By Amy Norton
HealthDay reporter
TUESDAY, Aug 17, 2021 (HealthDay News) – As the resurgence of COVID-19 cases dominates the news in the United States, an old viral enemy is making a quieter comeback.
In late spring, US children’s hospitals reported an unexpected surge in serious infections caused by respiratory syncytial virus (RSV).
Unlike COVID-19, RSV is a long-established enemy that usually shows up in late fall, peaks in winter, and almost disappears in summer.
For most people, RSV causes nothing but cold-like misery like a runny nose and cough. However, it can cause serious lung infections in babies, especially premature babies and young children with certain medical conditions.
RSV is the leading cause of pneumonia in babies under 1 year of age, according to the U.S. Centers for Disease Control and Prevention. It is also behind most cases of bronchiolitis, which is the small airways in the lungs that become inflamed.
If RSV gets deep into the lungs, teenagers may have difficulty breathing and may need to be hospitalized for oxygen and fluids.
In June, the CDC warned that children’s hospitals in the south are seeing an unusual increase in children with RSV.
Now the pattern is showing in other parts of the United States.
Salt Lake City Primary Children’s Hospital has seen an increase in positive tests for RSV in recent weeks, according to Dr. Per Gesteland, who is stationed at the Utah hospital.
During a recent hospital media briefing on RSV, he said the hospital’s current RSV numbers are similar to what they would normally have in early January.
“We are watching this very closely because we fear that these trends will really pick up and that we will see a lot more diseases,” said Gesteland.
One reason for concern is that the unusual RSV spike is associated with an increase in pediatric COVID-19 cases due to the more contagious Delta variant.
At several other hospitals, experts have warned that the combined trends are beyond resources. Last week, Texas Children’s Hospital in Houston said that its entire workforce must now be vaccinated against COVID-19. It said that “bold action” was needed amid the double surge in COVID and RSV.
The hospital has also reportedly seen more than two dozen children infected with both COVID-19 and RSV.
However, it is generally different groups of children at risk from the two viruses, said Dr. Larry Kociolek from Lurie Children’s Hospital and Northwestern University in Chicago.
RSV is ubiquitous, he explained, and for older children whose immune systems have been exposed to it, it’s simply a cause of colds. So the virus is primarily a threat to babies – especially premature babies and infants under 6 months of age.
According to the CDC, over 2 million American children see a doctor for RSV infection over the course of a normal year. About 58,000 end up in the hospital.
There is no vaccine for RSV. But, Kociolek said, there is a way to prevent serious infections in certain high-risk adolescents: an injection drug called palivizumab.
The American Academy of Pediatrics (AAP) recommends giving the drug to some premature babies in their first year of life and toddlers with conditions that severely weaken the immune system. The injections are given monthly for up to five months, usually starting in November.
But last week the AAP advised pediatricians to start palivizumab now.
“Given the RSV activity we are seeing now, we are looking to introduce this in the summer,” Gesteland said.
What’s wrong? It’s pretty simple, according to Kociolek and Gesteland: at the start of the pandemic, with widespread social distancing and masking, RSV cases almost went away and stayed low during the normal 2020-2021 season.
Then when restrictions were relaxed and large gatherings became the norm again, people came into contact with pathogens, including RSV, that were lurking, Gesteland said.
In addition to medication for high-risk babies, Kociolek says parents can also help protect infants from RSV by limiting their exposure to large gatherings or people with cold symptoms.
Early symptoms of RSV – fever, cough, and constipation – can be very similar to other respiratory diseases, including COVID-19. In general, Gesteland said, testing is the only way to be sure which virus is the culprit.
According to the AAP, almost all young people recover from RSV on their own. But if a baby is gasping or showing other signs of shortness of breath, parents should call their pediatrician, Kociolek said.
More information
The U.S. Centers for Disease Control and Prevention has more about respiratory syncytial virus.
SOURCES: Per Gesteland, MD, Hospitalist, University of Utah Health / Primary Children’s Hospital, Salt Lake City; Larry Kociolek, MD, Assistant Professor, Pediatrics, Northwestern University Feinberg School of Medicine and Lurie Children’s Hospital of Chicago
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