With many focused on rising cases of COVID-19 caused by the Delta variant, the Centers for Disease Control and Prevention and West Virginia health-care professionals are urging parents to also be aware of the risks to babies and other at-risk children and older adults posed by infections from respiratory syncytial virus, or RSV.
Some providers have also expressed concern about the risk of co-infection with RSV and COVID-19.
RSV infections are most common in the winter months in West Virginia, but cases have been on the rise during the summer months of 2021.
In June, the Centers for Disease Control and Prevention issued a health advisory warning of increasing RSV infection rates in parts of the South after more than a year with unusually low rates. The reduced rates were attributed to the adoption of disease mitigation measures implemented in response to the COVID-19 pandemic.
RSV infection rates began to increase in late March in some areas of the country as people began to return to normal activities, according to the advisory.
The advisory called for broader testing for RSV among patients with acute respiratory illness. The advisory also reminded health-care professionals, child-care providers and long-term care facility staff to avoid reporting to work when experiencing symptoms, even if they tested negative for COVID-19.
“I do not have statistics about local RSV rates. However, we are seeing numbers which may be similar to pre-pandemic,” said Dr. Parth Bhatt, a pediatrician with Bridgeport Pediatrics. “We may attribute drop of RSV last year to mask-wearing and physical distancing for COVID-19. There were cases of RSV in 2020, but [they] were fewer.”
The rise in cases over summer is atypical, as RSV usually occurs in the late fall through early spring months, Bhatt said.
He urged parents to be aware of the risks associated with RSV.
RSV is a virus causing respiratory illness, affecting the nose, throat and lungs. It is highly infectious, and almost all children get the virus at least once before age 2. While the majority of cases bring only minor cold-like symptoms, the virus can be more dangerous for some, including infants under 12 weeks old; babies less than 6 months old who were born prematurely; formula-fed babies; smoke-exposed babies; children with underlying medical conditions like chronic lung disease, certain heart defects, allergies or eczema or weakened immune system from cancer, organ transplant or immune-suppresive medications, Bhatt said.
In its health advisory, the CDC even warned parents of older children to be watchful.
“Due to reduced circulation of RSV during the winter months of 2020–2021, older infants and toddlers might now be at increased risk of severe RSV-associated illness since they have likely not had typical levels of exposure to RSV during the past 15 months,” the advisory states.
According to Bhatt, symptoms can include fever, runny nose, cough and respiratory distress, signaled by fast breathing, flaring of the nostrils, head bobbing with breathing, rhythmic grunting during breathing, belly breathing, tugging between the ribs or at the lower neck and wheezing.
Treatment is recommended for children who are symptomatic. This is especially important for children under age 1. A doctor may advise nasal saline drops and suctioning, as well as use of a cool-mist humidifier, depending on the child’s symptoms, Bhatt said.
“Typically, RSV causes a cold, which may be followed by bronchiolitis or pneumonia. Symptoms generally last an average of 5-7 days,” he said. “Usually RSV peaks at about 3-4 days and then starts to get better. If [the] child is admitted in [the] hospital, then your doctor will discuss a management plan.”
RSV is very infectious and spreads similarly to the common cold, entering through the nose or eyes from direct person-to-person contact with saliva, mucous or nasal discharge, from unwashed hands or from unclean objects and surfaces.
RSV can live on unwashed hands for 30 minutes or more and on surfaces like toys and doorknobs for up to six hours.
Limiting a baby’s exposure to crowds, other children and anyone with cold symptoms or fever can reduce the likelihood of infection. All individuals should wash their hands before holding or touching a baby, and children at high risk for severe RSV should avoid child-care settings, particularly during RSV season.
To avoid spread, parents should keep children home from school or child-care services when they are sick and teach children to properly cover coughs and sneezes. Disinfectant wipes should be used to clean surfaces in the home.
Breastfeeding to provide protective antibodies, as well as keeping children away from tobacco smoke, also can be helpful.
“Children and adults can get RSV multiple times — even during a single season. Often, however, repeat infections are less severe than the first one,” Bhatt said. “Symptoms can appear two to eight days after contact with RSV. According to the Centers for Disease Control and Prevention, people infected with RSV are usually contagious for three to eight days. However, some infants and people with weakened immune systems can be contagious for as long as four weeks even if they are not showing symptoms.”