What’s behind the disturbing increase in RSV in US children’s hospitals?

Children’s hospitals in parts of the United States are seeing an upsurge in a common respiratory disease that can cause serious breathing problems for babies.

RSV cases dropped dramatically two years ago when the pandemic shut down schools, daycares and businesses. With the easing of restrictions in the summer of 2021, doctors have seen an alarming increase in what is normally a fall and winter virus.

Now it’s back. And doctors are preparing for the possibility that RSV, the flu and COVID-19 could combine to stress hospitals.

“I call it an emergency,” said Dr. Juan Salazar of Connecticut Children’s Hospital, where RSV has caused a shuffling of patients in playrooms and other spaces not normally used for the beds. The institution has explored the use of a National Guard field hospital, but has put that option aside for now.

A look at RSV and what the recent surge may mean:

WHAT IS RSV?

It represents respiratory syncytial virus, a common cause of mild cold-like symptoms such as runny nose, cough, and fever. Almost all American children normally get an RSV infection by age 2.

Infected people are usually contagious for three to eight days. Babies and people with weakened immune systems can transmit RSV for up to four weeks. There is no vaccine for it, although several candidates are in testing.

WHO DOES IT AFFECT?

Anyone can get RSV. But it poses the greatest threat to infants, the elderly and other vulnerable people, who can contract serious respiratory and lung infections.

In American children under 5 years of age, RSV usually leads to 58,000 hospitalizations and up to 500 deaths in one year.

In adults aged 65 and over, RSV causes 177,000 hospitalizations and 14,000 deaths per year.

For babies, difficulty breathing can interfere with feeding. “And that’s really when we start to worry,” said Dr. Melanie Kitagawa of Texas Children’s Hospital in Houston, where more than 40 children have RSV.

“They breathe fast, breathe deeply. We see them using their chest muscles to help them breathe,” Kitagawa said. “These are children who find it difficult to take a bottle because their breathing is impacted and they cannot coordinate the two at the same time.”

WHY IS THERE AN INCREASE NOW?

The virus encounters a very vulnerable population of babies and children who have been immune to common insects during pandemic lockdowns.

Immune systems might not be as prepared to fight the virus after more than two years of masking, which offered protection, according to Dr. Elizabeth Mack of the Medical University of South Carolina.

“South Carolina is drowning in RSV,” Mack said in a press release. The surge came earlier this year than normal, she said.

For babies, their mothers may not have been infected with RSV during pregnancy, which could have given children some immunity.

U.S. health officials have noted an increase this month in nationwide reports of respiratory illnesses, which they say is at least partly due to the early spread of the flu across much of the South.

Last week, more than 7,000 tests came back positive for RSV, CDC figures show. This is more than in previous waves.

IS THERE A TREATMENT?

There is no specific treatment, so it’s all about managing the symptoms and letting the virus run its course. Doctors may prescribe oral steroids or an inhaler to help with breathing.

In severe cases, hospitalized patients may be given oxygen, a breathing tube, or a ventilator.

WHAT DO DOCTORS RECOMMEND?

Prevent the spread of viruses by washing your hands thoroughly and staying home when you are sick.

During RSV season, an injection of an antibody drug is sometimes prescribed to protect premature and other very vulnerable babies.

If you’re concerned your child has a serious breathing problem, “don’t hesitate” to go to the emergency room or call 911, said Dr. Russell Migita of Seattle Children’s Hospital, where RSV is on the rise.

For less serious medical issues, Migita said, call your regular healthcare provider for advice, use telehealth or go to the emergency room.

In Chicago on Saturday, Dr. Juanita Mora saw a family of five children all with RSV, ranging from a 3-year-old to a teenager. Fearing what awaits her this winter, she tells everyone to get a flu shot and a COVID-19 booster.

“We don’t want a triple whammy, a triple pandemic,” Mora said.

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Associated Press/Report for America reporter James Pollard contributed from Columbia, South Carolina. AP Medical Writer Mike Stobbe contributed.

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The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute Department of Science Education. The AP is solely responsible for all content.

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