Why is RSV so bad this year? Covid-19 may make it worse.

Suspension

Staff in US hospitals – Especially in the children’s suites We saw a sharp rise in the number of patients with RSV this fall.

According to experts, the virus came earlier and hit harder than it has in most years. Infectious disease specialists worry about what will happen to the health care system in the case of respiratory syncytial virus, influenza, and COVID-19 Peak at the same time – “three-dimensional”, as one expert called it.

RSV primarily affects children, but the sudden rise would tax all parts of the medical system. as in Corona Virus The worst days of the pandemic, elective surgeries can be paused again, doctors’ offices can be flooded with calls, and people can fill emergency rooms.

Here’s what RSV is and why it’s becoming a problem on such a large scale:

RSV is a common respiratory virus that causes cold-like symptoms in most people. Adults can usually clear RSV within a week or two. But it’s a different story for children under the age of 1.

The virus is usually behind bronchiolitis (inflammation of the small airways in the lung) and pneumonia (inflammation of the lungs) in children under one year of age. According to the Centers for Disease Control and Prevention. An estimated 58,000 children under the age of five are hospitalized each year in the United States with RSV, according to the CDC. Between 100 and 500 children under the age of five die each year from respiratory syncytial virus.

RSV, other viruses make it hard to find beds in children’s hospitals

The virus can give children a fever, runny nose, cough, and difficulty breathing. So how do you differentiate RSV from influenza or covid-19?

“It’s almost impossible,” said Thomas Murray, an assistant professor at Yale University School of Medicine who specializes in pediatric infectious diseases.

There is a rapid antigen test, but it cannot be done at home like coronavirus tests.

Murray said RSV, unlike the coronavirus, spreads more through surfaces than droplets. He suggests sanitizing high-touch areas such as toys, doorknobs, kitchen tables, and bathroom sinks, along with washing your hands.

“Where these infections have spread over time, they are all occurring simultaneously now,” said Celine Gunder, MD, associate clinical professor of medicine at New York University’s Grossman School of Medicine.

Simple physics is another reason children under age 1 struggle with RSV: They have smaller airways, so they’re more likely to need oxygen or treatment, because inflammation affects them more severely.

Why is RSV so bad this year?

Experts agree that people have done the right thing by wearing masks and social distancing due to the coronavirus, but not interacting with germs has made our bodies less resistant to disease.

Small interactions with viruses primes our system to better handle future virus exposure. After years of school cover-ups and social distancing, children have fewer biological defenses to fend off multiple viruses at once. Most children under the age of 3 have never known a world free of COVID-19, so they don’t have their immune systems. Part of this is also a numbers game – the more months viruses circulate, the better the immune system can be caught by surprise.

All this means that young children are almost helpless against all the respiratory viruses that thrive during the winter.

Elizabeth Mack, chief of the pediatric intensive care unit at the Medical University of South Carolina, said she’s been getting calls from employees in nearby states asking if she has cribs in her facilities.

“Children’s hospitals in this country are now flooding,” she said.

Mack said respiratory syncytial virus is the most common reason children are hospitalized. She said the RSV season usually begins in October. This year, the wave started in September or even August.

“Looks like she’s back early,” she said.

For decades, fear and failure in the search for an RSV vaccine. Now, success.

There is no research to show that RSV has changed. Instead, we have .

Cases starting a month or so ago may not seem like much, Mack said, but there are other disruptive forces beyond anyone’s control: She expects a worse flu season in South Carolina because Hurricane Ian delayed delivery influenza vaccines.

The epidemic caused the emergence of RSV and influenza New ways and strange times of the yearsaid William Schaffner, MD, medical director of the nonprofit National Foundation for Infectious Diseases and professor of infectious diseases at Vanderbilt University School of Medicine.

“It was just that the children were protected from it,” he said.

Covid makes flu and other common viruses work in unfamiliar ways

Unlike measles or mumps, people can get RSV multiple times during their lives. Once the virus has run its course, Schaffner said, people usually have greater immunity for a year or two. But this has become a problem, with all the different respiratory illnesses thriving during the winter.

“There are some of us who are concerned that we might have a triple disease” of respiratory syncytial virus converging COVID-19 and influenza, Schaffner said.

Gunder said there is no government-approved vaccine against respiratory syncytial virus (RSV).

For half a century, she said, researchers have tried to develop a vaccine or treatment for RSV They are closer than ever.

“We may have one in five years or so available for young children under five,” Gunder said.

She said there are two expected ways to vaccinate children against the respiratory syncytial virus: direct injection and vaccination of the person carrying the child.

This is particularly exciting for the medical community, Gaunder said, because so few vaccines are given to babies younger than 6 months old. Babies are born with antibodies provided by their mothers, and research shows that vaccines given during that time may not be as effective as those given later.

There may be no cure, but there is a preventative drug for respiratory syncytial virus. Schaffner said Palivizumab, sold under the name Synagis, is a monoclonal antibody treatment given to at-risk infants before the RSV season.

But, as with the coronavirus, doctors prefer active vaccination that gives the body what it needs to create its own protection rather than treatment with monoclonal antibodies. Think of it as teaching the body to fish versus just giving it a fish.

What do I do if my child has RSV?

Aside from cold-like symptoms, Gunder said there are other signs of a serious case of respiratory syncytial virus — children may be more irritable, not feeding well, and appear to be lethargic or coughing to the point that they can’t breathe.

Another sign of a severe case of respiratory syncytial virus is if a child “pulls,” which Gunder described as a struggle to breathe, and pulls on the skin around the ribs or collarbone.

Most of the focus was on kids getting RSV and filling out pediatric units, but seniors too vulnerable to virus. The advice from the experts remains the same: wash your hands, clean surfaces, and seek medical attention if someone is not doing well.

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