- RSV Positivity Rates Are Increasing
- Children under 1 year of age and adults over 65 years of age are at particular risk
- CDC Warns RSV Cases Are Putting Increased Pressure on Hospitals
Respiratory syncytial virus, Called RSV, it often takes hold in the fall and winter, like other upper respiratory infections. But it can be serious especially in infants Y older adultsand is the main cause of bronchitis Y pneumonia in children under 1 year U.S
This year, health experts are especially concerned about hospitals filling up with cases amid cold and flu season, compounded by an expected seasonal rise in COVID-19-19 cases.
the Centers for Disease Control and Preventionwhich has issued an alert on the increase in hospitalizations and emergency department visits, reports 2.1 million outpatient visits and between 58,000 and 80,000 annual hospitalizations among children under 5 years of age and between 60,000 and 120,000 hospitalizations among adults 65 years and older.
“Like children’s hospitals across the country right now, the sheer number of RSV infections, in addition to other respiratory viral illnesses circulating right now, is putting a strain on our emergency department and inpatient services,” said Dr. Kristin Moffittinfectious disease physician Boston Children’s Hospital.
November 5 Weekly records from the CDC reported a test-positive rate approaching 18.9%a steady increase from the 10.5% rate on October 1.
wicked place asked health experts what to know about RSV and ways to reduce its spread.
What are the symptoms of RSV?
RSV symptom, such as a runny nose, are similar to those of colds or other respiratory infections and usually appear four to six days after infection. Symptoms often include:
- runny nose
- decreased appetite
- cough
- sneezing
- fever
- wheezing
- irritability
Why is RSV a concern now?
“This is not a new virus, and RSV infections do not appear to be more severe this year than in previous more typical respiratory viral seasons,” Moffitt said. “But the number of respiratory viral infections with RSV and other viruses like [COVID] and influenza that occurs suddenly is putting pressure on inpatient and pediatric emergency services.”
“It’s because we really haven’t seen much in the last two or three years, because of COVID,” said Dr. Jeannie Kenkare, medical director of PhysicianOne Urgent Carewhose Massachusetts locations include Brooklyn, Medfordwaltham Y Franklin.
Kenkare said that COVID measures, such as wearing masks and social distancing, have likely slowed the spread of other infectious diseases, including RSV.
“Now, those things really get done a lot less,” he said. “The children are back in school. They don’t wear masks at school, so they’re sharing those viruses again.”
Is it possible to test for RSV?
Testing may be available through a doctor or other health care provider. Home test kits may be available without a prescription, but it’s best to check availability.
Medline Plus, part of the National Institutes of Health Information Library, notes that two types of tests are commonly used:
- Rapid RSV Antigen Tests, that work by checking a sample of fluid from the nose for proteins from the RSV virus called antigens RSV antigens activate your immune system to attack the virus. Rapid antigen tests can provide results in an hour or less.
- molecular tests known as RT-PCR o Polymerase chain reaction tests look for genetic material from the RSV virus in a sample. The tests can find smaller amounts of the virus than antigen tests, which means they can be used for older children and adults, who tend to have less virus in their noses than babies and younger children. The samples are usually sent to a laboratory for analysis.
- In some cases, a health care provider may order a molecular test called respiratory pathogen panel. The test looks for RSV, other respiratory viruses, and bacterial infections at the same time.
Why is RSV more serious in infants and young children?
The CDC notes that almost all children will have had an RSV infection before their second birthday, and can get it more than once in their lives.
Although most recover within a week or two, the virus can cause serious complications for some, including the effects of reduced oxygen due to airway obstruction.
“It’s mainly dangerous in very young babies, because their airways are smaller. They have a much more severe response,” Kenkare said.
Moffitt said very young children and infants are most at risk because they have less immunity.
“Before the pandemic, we were all exposed to RSV regularly during the respiratory viral season, and each exposure boosts our immunity and helps prevent the infection from becoming very severe,” Moffitt said.
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“Infants and young children seeing RSV for the first time don’t have that defense yet,” Moffitt said. “Second, their airways are smaller and more easily filled with inflammation and debris that develop in response to infection. This can lead to a greater work of breathing and make it harder for them to stay hydrated.”
Kenkare said RSV can cause particular problems in young patients with chronic respiratory conditions such as asthma. It can also cause problems for older adults with chronic obstructive pulmonary disease, commonly called COPDeither emphysema.
RSV can cause death, although research on death rates in children is ongoing. This includes a recent Boston University study suggesting that the estimated global rate of 120,000 deaths may in fact be more, with the highest rates in low-income countries with less access to treatment and medical care.
“Prior to COVID-19, RSV was a major contributor to surges in pediatric hospitalizations each respiratory viral season,” Moffitt said. “But normally we would see a slower increase in the number of cases later in the season, usually peaking around January or February.”
How does RSV affect upper respiratory virus season?
With so many RSV infections today, Moffitt said, it’s possible to see a sharp spike that may drop sharply in the next month or two. “This would certainly be a welcome change if other viruses such as SARS-CoV-2 [COVID] and the increase in influenza this season, but it is difficult to predict if this will be the case.”
What is the treatment for RSV?
“There are no antivirals that work directly against RSV,” Moffitt said. “Infants and children hospitalized for RSV generally need respiratory support, such as supplemental oxygen and hydration.”
“We really focused on keeping hydration and oxygenation, making sure the child gets enough oxygen to support the body,” Kenkare said.
For patients with other chronic respiratory conditions such as asthma either COPD, steroids can be used, said Kenkare.
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Kenkare noted that, as a viral infection, RSV cannot be treated with antibiotics, that only work on bacterial infections.
“A baby may feed better if he can remove some of the nasal secretions with a bulb suction before attempting to feed,” Moffitt said.
Is an RSV vaccine in the works?
A vaccine that protects those most vulnerable to severe RSV infection would be a game changer, Moffitt said. “Recent studies of two investigational RSV vaccine candidates have suggested efficacy in preventing RSV infection in people over 60 years of age and one, when given to pregnant women, reportedly reduced RSV infection in their newborns.” “.
USA Today reports that six companies are working on RSV vaccines or antibodies, with the possibility that this year will be the last without a vaccine to combat the disease.
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Should children with RSV symptoms stay home from school?
“Yes. If your child has new symptoms of any respiratory illness, they should stay home,” Moffitt said, noting that it’s impossible to distinguish RSV symptoms from those of other respiratory infections like COVID and rhinovirus.
“Absolutely. The virus spreads from person to person, so if you can keep an infected person away from a group of other people, I think that’s absolutely relevant,” Kenkare said. “I know our kids are getting virus after virus. I know it’s a really tough question: Moms and dads go to work, and what if you have to have a child at home? It disrupts family life and upsets parents. “. . Nobody wants a sick child.”
Still, it’s one of the best ways to reduce the spread of RSV and other respiratory infections, Kenkare said.
“Most children with any of these infections can be treated at home with supportive care including hydration and fever medication if needed,” Moffitt said. “Humidifying the air near where a child or baby sleeps can also help. If it is possible to control the disease at home, a rapid COVID-19 test should be done if possible. If the result is negative and the symptoms of your child are improving, they may be able to return if they meet the criteria for returning to school.
What is the best way to reduce the spread of RSV?
“Frequent handwashing can reduce RSV contamination and the chance of infecting yourself or a child or infant,” Moffitt said. “Keeping your child or infant away from people with symptoms of a respiratory infection can reduce the risk of infection.”
While the holiday season means large gatherings, viruses have plenty to celebrate, including rapid person-to-person movement.
A variety of memes are circulating on social media, urging the resistance to smother children and grandchildren with lots of hugs and kisses to the face, due to the risk of RSV.
Kenkare said the idea has some validity. “It’s dangerous, especially with very young babies,” Kenkare said. Older children may also love kissing their little siblings.
As an alternative, Kenkare suggested: “Let the 2-year-old kiss the baby on the feet, but stay away from the face. Stay away from the hands. Hands go to mouth, rubs face.”
The mouth, nose and eyes allow the rapid passage of many microbes.