RSV Surge is "Unprecedented" as Hospitals are "Overwhelmed." Here's What You Need to Know.
With the holidays around the corner and RSV on the rise, health officials are urging people to take precautions. "Unlike Covid, R.S.V. can spread when people touch contaminated surfaces, "Emily Martin, an associate professor of epidemiology at the University of Michigan School of Public Health told the New York Times. "It also spreads through respiratory droplets. So it's a good idea to disinfect surfaces, particularly in settings like day care centers, where young children are constantly touching things, sneezing on things and sticking them in their mouths."
While recent headlines are often about young children getting RSV, anyone can catch the virus and everyone is advised to take steps to avoid getting sick. "It's important to know that RSV can affect all ages," Dr. Bayo Curry-Winchell, Urgent Care Medical Director and Physician, Carbon Health and Saint Mary's Hospital tells us. "It's a viral illness that has a wide range of symptoms and severity that can resemble the common cold or respiratory distress (a term used to describe a display of struggling to breath that requires emergency care and hospitalization). Those under the age of one, or over the age of 65, or someone with underlying health conditions such as lung disease (asthma) are at an increased risk for complications."
A spike in RSV, COVID and influenza cases is causing hospitals around the country to experience overcrowding and healthcare workers are feeling the strain. Several states are reporting they are almost at capacity and Oregon's governor recently issued orders to help hospitals. Kezi 9 ABC News reports, "Oregon's nurses, doctors, and hospital staff are deeply committed to caring for our children, and I'm grateful for all the work they are doing under difficult circumstances to help our kids," said Governor Brown. "As the country faces a surge in pediatric RSV cases, we want to make sure Oregon's hospitals have access to the tools they need to provide care for sick kids. For parents, please know you can take steps to reduce the risk of RSV, including practicing the good health and hygiene habits we've learned over the past few years." Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.
What to Know About RSV
Dr. Preeti Parikh, board-certified practicing pediatrician and Executive Medical Director at GoodRx tells us, "Respiratory Syncytial Virus (RSV) is a very contagious virus that affects the respiratory system and is typically a cause of the common cold. Most people who have RSV experience mild, cold-like symptoms, however, the virus can also develop into more severe symptoms, especially for babies and older adults. Mild RSV occurs in the upper respiratory tract where you'll feel common cold symptoms like a runny nose or cough. When the infection spreads to the lower respiratory tract, dangerous infections can develop like bronchiolitis and pneumonia which causes severe symptoms."
Joyce Baker, RRT, RRT-NPS, AE-C, Fellow of the American Association for Respiratory Care says, "Respiratory syncytial virus (RSV) is a common virus that usually causes mild, cold-like symptoms (coughing, runny nose, sneezing, fever, decreased appetite). RSV does have similar symptoms to the flu, however, with the flu symptoms (fever, dry cough, sudden feeling of being tired, headache, loss of appetite, sore throat, chills) have a sudden onset. With RSV symptoms (runny nose, wheezing, low grade fever, congested cough, tiredness, shortness of breath) gradually get worse."
Why There's an Uptick in Cases
Dr. Curry-Winchell says, "The measures used to mitigate the pandemic decreased our exposure to common viruses and bacteria which ultimately caused a weakened immune system — especially in our pediatric population which has an increased risk for contracting the virus."
Dr. Parikh says, "RSV is highly contagious and passed between individuals through respiratory droplets. Since more people spend more time indoors during the winter months, this creates an ideal situation for the virus to spread and is why we see an uptick in cases during the cold months. We saw a decline in infections during the winter of 2020-2021 due to mask mandates and restrictions on people gathering indoors. However, once Covid-19 restrictions began to loosen, we saw an increase of RSV cases. Additionally, most children are usually exposed to RSV by their second birthdays, but fewer children have had that exposure and are now getting sick."
Who is at the Greatest Risk for RSV
According to Dr. Parikh, "Those most at risk of severe RSV are premature infants, babies younger than 6 months, children with existing medical conditions like asthma, COPD or congenital heart disease, and children and young adults who are immunocompromised. RSV spreads quickly between young children in particular because most aren't very good at covering their coughs and sneezes. They are in crowded settings like daycares and schools, and they most likely have not built up immunity to RSV yet. Most people are contagious with RSV for about a week. However, if you have a weakened immune system you may be contagious for several weeks following infection."
Baker adds, "All ages can get RSV. For most people it is a mild cold, and they recover in a week or so, but for older adults and younger children it can be serious. It is most dangerous for children who were born prematurely or are less than 6 months of age, have chronic lung disease, congenital heart disease, weakened immune systems, and/or neuromuscular disease where it is difficult to clear mucus from the lungs. According to the Centers for Disease Control and Prevention "One to two out of every 100 children younger than 6 months of age with RSV infection may need to be hospitalized." It is also dangerous for adults who have obstructive lung disease, weakened immune systems, and neuromuscular disease."
How RSV is Different From the Flu
Dr. Curry-Winchell explains, "RSV and the flu are both viral illnesses with similar symptoms such as cough and fatigue; however, the flu normally starts with a high fever and body aches versus RSV will resemble a common cold. In some people, this can turn into difficulty breathing especially in those with health conditions, younger children, and older adults. Treatments are different. A good medication is Tamiflu for the flu. Unfortunately, there's no specific medication for RSV at this time."
Dr. Parikh explains, "The symptoms for the flu and RSV appear to be similar, and without testing it can be difficult to tell. In general but not always the flu has high fever, body aches and headaches whereas RSV can have fever too but also has a lot of congestion and secretions. If there is suspicion of flu it is important to get tested within 48 hours of onset of symptoms so you can qualify for an antiviral against the flu. Also, don't forget to get the flu vaccine for additional prevention against the flu.
RSV can be difficult to treat since there is no medication for RSV. The best way to recover from a mild case of RSV is to use supportive care of fluids, suctioning, steam, and to administerOTC medications such as acetaminophen or ibuprofen. Giving honey to children above the age 1 is also great as a cough suppressant and to thin out mucus. For severe cases, treatments can include fluids to help with dehydration, or wearing an oxygen mask or intubation to help breathing. There is currently no vaccination against RSV, but an injection of palivizumab (Synagis) is often given to high-risk babies as protection."
Three Common RSV Symptoms
According to Dr. Curry-Winchell, "The most common symptoms are a cough, runny nose, and a change in appetite. Because the symptoms (especially at the beginning) are like a cold, it can be hard to separate the two."
Dr. Parikh says, "Adults who catch RSV usually experience symptoms similar to that of a common cold. Among the most common symptoms are:
o A stuffy nose
For infants 6 months or younger, more serious symptoms can arise including severe congestion/runny nose, rapid breathing, struggling to breath, and signs of less or no appetite."
There's No Vaccine, But Here's How to Stay Healthy
Dr. Curry-Winchell advises, "Help others by staying home or avoiding social situations when you are not feeling well. This will help reduce transmission. Also, if you're traveling or eating out, wipe down surfaces, get enough rest, and try to eat a healthy diet as much as possible." Dr. Parikh states, "People can take many of the same precautions that they take to prevent COVID-19 infections. These include hand washing, social distancing, wearing a mask, and avoiding crowded areas."
Erica Susky, Certified Infection Control Practitioner with a Masters' Degree in Medical Microbiology and over fifteen years of training and experience in laboratory and clinical settings adds, "Those at higher risk of severe RSV infection are particularly vulnerable as there is yet no vaccine available to reduce the risk of transmission and severe disease. Many healthy children and adults may have a very mild form of RSV and may not know they have anything more severe than the common cold and may not consider the potential repercussions of exposing higher risk groups. Because of this, the measures learned during the COVID-19 pandemic are excellent to continue if one has a friend or loved one in a vulnerable population. This would include wearing a mask around a vulnerable individual, frequent hand washing, and to abstain from visiting them even when mildly ill."