The recent emergence of a virus that typically afflicts children in colder months has confused American pediatricians and placed many infants in the hospital with annoying coughs and difficulty breathing.
RSV or respiratory syncytial virus is a common cause of cold-like symptoms, but can be severe in infants and the elderly. Cases dropped dramatically last year, with people staying home and taking social distances, but began to emerge as pandemic restrictions were eased.
“I’ve never seen anything like it before,”
The U.S. Centers for Disease Control and Prevention issued health advice on June 10 on an increase in RSV cases across parts of the South. There have also been cases in many other states.
LaRanda St. John became concerned when her 6-week-old son, Beau, developed a bad cough a few weeks ago. Mattoon, the Illinois mother has a medical background and suspected RSV when she opened her sleeper and watched her chest swing with cramped breathing.
“The doctor’s office could not get me in because they were flooded with people calling” about children with similar symptoms, “said St. John.
A positive test in ER confirmed RSV. The infant developed a rapid pulse and had to be hospitalized overnight. His 16-month-old sister, Lulabelle, also contracted the virus but was not as ill and did not need hospitalization.
St. John said she wondered if it might be COVID-19 because it’s the wrong season for RSV.
“I can’t say I was relieved because I know RSV is just as bad,” she said.
Children infected with both viruses usually develop only mild illness, but for some, these infections can be serious.
Among U.S. children under the age of 5, RSV typically leads to 2 million doctor visits each year, 58,000 hospitalizations and up to 500 deaths – higher than the estimated toll on children from COVID-19.
Among adults aged 65 and over, RSV can lead to pneumonia and cause nearly 180,000 admissions and 14,000 deaths annually. Cases in children and adults usually occur in the fall through early spring.
Off-season seasons in Australia were a hint that the same could happen in the United States, said Dr. Larry Kociolek, an infectious disease specialist with Chicago’s Lurie Children’s Hospital.
Typically, infants are exposed to RSV during the first year of life, often when older siblings become infected at school and bring the virus home, Kociolek said. But, he added, ” there were many children and babies who were not exposed to RSV in the winter of 2020 and the winter of 2021. That just leaves a much larger proportion of susceptible infants. ”
In infants, symptoms may include discomfort, poor feeding, fever and lethargy. Children may have runny nose, decreased appetite, cough and wheezing.
However, in very young infants and those born prematurely, the virus can cause small airways in the lungs to become swollen and filled with mucus. Babies who develop this condition, called bronchiolitis, may need hospitalization and oxygen or ventilator treatment.
There is no approved treatment for RSV, although an injection of an antibody-based medication once a month is sometimes prescribed before and during the RSV season to prevent severe RSV lung problems in premature infants and other infants at risk of serious illness.
Genetic infections are common, but typically cause milder symptoms than the original disease.
Kociolek said the recent unusual increase in cases could be due in part to several tests due to COVID-19 fears. In normal times, parents may dismiss RSV symptoms as nothing serious, but now they may fear that they are signaling the pandemic virus.
RSV is spread through contact with airborne droplets from an infected person, but it is much more likely than COVID-19 to stick to the skin and other surfaces including toys, which can also be a source of transmission.
RSV is one of the reasons why day care centers and kindergartens often have strict policies to keep children with coughs at home from school.
“A lot of parents think, ‘Well, it’s just cold, they’re fine going to 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 in her center have become ill with RSV in recent weeks, including her own 4-month-old son. He had violent coughing sticks and was prescribed medication that was often used to treat breathing problems in asthma, but did not need to be hospitalized.
She called the summer outbreak in her center “just weird.”
“It did not even occur to me that it would end up being something like RSV,” Blackwell said.
Dr. Mary Caserta, a member of the American Academy of Pediatrics’ Committee on Infectious Diseases and a professor at the University of Rochester, said parents should be aware of the unusually timely viral activity and seek medical attention if babies look very ill or have trouble breathing. .
RSV is one of the reasons why paediatricians often warn parents of young children to avoid crowds during winter coughs and cold seasons.
“COVID has made people so hungry to be with other people that it would be difficult now” to come up with the same recommendation, Caserta said.
Whether the unusual summer virus activity anticipates less than normal RSV this coming winter is uncertain, she said.
“I have somehow given up trying to predict the future,” Caserta said.
Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.
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