What causes this “incredible increase” in RSV?  Experts explain.

What causes this “incredible increase” in RSV? Experts explain.

RSV flare - African American premature baby being examined

RSV cases and hospitalizations are increasing in the United States (Photo: Getty Images)

RSV is on the rise across the country. The Centers for Disease Control and Prevention (CDC) reports an increase in RSV detections and RSV-associated emergency department visits and hospitalizations across the United States, stretching children’s hospitals.

“There’s been such an incredible increase this year,” Dr. John Carl, a pediatric pulmonologist at the Cleveland Clinic, told Yahoo Life.

Although the common respiratory virus normally causes cold-like symptoms that usually resolve within about a week, RSV can be severe in infants and the elderly, according to the CDC, as well as in immunocompromised people.

Although some may think this virus came out of nowhere, RSV is not new. It was first discovered in 1956 and, according to the CDC, is considered one of the most common causes of childhood illnesses. “RSV has always had a major impact,” Dr. Pedro Piedra, a professor of molecular virology and microbiology and pediatrics at Baylor College of Medicine, told Yahoo Life. “So it’s not that it’s new. It is a major cause of hospitalization and death in infants. In older adults, it’s similar to the flu – it has a huge impact.

And yet this year, the incidence of the disease seems particularly high. “Here’s this typical virus, but it comes in triple and quadruple numbers and severity,” says Carl. “It’s the pediatrician’s COVID, really.”

So what’s going on? Experts explain.

What is causing the RSV surge this year?

RSV season came early this year – appearing in the summer rather than its typical fall and winter season – and has persisted, Piedra says – “and that’s unusual for the amount of virus we’re seeing for the RSV”.

Adding fuel to the fire is the fact that RSV isn’t the only respiratory virus doing the rounds — along with COVID, flu cases are “growing like wildfire,” Piedra says, which creates a “triple epidemic”. “Never before have we had so many hospitalizations and cases at this time,” he says. “I think it’s going to be a bad season, because it caught a number of people off guard in terms of [influenza] vaccines, as people tend to delay getting their shots.

Although there has been some debate about ‘immune debt’ or the ‘immune gap’ – namely, that we are seeing more respiratory infections after hunkering down for the first two years of the pandemic and limiting our exposure to these viruses – experts say the pandemic played a role.

Almost all children have had at least one RSV infection before the age of 2 years. For babies in the first six months of life, RSV can be “particularly severe, leading to bronchiolitis – infection of the lung tract – and pneumonia”, according to JAMA Network. “Later infections are usually milder, causing cold-like symptoms. But there was virtually no RSV in 2020, and now children are paying the price.

Carl explains that for the first two years of the pandemic, “people really bought into isolation. We had nothing to offer him,” meaning respiratory viruses, including RSV, didn’t have as many hosts to infect while people mostly stayed at home. As the shields people had used to ward off COVID began to fall by the wayside, respiratory infections soared, with RSV “rearing its ugly head,” Carl says.

Piedra agrees, saying SARS CoV-2 had a “tremendous” impact on the epidemiology of other respiratory viruses. “It could be due to the non-pharmaceutical interventions that have taken place — wearing masks, social distancing, fewer gatherings — impacting the incidence of all other respiratory viruses,” including RSV, he says. .

However, as children returned to school, families began to travel again, and non-pharmaceutical interventions such as wearing masks were significantly reduced. “We basically saw the absorption of many respiratory viruses,” explains Piedra.

COVID – which, like RSV, is transmitted through droplets from an infected person’s mouth or nose when they speak, cough or sneeze – has also made us more aware of respiratory viruses in general, including better understanding how they spread and how to prevent them. Cases of RSV “occurred every year before COVID, but because of COVID, it made us be much more aware of respiratory viruses,” says Carl.

What can people do to protect themselves against RSV?

Carl and Piedra both recommend making sure children and adults are up to date on their COVID and flu vaccinations, to minimize other concurrent infections. Pfizer is working on an RSV vaccine, but, as Carl points out, “it’s not in our hands right now.”

So in the meantime, experts recommend regular hand washing. For daycares and schools, Carl says disinfecting all hard surfaces also helps because the virus can survive on objects, such as doorknobs and toys. “Teach children if you have to cough, cough into your elbow,” he adds.

Experts recommend children (and adults) stay home when they feel sick. If a child has a stuffy nose and you’re not sure whether to send them to school, Carl recommends having them wear a mask for three to four days to prevent infecting others. They can “explain to their classmates, ‘I have a cold and I don’t want to give it to you.’ »

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