RN, BSN, CPN
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