A common virus in young children is increasing in the United States and raising fears that hospitals could be overwhelmed this year by potential winter spikes in flu and COVID-19.
Respiratory syncytial virus (RSV) is extremely common, with almost everyone having been exposed to the pathogen before the age of 2. In healthy adults and older children, RSV usually causes mild cold-like symptoms that resolve with moderate rest and self-care.
Young children, especially those younger than 6 months, have the highest risk of developing severe cases that can lead to hospitalization.
There is currently no vaccine available against RSV, and the only treatment is monoclonal antibodies, usually reserved for extremely high-risk cases, including infants born prematurely or those with chronic heart and lung diseases.
Data from the Centers for Disease Control and Prevention (CDC) shows that more than 4,000 cases of RSV are being reported each week recently, similar to the last major outbreak, which was in the summer of 2021.
“We still expect it to start showing up in late November and peak in December, January, then decline in March, April,” Diego Hijano, an infectious disease specialist at Children’s Research Hospital, told The Hill. St. Jude.
“That hasn’t been the case for the past few years, where we had an outbreak over the summer and then little activity at first,” Hijano said. “We have already seen above what we expect for October of any given year in terms of RSV locally and across the country. So certainly that’s a concern as we head into winter with COVID, flu and RSV.
The CDC predicts that cases have already started to decline, though information is incomplete and subject to change.
Like the flu virus, exposure to RSV has been lower in recent years as people work from home and keep their children out of child care during the coronavirus pandemic.
At St. Jude in Memphis, where he is based, Hijano said he is seeing an equal number of cases of COVID-19, influenza and RSV.
“It’s concerning, you know, because it’s definitely going to overwhelm the emergency department and the health care system as these trends continue,” he said.
As The Washington Post reported this week, several DC-area children’s hospitals have already reached capacity in response to spikes in RSV and the common cold.
Juan Salazar, the vice president of Connecticut Children’s Medical Center, told NBC’s “Today” on Thursday that in his more than 30-year career, he had never seen this level of viral transmission or the need for hospitalization for RSV. Salazar said his hospital is considering temporary units on its lawn, as well as the use of state and National Guard resources.
Kristin Moffitt, an infectious disease specialist at Boston Children’s Hospital, said she believes her hospital is prepared for a potential increase in cases. Speaking to The Hill, Moffitt noted that the sharp rise in virus cases has yet to be seen where she works, but said the North East should soon expect a slight increase.
“I can only speak for my hospital. We’re very, very adaptable,” Moffitt said. “And frankly, children’s hospitals and pediatric emergency rooms have been adjusting for two and a half years now to what has been a real – especially in the last year and a half – a real incredible increase in utilization pediatric care, emergencies.”
“I’m not terribly worried that we can’t meet demand if needed and if there’s a real increase in pediatric hospitalizations,” Moffitt added.
She said the recent change in the annual resurgence of RSV cases has presented a potential challenge in treating severe cases. Monoclonal antibodies do not last very long and must be ordered monthly. RSV’s earlier predictability had allowed hospitals to order enough treatments ahead of time, but Moffitt said the earlier push increased the chance a hospital wouldn’t have enough on hand.
With no vaccines available for the virus and no single viable treatment, infectious disease experts who spoke to The Hill said the best way for parents to approach this season of respiratory viral spread is to limit and prevent potential exposure in general.
Hijano noted that wearing a mask, especially in daycares and preschools, is almost forgotten now. Recognizing that this option can be difficult for parents to consider, he advised keeping children home if they are sick to avoid the potential spread of any virus in the community.
“As for daily life, stay home if you are sick, wash your hands and avoid coughing into each other,” Hijano said.
Moffitt said parents should make sure they are aware that people who are in close contact with their young children feel healthy themselves. She added that parents could also take the extra step of asking people outside their household not to kiss their babies, as respiratory secretions from the mouth are a common route of transmission.
She added that parents of a young infant as well as a toddler should also make sure their toddler is clean and symptom-free before interacting with their younger siblings, as toddlers are often exposed to daycare or playgroups.
“I think parents can make decisions about their risk tolerance,” Moffitt said. “Steps like this can help not eliminate but at least decrease the possibility of exposure for infants.”
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