Viral Concerns: Keep Your Children Safe from the RSV Virus

We have battled COVID-19 for about 18 months, during which time we’ve managed to suppress the virus by following public health advice to wear masks, social distance, sanitize our hands and get vaccinated. 

But a troubling trend has emerged as we’ve relaxed our safety behaviors and resumed spreading viral droplets: more children and adults are showing up at doctor’s offices and, in more severe cases, hospitals with viral illnesses that include respiratory syncytial (sin-SISH-ul) virus, or RSV.

RSV, a common cause of bronchiolitis and pneumonia in children under one, also poses significant health risks to premature infants, the elderly, people with heart and lung disease, or anyone with a weak immune system (immunocompromised).

Pediatric Infection Specialist Stephanie Stovall, M.D., tells us what we need to know about this summer’s unusual uptick of viral activity and RSV.

What happened to our winter flu season?

According to the experts, our safety behaviors have worked wonders in helping protect us not just from COVID-19 but also other common illnesses. For example, in terms of reported cases and deaths, there wasn’t much of a flu season this year.

“Our flu season was the mildest on record,” says Dr. Stovall, chief of quality and patient safety at Lee Health. “The same safety measures we practiced to stop the spread of COVID-19 worked well, along with flu vaccinations, to really protect us from influenza.”

According to the Centers for Disease and Control (CDC), the hospitalization rate for the 2020-21 flu season was 0.7 per 100,000 people—the lowest rate ever. The agency also reported a single pediatric flu death compared to 196 in the 2019-20 flu season.

But while our safety behaviors helped knock down infection rates of COVID-19, public health experts have become alarmed by a summer spike of respiratory-related illnesses, especially with RSV. More children and adults were contracting RSV at higher rates than in previous years this summer.

RSV infections occur primarily during the fall and winter cold and flu season, according to Dr. Stovall. However, she says that since late March, the CDC has observed an increase in RSV detections. 

The surge in RSV cases led the CDC to issue an advisory warning to doctors and other healthcare providers about the virus, which can cause pneumonia, especially in young children and babies.

Why are more people getting sick in the summer?

“The increase in cases is indeed unusual for this time of year, but epidemiologists and infectious disease experts predicted a surge in respiratory viruses as we return to our new normal,” Dr. Stovall explains. “A key reason for the rise in cases is that the pandemic kept people at home, which didn’t allow their immune systems to build up recent familiarity with these common viruses and kept them from spreading person to person. The more respiratory virus seasons you have under your belt, the better your immune system is in fighting these infections off.”

Dr. Stovall says the CDC’s advisory encourages healthcare providers to consider testing their patients with acute respiratory illness for RSV if they have tested negative for the virus that causes COVID-19.

How RSV spreads

Respiratory syncytial virus spreads easily when the virus gets into a person’s eyes, nose, or mouth either through touching or by close respiratory contact like kissing, sneezing, or coughing. RSV can survive on hard surfaces for many hours. If a person touches it and then touches their own eyes, nose, or mouth, they become infected.

Symptoms

Adults and older, healthy children with RSV typically experience mild, cold-like symptoms. Self-care measures will usually do the trick at relieving any discomfort.

Signs and symptoms of RSV most commonly appear about four-six days after exposure to the virus. In adults and older children, RSV causes mild cold-like signs and symptoms that include:

• Congested or runny nose
• Dry cough
• Low-grade fever
• Sore throat
• Sneezing
• Headache

In severe cases of infection, RSV can spread to the lower respiratory tract, causing pneumonia or bronchiolitis or inflammation of the small airway passages entering the lungs.

Signs and symptoms of severe RSV infection may include:

• Fever
• Severe cough
• Wheezing — a high-pitched noise that's usually heard on breathing out (exhaling)
• Rapid breathing or difficulty breathing — the person may prefer to sit up rather than lie down
• Bluish color of the skin due to lack of oxygen

Dr. Stovall warns that infants are especially at risk for severe infection from RSV.

“The signs and symptoms of severe RSV infection in infants may include short, shallow and rapid breathing, a struggle to breathe, coughing, poor feeding behavior, tiredness, and irritability,” Dr. Stovall notes.

“Most children and adults usually get better in one-two weeks after onset,” Dr. Stovall says. “Severe or life-threatening RSV infection in premature infants or anyone with chronic heart or lung problems may require hospitalization.”

Each year in the United States, RSV leads to approximately 100-500 deaths among children younger than five years old and 14,000 deaths among adults aged 65 years or older.

When to see your doctor

If your child or any family member who is at risk for severe RSV infection develops breathing difficulties, a high fever, or their skin turns blue, particularly on the lips and in the nail beds, see your doctor immediately.

How to help prevent RSV infection

According to Dr. Stovall, RSV has no vaccine. “To prevent the spread of RSV, we should use the behaviors we learned during COVID-19,” Dr. Stovall says. “Wash your hands frequently, cover your mouth and nose when you cough or sneeze, limit contact with people who have fevers or colds, and keep things clean, such as the kitchen, bathroom, doorknobs, and handles.