RSV in cold summer weather confuses docs, parents worried

WASHINGTON (AP) – The recent emergence of a virus that typically makes children sick during the colder months has baffled American pediatricians and has put many infants in hospital with bothersome coughs and breathing problems.

RSV, or respiratory syncytial virus, is a common cause of cold-like symptoms, but can be serious in infants and the elderly. Cases have dropped dramatically over the past year, with people staying at home and social distancing, but have started to crop up as pandemic restrictions have eased.

“I’ve never seen anything like it before,” said Dr. Kate Dutkiewicz, medical director of Beacon Children’s Hospital in South Bend, Indiana, after recently treating two infants infected with RSV. Both needed oxygen therapy to help them breathe. “I never saw a case in July or near July.”

The U.S. Centers for Disease Control and Prevention issued a health notice on June 10 regarding an increase in RSV cases in parts of the South. Cases have also emerged in many other states.

LaRanda St. John became concerned when her 6 week old son Beau developed a bad cough a few weeks ago. The mother from Mattoon, Illinois, has a medical history and suspected RSV when she opened her sleeper and saw her chest rise with labored breathing.

“The doctor’s office couldn’t get me in because it was inundated with people calling” about children with similar symptoms, “St. John said.

A positive test in the emergency room confirmed RSV. The infant developed a rapid heart rate and had to be hospitalized overnight. Her 16-month-old sister, Lulabelle, also contracted the virus but was not as sick and did not need to be hospitalized.

St. John said she wondered if it could be COVID-19 because it is not the right season for RSV.

“I can’t say I was relieved because I know the RSV is just as bad,” she said.

Children infected with either virus usually only develop mild illness, but for some these infections can be serious.

In American children under 5, RSV typically results in 2 million doctor visits each year, 58,000 hospitalizations, and up to 500 deaths – more than the estimated number of children from COVID-19.

In adults 65 years of age and older, RSV can cause pneumonia and cause nearly 180,000 hospitalizations and 14,000 deaths each year. Cases in children and adults usually occur from fall to early spring.

The off-season cases in Australia were a sign the same could be happening in the United States, said Dr Larry Kociolek, an infectious disease specialist at Lurie Children’s Hospital in Chicago.

Typically, infants are exposed to RSV during the first year of life, often when older siblings get infected at school and bring the virus home, Kociolek said. But, he added, “there were a lot of children and babies who weren’t exposed to RSV in the winter of 2020 and the winter of 2021. That just leaves a much larger proportion of sensitive infants. “

In infants, symptoms may include restlessness, poor nutrition, fever, and lethargy. Children may have a runny nose, decreased appetite, cough, and wheezing.

But in very young infants and premature babies, the virus can cause swelling and mucus filling of the small airways in the lungs. Babies who develop this condition, called bronchiolitis, may require hospitalization and treatment with oxygen or ventilation.

There is no approved treatment for RSV, although a monthly injection of an antibody medication is sometimes prescribed before and during RSV season to help prevent severe RSV lung problems in patients. premature babies and other babies at risk of serious illness.

Reinfections are common but usually cause milder symptoms than the initial illness.

Kociolek said the recent unusual increase in cases could be in part due to more testing due to fears of COVID-19. Normally, parents may dismiss the symptoms of RSV as nothing serious, but now they may fear reporting the pandemic virus.

RSV is spread through contact with airborne droplets of an infected person, but COVID-19 is much more likely to linger on the skin and other surfaces, including toys, which can also be a source of transmission.

RSV is one of the reasons that daycares and preschools often have strict policies about keeping coughing children at home.

“A lot of parents think, ‘Well it’s just a cold, they’re doing well in school,’ said Diana Blackwell, director of children’s programs at Auburn University-Harris Early Learning Center in Birmingham, Alabama.

Despite strict cleaning measures, several children at his center have fallen ill with RSV in recent weeks, including his own 4-month-old son. He had violent coughing fits and was prescribed drugs often used to treat asthma breathing problems, but did not need to be hospitalized.

She called the summer epidemic at her center “just plain weird”.

“I didn’t even think it would end up being anything like RSV,” Blackwell said.

Dr Mary Caserta, a member of the American Academy of Pediatrics’ infectious disease committee and a professor at the University of Rochester, said parents should be aware of unusually scheduled viral activity and see a doctor if babies appear very sick or have trouble breathing. .

RSV is one of the reasons pediatricians often warn parents of young babies to avoid crowds during winter cough and cold weather.

“COVID has made people so hungry to be with other people that it would be difficult now” to make the same recommendation, Caserta said.

It is not known whether the unusual summer virus activity portends less RSV than usual this winter, she said.

“I gave up in any way trying to predict the future,” Caserta said.

Follow AP medical writer Lindsey Tanner at @LindseyTanner.

The Associated Press’s Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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