The Pinellas County Health Department and doctors at Johns Hopkins All Children’s Hospital in St. Petersburg are monitoring an unusual rise in a respiratory virus ahead of its typical winter spike.
Respiratory syncytial virus (RSV) cases are on the rise nationally, with All Children’s Hospital recording more than 350 through September and October. Doctors believe that Covid is the likely cause of the change in viral seasons.
RSV is highly contagious and affects the lungs and breathing. While most adults with the virus attribute symptoms to a bad cold and don’t get tested, the virus is much more serious in newborns, children, and people with asthma or breathing problems.
Dr. Allison Messina, an infectious disease physician at All Children’s, said the hospital is now seeing 35 to 45 cases a week, numbers typically seen during a severe winter outbreak.
“It could go higher,” Messina said. “I mean, there’s no telling how high it could go.”
In the past, Messina explained, health officials would see cases start to rise in November and peak in January and February. She said respiratory virus seasons have been significantly more unpredictable after the pandemic, noting that the situation is similar to the local peak of flu cases in June.
Messina said All Children’s noted more pediatric patients testing positive for RSV in May and persistently higher-than-average rates since the start of the summer, which it called “really unusual.” Health officials are wary of what the winter months might bring and aren’t sure how the virus could collide with covid and flu season.
“I guess there’s nothing stopping it from getting worse,” Messina said. “It’s hard to predict, especially in these times.”
She relayed that health officials reported a record number of RSV cases in Colorado, numbers they had “never seen before.” The influx of patients, Messina said, has prompted hospitals in the state to open tents outside their facilities. She noted that she called that an unusual move during RSV’s regular seasons.
Messina explained that healthy adults with the virus would experience symptoms similar to those of a severe cold. However, infants and young children have smaller airways and lungs, and she said any amount of inflammation makes breathing difficult.
RSV constricts the airways, and Messina compared its effects in pediatric patients to drinking a milkshake through a small straw.
“It makes it very, very difficult for them to get air into their lungs,” he said. “In particular, very young infants, much more dramatically than older people.”
Messina added that RSV may have the same impact in elderly patients for similar reasons, saying the virus is “not something to be played with.”
Staff at All Children’s have a heightened concern about transmitting RSV to babies they encounter on a daily basis, Messina said. The highly contagious virus is spread through droplets or contaminated surfaces, and doctors perform a nasal swab to determine positive cases.
Messina noted that during Covid, pediatric hospitals would take older patients from other facilities to ease overcrowding. She said health officials could implement a reverse process if the situation worsens, where pediatric hospitals send older children to facilities typically reserved for adults.
One of the benefits of the pandemic, Messina said, is the experience health officials have gained by creatively addressing capacity issues. She said flu cases are on the rise and “it looks like covid might be on the rise a little bit as well.”
“I think it’s almost certain that we will see flu cases increase,” he said. “The million dollar question is how bad is it going to get? We know we’re going to stretch a lot.”
As a respiratory virus, preventive measures for RSV are the same as for the flu and Covid. Messina said regular handwashing is critical, especially before touching a baby.
While there is no vaccine for the virus, she encourages everyone to get vaccinated against the flu. Doctors have therapies to ease RSV symptoms, Messina said, but the lack of a vaccine is another reason helping prevent its spread is critical.
“Go back to the basics of hand hygiene and cough etiquette,” he said. “And staying home when you’re sick. That is the way to stop the spread of RSV.”