What’s behind the alarming RSV surge in US children’s hospitals?

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by Carla K. Johnson

This 1981 photo provided by the Centers for Disease Control and Prevention (CDC) shows an electron micrograph of respiratory syncytial virus, also known as RSV. Children’s hospitals in parts of the country are experiencing an alarming surge in RSV, a common respiratory disease that can cause serious breathing problems in infants. Cases fell sharply two years ago, when the pandemic closed schools, daycare centers and businesses. Then, with the easing of restrictions, the summer of 2021 brought an alarming rise in what would normally be an autumn-winter virus. Credit: CDC via AP

Children’s hospitals in parts of the U.S. are experiencing an uptick in a common respiratory disease that can cause serious breathing problems in babies.

RSV cases fell sharply two years ago when the pandemic closed schools, daycare centers and businesses. With the easing of restrictions in the summer of 2021, doctors have noticed an alarming increase in the number of viruses that are usually autumn-winter.

Now it’s back again. And doctors are preparing for the possibility that RSV, the flu and COVID-19 can combine in stress hospitals.

“I call it an emergency,” said Dr. Juan Salazar of Connecticut Children’s Hospital, where RSV has caused patients to be shuffled into playrooms and other spaces not normally used for beds. The facility has explored using a National Guard field hospital, but has shelved that option for now.

A look at RSV and what the recent surge could mean:

WHAT IS RSV?

This means respiratory syncytial virus, a common cause of mild cold-like symptoms such as a runny nose, cough, and fever. Almost all American children usually contract RSV by age 2.

Infected people are usually contagious for three to eight days. Babies and people with weakened immune systems can spread RSV for up to four weeks. There is no vaccine against it, although several candidates are in trials.

WHO CARES?

Anyone can get RSV. But it poses the greatest danger to babies, elderly people and others vulnerable peoplewhich can get serious respiratory and lung infections.

Among US children under 5 years of age, RSV usually leads to 58,000 hospitalizations and up to 500 deaths per year.

For adults age 65 and older, RSV causes 177,000 hospitalizations and 14,000 deaths each year.

Babies may have breathing difficulties that prevent them from eating. “And that’s when we really start to worry,” said Dr. Melanie Kitagawa of Texas Children’s Hospital in Houston, where more than 40 children have RSV.

“They breathe fast, they breathe deeply. We see them using the muscles in their chest to help them breathe,” Kitagawa said. “These babies have difficulty picking up a bottle because their breathing is compromised and they can’t coordinate both at the same time.”

WHY IS IT HAPPENING NOW?

The virus is hitting a very vulnerable population of babies and children who have been protected from common mistakes during the pandemic lockdown.

According to Dr. Elizabeth Mack of the Medical University of South Carolina, the immune system may not be as ready to fight the virus after more than two years of masking that provided protection.

What's behind the alarming RSV surge in US children's hospitals?

A sign stands outside Seattle Children’s Hospital on March 18, 2020 in Seattle. Children’s hospitals in parts of the country are seeing an alarming surge in RSV, a common respiratory disease that can cause serious breathing problems in babies. Cases fell sharply two years ago when the pandemic closed schools, daycare centers and businesses. Then, with the easing of restrictions, the summer of 2021 brought an alarming increase in the number of viruses that usually appear in winter. Credit: AP Photo/Elaine Thompson, file

“South Carolina is drowning in RSV,” Mack said in a news release. According to her, the surge this year occurred earlier than usual.

As for the infants, their mothers may not have been infected with RSV during pregnancy, which may have given the children some immunity.

USA health officials noted an increase this month in national reports of respiratory illnesses, which they say is at least partly due to the early spread of the flu in much of the South.

Last week, more than 7,000 tests came back positive for RSV, according to the CDC. This is more than in previous surges.

IS THERE A TREATMENT?

There is no specific treatment, so it’s a matter of managing the symptoms and letting the virus run its course. Doctors may prescribe oral steroids or an inhaler to help you breathe.

In severe cases, patients may receive oxygen, a breathing tube, or a ventilator in the hospital.

WHAT DO DOCTORS RECOMMEND?

Prevent the spread of viruses by washing your hands thoroughly and staying home when you are sick.

During RSV season, injections of antibody-based drugs are sometimes given for protection premature babies and other very vulnerable infants.

If you’re worried your child has a serious breathing problem, “don’t hesitate” to go to the emergency room or call 911, said Dr. Russell Migita of Seattle Children’s Hospital, where RSV is on the rise.

For less serious medical problems, Migita said, call your regular health care provider for advice, use telehealth or go to an emergency room.

On Saturday in Chicago, Dr. Juanita Mora saw a family of five children, all with RSV, ranging in age from 3 years old to a teenager. Afraid of what’s to come this winter, she orders everyone to get a flu shot and a COVID-19 booster.

“We don’t want a triple whammy, a triple pandemic,” Mora said.


RSV season: What parents need to know


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Citation: What’s behind the alarming RSV surge in US children’s hospitals? (October 25, 2022) Retrieved October 25, 2022, from https://medicalxpress.com/news/2022-10-rsv-surge-children-hospitals.html

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