What parents need to know about the RSV surge
Just as is the case in much of the nation, patient counts for RSV have spiked on Cape Cod in recent months.
“I've never seen this many children sick with RSV,” said Pediatric Hospitalist Christopher Lops, MD, who practices at Cape Cod Hospital as part of its Pediatric Hospitalist program with Boston Children’s Hospital.
RSV stands for respiratory syncytial virus. It’s so common that most children get it before they turn 2, and the majority of them suffer only symptoms like a mild cold, he said.
“It’s one of the respiratory viruses that would cause something like the common cold in adults, but it can cause a more severe illness in children,” he said. “At Cape Cod Hospital, we’re seeing a lot of children, even four, five, six weeks old, who are presenting with moderate to severe symptoms from RSV.”
While RSV used to be mostly a cold-weather ailment, he’s now seeing patients with the virus throughout the year.
Dr. Lops said there’s no definitive explanation yet for this year’s surge. One theory is that the masking, hand hygiene and social isolation that helped protect people from COVID-19 over the past two-plus years also prevented children from encountering other viruses.
“Children’s immunity sort of waned during the last few years,” he said. “You see a virus every year, you fight it off with an immune response, and then when you see it the next time, you’re supposed to be a little bit stronger. But if you don’t see it for a while, your immune system weakens. The two-, three-, four-year-olds who are getting sicker haven’t seen RSV in quite a long time, and their body is just not as responsive to it.”
RSV causes inflammation and infection in the entire respiratory tract, especially in the lungs, he said.
“You typically see a little bit of a cough the first day or so with a runny nose,” he said. “Then as time goes on, you get a lot more of a runny nose, just tons and tons of secretions from the nose. The cough becomes worse, and then you get a lot of mucus in your lungs that you have to cough up and get out.”
The problem for younger children, he said, is that their cough is not as effective as an older child’s or adult’s at clearing the secretions, so the secretions get stuck in the lungs. “It clogs the airways and makes it difficult for them to breathe. It causes oxygen not to get from their lungs into their blood as easily as it normally does.”
When to Call the Doctor
Parents should contact their pediatrician if a child has difficulty breathing, is breathing rapidly or makes grunting sounds while breathing. RSV can cause a fever, and infants 3 months old or younger with a fever (temperature greater than 100.4 degrees) should always be evaluated, he said.
RSV is contagious, spreading through respiratory droplets when someone coughs or sneezes. “When anyone then comes in contact with that, if they rub their eyes or rub their nose, the virus can get in that way, and then cause an infection,” said Dr. Lops.
Children who have difficulty breathing, are coughing frequently or have a lot of nasal secretions shouldn’t go to daycare or school, he said.
Because RSV is a virus, it’s not treatable by drugs. Parents and caregivers should focus on symptom relief until symptoms pass, typically after a few days in mild cases, he said. In a hospital setting, treatment might include providing supplemental oxygen, monitoring hydration and suctioning the nose.
“You just watch and wait, and you hope that they get better over time, and generally most kids do,’ he said.
Dr. Lops finished with a note of comfort for parents.
“If children need to be admitted to the hospital, we certainly feel comfortable managing them,” he said. “This is our bread and butter. This is something we see all the time, and we feel comfortable managing it.”
