The story at a glance
- Cases of respiratory syncytial virus (RSV) are on the rise in the United States, especially among children.
- Symptoms can be mild like those of a cold: runny nose, coughing and sneezing.
- But in young children and older adults, RSV can cause more serious illnesses like bronchiolitis and pneumonia.
Cases of respiratory syncytial virus (RSV) are currently high across the country and experts say they could continue to rise, putting children and the elderly at risk of serious illness as winter approaches.
Adults infected with RSV usually show symptoms colds, but babies, young children and the elderly who are infected with the virus can develop more serious illnesses such as pneumonia.
This year, several children’s hospitals are reporting an increase in RSV cases and the number of cases requiring hospitalization.
Cases also arrive exceptionally early in the year. The test positivity rate for the virus has been around 10-15% in recent weeks, according to the Centers for Disease Control and Prevention (CDC). The number of positive cases increased rapidly from late August, which is early compared to a typical year, where this increase may not start until November. The early surge calls into question when virus cases will peak and how long this season could last.
“This year we’re already seeing a lot of RSV and I don’t think we’ve peaked yet,” says Benoosh Afghani, a pediatric infectious disease specialist at the University of California, Irvine. “I think in the next few weeks we’re going to see a peak.”
Here’s what to know about RSV amid rising cases.
How is RSV transmitted?
RSV is transmitted primarily through contact with bodhey fluidsand less frequently by air or skin-to-skin contact.
People can become infected with the virus if they come into contact with droplets containing RSV and then touch their eyes, nose or other routes of entry into the body.
The upcoming winter season will bring holidays and large gatherings, where people sharing a space run the risk of transmitting viruses to each other, including RSV but also others, such as influenza and COVID-19, which are mainly spread by airway.
For RSV in particular, families should note that touching surfaces can lead to transmission of the virus. “If they touch their nose and touch a surface and someone comes and touches that surface and then their nose or their eyes, they could pick it up if they’re not immune to it,” Afghani says.
RSV can survive on hard surfaces, such as tables and railings, for many hours and for shorter periods on surfaces such as fabrics or skin.
Transmission can also occur more directly if, for example, someone coughs in a person’s face and they are not wearing a mask, allowing droplets to land in their eyes and nose.
What are the symptoms of RSV?
Both adults and children can be infected with RSV. The illness is usually more severe in young children and older adults, much like the flu.
Adults infected with the virus usually have symptoms of a cold such as runny nose and sneezing. The common cold is caused by several types of viruses, including RSV, coronaviruses and rhinoviruses.
RSV infection in infants, children, and the elderly can resemble a cold, but it can also lead to serious respiratory illness. Symptoms include runny nose, decreased appetite, coughing, sneezing, fever, and wheezing, according to the CDC. For babies and children, mucus buildup and wheezing can be signs that the disease has progressed to a more serious condition. Older people may be at risk for pneumonia, exacerbation of asthma, or congestive heart failure.
In addition to pneumonia, which is an infection of the lungs, RSV can cause bronchiolitis, which is inflammation of the small airways in the lungs.
The virus doesn’t usually cause diarrhea, but can cause vomiting if there’s a lot of mucus, Afghani says. For example, if an infected person has difficulty breathing or coughs a lot, they may swallow the mucus and then vomit it up.
Adults and children with a severe case of RSV may need to be hospitalized if they have difficulty breathing or are dehydrated. In some severe cases, the patient may need supplemental oxygen or intubation.
How is RSV treated?
There is no approved vaccine or treatment for RSV. In most cases, adults and children can overcome the infection within a week or two without treatment.
There is a monoclonal antibody sometimes used to protect against serious illness caused by the virus called palivizumab, but it is only intended for the prevention of serious illness in high-risk infants. It is not intended for use as a treatment once a patient has been infected with RSV. Palivizumab is given by intramuscular injection which must be repeated approximately once a month during the RSV season.
Caregivers can manage fever and pain in people infected with the virus with over-the-counter products. The CDC says staying hydrated is crucial for patients with RSV.
Afghani notes that aspiration, the process of removing fluid from the airways, is the most important step to take when babies with RSV who have developed symptoms of severe illness, such as mucus buildup, are admitted. to the hospital.
Why is RSV on the rise?
One of the potential reasons why RSV is currently increasing is that fewer people are immune to previous infections than in a typical year.
Although there is no vaccine against the virus, adults and children can develop immunity to RSV following infection. A pregnant person who is exposed and develops antibodies can even transmit these antibodies to their fetus. Once born, the baby would then have some protection against the virus.
But restrictions on in-person activities during the coronavirus pandemic have prevented the circulation of respiratory viruses in general.
Influenza is also currently a concern partly for this reason, with cases increasing rapidly in the United States. “If both viruses have the same kind of spike, that’s going to be a real strain on the healthcare system on top of the COVID virus,” Afghani told Change America.
More information about RSV is available on the CDC’s website.