Dr. Hossein Sadeghi, a pediatric pulmonologist and director of the Sue and John L. Weinberg Cystic Fibrosis Center at NewYork-Presbyterian Morgan Stanley Children’s Hospital, said that the rise could be due to the loosening of COVID-19 mitigation efforts, such as masking, social distancing, and limitations on travel. “Most children, by the time they were two years of age, had at least one episode of RSV infection, which helped them build immunity,” says Dr. Sadeghi, who is also an associate professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons. “That changed with pandemic precautions and isolations in the past few years.”
With flu already on the rise and concerns for another wave of COVID-19 cases, experts are concerned that the spike in RSV could signal a “tripledemic” this winter. According to the CDC, RSV causes 58,000 hospitalizations and 100 to 300 deaths among children under 5 each year. In adults 65 and older, an estimated 177,000 are infected with RSV, resulting in 14,000 deaths annually.
Dr. Sadeghi spoke with Health Matters to help understand the signs and symptoms of RSV, how to protect your family from the virus, and when to seek medical attention.
Who does RSV affect? Who is most vulnerable?
Dr. Sadeghi: RSV can affect anyone, typically presenting like a cold and usually clearing up with plenty of rest and fluids, but those who are most at risk for developing severe symptoms are premature infants or people with underlying conditions or a weakened immune system. For example, babies who are born after less than 29 weeks of gestation, people who are 65 years or older, and anyone with chronic lung disease, congenital heart disease, or neuromuscular conditions, may experience RSV symptoms more severely.
What are the signs and symptoms?
They typically include a runny nose, coughing, sneezing, wheezing, fever, and a decrease in appetite. Symptoms can appear within four to six days and last for seven to 10 days.
A sign of RSV in babies, which may be more serious since their immune system is still developing, is when they appear to be having a harder time breathing, such as wheezing, nasal flaring, or belly breathing. Belly breathing is when their ribs are visibly going in and out. Another clue is when they are feeding less, meaning their milk or food intake has reduced compared to before.
Why is RSV dangerous for infants?
RSV is more dangerous in babies because their immune system is still developing. In babies, RSV can cause bronchiolitis (inflammation in the small airways of the lungs), pneumonia, or croup, which can lead to breathing difficulties and a persistent cough. For premature babies, they could end up in the intensive care unit.
What are your recommendations for parents? How can they tell the difference between RSV and other viruses, like COVID-19?
Caregivers should be vigilant about infection control, know the signs and symptoms, and when to seek medical attention — the sooner the better. It is hard to distinguish one virus from another, so it is best for parents to contact their child’s pediatrician if the child is displaying signs and symptoms of RSV that continue with little to no improvement.