Why Is RSV So Bad Right Now? Pediatricians Explain

If you haven’t heard of it before, respiratory syncytial virus (RSV) is a very common respiratory virus. No doubt, though, if you have a baby or young toddler, you’re at least somewhat familiar with this common virus and its hallmark cold-like symptoms (think coughs, runny nose, fever). In fact, if you have a baby or toddler, your child has likely had RSV at some point, since, according to the Centers for Disease Control (CDC), most babies catch RSV before the age of 2. But, while many cases of RSV present as a cold like any other, the virus is also the top cause of bronchiolitis and pneumonia in babies under 12 months. So yeah, parents — particularly parents of infants — tend to worry about RSV. And this year, RSV seems to be making headlines a bit earlier than usual. But exactly why is RSV so bad right now? And is it particularly bad this year?

Here’s what you need to know to keep you and your family informed, and as safe as can be.

Why is RSV so bad right now? Do parents need to worry?

“They should be aware that we’re seeing very high numbers of RSV right now, but this should not be alarming,” offers Dr. Kristin Moffitt, Associate Physician in Pediatrics, Division of Infectious Diseases at Boston Children's Hospital. In other words? Yes, it’s circulating, but most parents do not need to be overly worried.

It can be hard not to worry, though, particularly when scary headlines are everywhere. So, why do most parents not need to be particularly alarmed? “This is not a new virus, and it does not appear that RSV infections are more severe this year than they have been in previous more typical respiratory viral seasons,” Moffitt explains.

However, it’s not all sunshine and rainbows. With so many infections, the system is struggling. “But the number of respiratory viral infections with RSV and other viruses such as SARS-CoV-2 and influenza happening all at once is putting a strain on pediatric emergency and inpatient services,” Moffitt warns. Dr. Russell Migita, Attending Physician and a Clinical leader of Emergency Services at Seattle Children’s, agrees. “Typically, RSV runs from December to April. We plan for volumes that typically peak in February and March,” says Migita. “This season is likely to be different. In addition to being early, this season is likely to be severe.”

Why is RSV spiking right now?

Why is the U.S. seeing a surge in reported cases of RSV? Well, we all took off our masks and started playing together at the same time, which manes lots of things spread, from the common cold to RSV. “We are seeing higher numbers of RSV infections in a shorter period of time right now than in typical respiratory viral seasons,” Moffitt confirms. “This is probably due to two main factors. Decreased immunity to RSV because respiratory virus transmission was reduced during the pandemic and removal of measures to reduce respiratory virus transmission, such as masking and distancing.”

When to worry about an RSV infection

If your baby or child has respiratory symptoms from any viral infection — including RSV — that include the following, Moffitt says they should be evaluated by a medical provider right away:

• labored breathing
• grunting or flaring of nostrils with breathing
• rapid breathing
• wheezing
• dehydration or difficulty drinking
• lethargy or difficulty waking

RSV is not always mild for all kids. As the American Academy of Pediatrics (AAP) shared, premature babies, or those with lung or heart conditions, may be more susceptible to serious cases of RSV. If you suspect your baby might have caught the virus, observe their symptoms.

Are RSV & Covid-19 related?

They’re different viruses that are spread in some of the same ways. “RSV and Covid are two unrelated viruses, but they are both spread through droplets — and touch for RSV,” Michael J. Smith, professor of pediatrics with Duke University School of Medicine, tells Romper. “It's not surprising that we did not see much of a typical RSV season this year while everyone was masking and social distancing. As society began to open up, incidence of both infections has increased.”

How can I protect my baby or child against RSV?

Being cautious and observant can go a long way, both to help prevent RSV and stop its spread. “As with any other respiratory virus, we know that infants and children, the most vulnerable being very young infants — none of whom are eligible currently to be vaccinated against Covid-19 — can be co-infected with both RSV and Covid-19,” says Alyssa Silver, pediatric Hospitalist at the Children’s Hospital at Montefiore.

“If possible, if you or your child is sick, don’t go to work or school,” suggests Migita. “If this is not an option, wearing a mask and practicing good hand hygiene can reduce viral transmission.”

“Frequent hand-washing can reduce RSV contamination and the possibility of infecting oneself or a child or infant,” Moffitt adds. It’s always a good idea to — within the best of your ability — keep your child or infant away from individuals with symptoms of a respiratory infection can reduce the risk of infection.

The medical community is on high alert for signs their vulnerable patients — infants who are premature or who have certain medical conditions, typically heart or lung problems — may be developing RSV. The American Academy of Pediatrics recently put out a statement suggesting that distribution of a prophylactic medicine called Synagis may need to start earlier this year in areas with high rates of RSV. You should discuss that treatment option with your healthcare providers if you’re concerned about RSV.

My child has RSV. Now what?

It’s crucial to remember, as Smith tells Romper, that “in most children, RSV is a mild respiratory illness.”

“The very young (and very old) are at most risk for more severe RSV disease, as well as those with underlying conditions like lung conditions or heart problems,” Migita adds. So, if your child is over the age of 1 and overall healthy, take a deep breath, and simply work closely with your child’s health care provider. “Most RSV infections can be managed at home with supportive treatment,” Moffitt explains. As you would with any virus, she encourages parents of children and babies with RSV to focus on:

• hydration
• humidification of the air near where a child or infant sleeps
• fever medicine if needed
• bulb suction prior to attempts to feed, for infants

And don’t hesitate to get help if you’re really worried. “If you are worried that your child is having a breathing problem, do not hesitate to go to an Emergency Department (ED) near you,” says Migita. “If your child is having severe difficulty breathing, call 911.”

Looking ahead: What parents can expect

So what does all of this mean for the future? It means doctors don’t know exactly how this will all play out. “I think the normal seasonality of RSV has been disrupted during the Covid-19 pandemic, which makes it harder to predict what the seasonality may look like in current times and in the upcoming year,” says Silver.

For now, it’s key to remain focused on what you can do: Keep up those 20-second hand-scrubs, be mindful of others with potential illnesses, consider masking and distancing, and keep your healthcare providers informed of any symptoms.

Experts:

Dr. Russell Migita, Attending Physician and a Clinical leader of Emergency Services at Seattle Children’s

Dr. Kristin Moffitt, Associate Physician in Pediatrics, Division of Infectious Diseases at Boston Children's Hospital

Alyssa Silver, M.D., pediatric Hospitalist at the Children’s Hospital at Montefiore

Dr. Michael J. Smith, professor of pediatrics, Duke University School of Medicine