RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children under 1 year of age in the United States, according to the Centers for Disease Control and Prevention (CDC). Tracking by the CDC shows that nearly 5,000 tests came back positive for the virus as of October 8. While the respiratory illness typically peaks in January or February, a CDC official told NBC News that some U.S. regions are already hitting case-level highs. The spike in RSV, combined with the early onset of flu season and a possible winter COVID-19 surge, has public health officials concerned about the capacity of the U.S. healthcare system to treat patients in the coming months. Other reports indicate that medical facilities in Florida, Missouri, Colorado, and elsewhere are experiencing a spike in the virus. In Connecticut, Children’s Medical Center in Hartford is out of beds and has reached out to the National Guard and FEMA (the Federal Emergency Management Agency) to set up a tent unit on its lawn, according to local news reports. “Our region is seeing a surge in respiratory viruses that more typically peak in the winter,” said Charlotte Boney, MD, the pediatrician-in-chief at Baystate Children’s Hospital in Springfield, Massachusetts, in a statement. “These viruses can cause mild to moderate, even severe symptoms. Children who may not have had recent exposures to these viruses are now getting sick from them, and many are getting sicker than usual.” The CDC estimates that in a typical year, RSV leads to about 58,000 hospitalizations and 100 to 300 deaths in children under the age of 5.
Signs of RSV Infection in Children
Most kids get at least one RSV infection by age 2, and few experience serious health issues. In the majority of cases, RSV infections cause mild, cold-like symptoms that clear on their own, such as runny nose, decrease in appetite, coughing, sneezing, fever, and wheezing. Boston Children’s Hospital estimates that about .5 to 2 percent of infected children have to be hospitalized. Babies with severe, potentially life-threatening forms of RSV infection will become dehydrated and have difficulties breathing. “The best way to assess if your child is staying hydrated is to check if they are having less wetness in their diapers or fewer wet diapers than they normally would,” says Alan Schroeder, MD, the associate chief for research in the division of pediatric hospital medicine at Lucile Packard Children’s Hospital Stanford in Palo Alto, California, which has also seen a spike in RVS hospitalizations. “The other important thing to look out for is whether your child is having a hard time breathing,” he adds. “When babies have a harder time breathing, you can see that the skin sort of pulls in between the ribs or over the clavicle and they start breathing faster. So if you see those signs in your baby, that is worth bringing to the attention of your pediatrician or even going to an emergency room if you’re really concerned.”
Why Is RSV Surging?
Dr. Schroeder and other pediatricians think the COVID-19 pandemic may be one of the driving forces behind the RSV surge. Usually, the season for RSV runs from November to April, so seeing many infections this early is unusual. “With the pandemic, we saw all viruses practically disappear for about a year because of all the isolation measures intended to prevent transmission of COVID,” says Schroeder. “Right now, it’s like the clock got reset and the seasonality is just really out of whack.” Babies who have had minimal exposure to the virus due to pandemic precautions may not have developed antibodies that can help protect them now, particularly as maternal antibodies (passed to them in utero) wane. They also may have fewer maternal antibodies to begin with if their mothers avoided exposure to respiratory viruses while pregnant due to COVID-19 concerns. According to the CDC, in addition to very young infants, other populations at high risk of severe RSV infections include premature babies, young children with chronic lung or heart disease, older adults, and people with weakened immune systems.
How Do You Treat RSV?
There is no specific treatment for RSV infection, but researchers are working to develop vaccines and antivirals (medicines that fight viruses). Treatment currently focuses on relief of symptoms, with pain relievers, hydration, and rest. Hospital care may involve intravenous fluids, tube feedings, supplemental oxygen, and bronchodilator medications to open airways.
How Can RSV Infection Be Prevented?
Schroeder stresses that the virus usually spreads by direct contact with secretions from the mouth or nose, so hand-washing is key to prevent infecting others. “A classic example is a baby or young child in day care that has a snotty nose, and that gets on the hand of another kid or a caregiver and then that person goes on and touches another kid, spreading the virus,” says Schroeder. The CDC offers additional tips on how to minimize RSV transmission.
