Canada is reporting an increase in respiratory syncytial virus (RSV) which is “above expected levels for this time of year,” leading to an increase in cases in emergency rooms and hospitals across the country.
According to the Canadian Pediatric Society (CPS), rRespiratory syncytial virus (RSV) “is the most common virus that can infect the lungs and airways.” The infection is “more serious in young babies.”
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Thanks to masking, distancing and handwashing, Canada recorded just 239 RSV cases between August 2020 and May 2021, compared to nearly 19,000 in 2019, Global News reported previously. This year, the number rises to 486.
Montreal and Quebec City have the highest positivity rate so far compared to the rest of the country, at 15 percent.
National figures show a positivity rate of two percent in Ontario and 3.4 percent in Atlantic Canada. The lowest rates were in British Columbia (1.4%), one percent in the prairies, and two percent in the Northwest Territories.
Why RSV Cases Are Soaring
The virus, which typically emerges a bit later in the fall and winter seasons, is taking off earlier than usual this year, as reflected in tests no longer focused on COVID-19 and relaxed public health measures, says Dr. Donald Vinh, an infectious disease specialist at the McGill University Health Center.
“In the last two years…the testing policy was focused on COVID-19, so we obviously lost track a little bit of what was going on with the other viruses,” Vinh told Global News.
“The other aspect is the fact that we’ve had two and a half years of people…wearing masks and distancing…and of course that works extremely well, not only for COVID-19 but for other respiratory viruses,” he added.
Vinh says that while it may “probably (be) the first time in humanity, where we were able to get rid of some of these viruses,” but with people no longer wearing masks and following public health measures, emergency rooms and Hospitals are now “overflowing” with respiratory-related cases.
“RSV is surely in the lead at the moment. That’s the one that’s taking off,” she said, especially among young children.
What do we know about RSV?
Respiratory syncytial virus (RSV) is common, highly contagious, and infects the respiratory tract of most children under the age of two. For most children, the infection does not manifest itself beyond a cold. But for a small group, RSV can cause bronchiolitis, which is an inflammation of the lungs, or pneumonia, depending on the US Centers for Disease Control and Prevention (CDC).
“RSV is … very transmissible, especially in schools, so school children are the ones who first transmit RSV to each other,” Vinh said. “Beyond the age of two, we believe that all children have been infected with RSV at some point. That’s how contagious it is.”
However, adults can also get RSV, the The Mayo Clinic website states, but the symptoms are “mild and typically mimic the common cold.”
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Children, on the other hand, can spread the virus to other demographic groups, including those 12 months and younger, Vinh said.
“This includes adults … the elderly … Anyone who has underlying heart or lung disease, RSV tends to cause very serious problems in those people,” Vinh said.
However, the chance of a serious infection is greater for premature babies, children under two years of age who are born with heart or lung disease, and children with weakened immune systems.
the The Canadian Pediatric Society says that symptoms of RSV He says symptoms include cough, runny nose, fever, and loss of appetite and energy.
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Dr. Mélissa Langevin, an emergency medicine pediatrician at CHEO in Ottawa, says nasal and respiratory congestion are common in RSV cases.
“You can imagine that the smaller you are, the more congestion affects your ability to breathe, to eat and drink, and to be comfortable,” Langevin told The Canadian Press.
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An RSV attack typically lasts more than a week, Langevin says, with a fever typically lasting a day or two and the peak of illness coming on days four and five.
“This usually gets worse before it gets better. And that is a natural course of RSV. And after that spike, kids usually turn the corner and start doing much better,” Langevin said.
Vinh says there are no vaccines or drugs available for RSV yet.
“When people are admitted to the hospital for RSV, the main problem is that there is no medicine to treat it… so what we do is we give them what we call supportive care… we help them with their breathing and we give them medical care. how your body tries to fight off RSV,” he said.
He says the best way to prevent the spread of RSV in at-risk group settings is to wear a mask, wash your hands and maintain physical distancing.
Dr. Jesse Papenburg, a pediatric infectious disease specialist at Montreal Children’s Hospital, recommends the same, suggesting that people not visit young children if they are sick.
“Even if it’s just a minor cold. Avoid visiting newborns especially,” she said. “When in crowded indoor areas, wearing a mask can help reduce risk for children and adults as well. “
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For babies at very high risk of serious infection, a monthly injection of a monoclonal antibody called palivizumab can be given during RSV season to help cut the risk of hospitalization in half, says Papenburg.
But for the most part, Papenburg said only a small proportion of cases are serious enough to require hospitalization: Most children can be treated and recover at home.
How to treat RSV at home?
Dr. Antonio D’Angelo, chief of the pediatric emergency department at Montreal’s CHU Sainte-Justine, says maintaining hydration and comfort is key. For babies, it is especially important to clean the nose because they depend on a liquid diet and have to breathe while drinking and swallowing.
“If they are completely congested, what happens is that they take a lung full of air out of their mouth and as they breathe they can choke,” he says.
He suggests cleaning a baby’s nose with saline solution so he can drink properly. The drops can cause a cough, and that’s a good thing, he adds.
“Sometimes they even cough to the point of throwing up some secretions and that’s good because you want those secretions out of their bodies,” he says.
Langevin recommends a “snot pacifier” for children under six months who are very congested. If clearing your nose and clearing secretions doesn’t help, see your primary care provider.
“I always tell families not to worry too much about solids, your kids may not be very hungry for solids, but you want to drink a lot very often.”
Langevin says babies should be watched closely for signs of difficulty breathing. That can include pulling between the ribs or pulling on the neck.
When should we go to the emergency room?
Take your child to an emergency department if he’s having trouble breathing or his lips look blue, says the Canadian Pediatric Society.
Babies younger than three months with a fever should always be taken to the emergency room, CPS adds, or if they can’t suck or drink.
For those a little older, the society says symptoms that warrant a doctor’s attention include fever for more than 72 hours, loss of appetite or vomiting, or coughing to the point of choking or vomiting.
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Watch for any signs of shortness of breath and monitor for fatigue, eating and drinking, D’Angelo says.
“If they can’t drink half as much as they normally would, or if they’re so distressed that they get fatigued… then obviously they need to be seen by the emergency department,” he says.
— With archives from The Canadian Press