Our immune systems have certainly been through a LOT in the past few months and years in what has seemed to be one disease onslaught after the other.

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Unfortunately, the assault isn’t letting up, as the US Centers for Disease Control and Prevention (CDC) reports abnormally early onset and high rates of RSV cases, with at least 2 pediatric deaths and an increase in hospitalization rates for children 6 months and younger to seven times higher than before the COVID-19 pandemic.

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Adults, especially seniors, also haven’t been spared as the CDC reports that 6 in every 100,000 seniors have been hospitalized with RSV. While these numbers aren’t as high as those for children, they are still uncharacteristically high for elderly folks and show a ten times increase in hospitalization rates than before the COVID-19 pandemic.

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Hospitals are getting filled to the breaking point. The numbers are undoubtedly grim, and with the holiday season in view, they’re likely not going to get any better. Therefore, following the advice of healthcare professionals, it is crucial to go over the steps to take to prevent and defend against the illness.

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Let’s take a dive into why RSV is on the rise and how to stay safe this holiday season.

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A rundown of RSV

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RSV stands for “respiratory syncytial virus,” a major respiratory virus that affects the nose, throat, lungs and respiratory tract. It is the leading cause of lower respiratory tract infections in babies and young children, and most of them come down with the illness at least once before their second birthday.

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The virus usually makes people sick with cold-like symptoms but can also cause serious illnesses like bronchiolitis and pneumonia.

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Although the illness is more prevalent in young children, it can affect anyone regardless of age.

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Why now?

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We’ve always known RSV to be more of a late fall to winter illness, but we saw it peak earlier this year with much higher case numbers than usual happening around spring into summer and fall months.

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While health officials aren’t exactly sure why this is happening, they say that it is most likely due to the lack of exposure of most children to common germs including respiratory viruses like RSV because of COVID-19 precautionary measures such as hand hygiene, masking, and social distancing.

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This meant that they didn’t get to build natural immunity to these microbes, and now many of the anti-COVID measures have been abandoned and many children have returned to school and other crowded areas, making them more vulnerable to infection and leading to the skyrocketing numbers we’re currently facing.

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Children are usually sicker the first time they have an RSV infection than subsequent infections. Unfortunately, most of them are only now having their first experience with the virus, which explains the severity of the recent trends of the infection.

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A recent study has also revealed a shift in the seasonality of RSV and according to the Centers for Disease Control and Prevention (CDC), the seasonal patterns of circulation of RSV have been disrupted since the start of the COVID-19 pandemic in 2020.

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These may well explain the recent trends in rate and severity of RSV this season.

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How does it spread?

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As with most respiratory viruses, RSV usually spreads via

• Exposure to virus droplets from an infected person when they cough or sneeze
• Direct contact with the virus e.g. kissing a loved one who is infected with the virus
• Contact with a contaminated surface like door knobs or counter

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It’s important to note that those with RSV are typically contagious for 3–8 days. However, some babies and persons with compromised immune systems can spread the disease for up to four weeks–even if they aren’t exhibiting symptoms!

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What are the symptoms like?

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RSV symptoms come in stages and usually show up 4-6 days after getting infected with the virus. They include:

• Congested or runny nose
• Decreased appetite
• Sneezing
• Coughing and wheezing
• Fever

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However, babies who get infected may only show signs of irritability, decreased activity, and breathing problems.

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Adults who come down with RSV may have symptoms usually involving:

• Runny nose
• Sore throat
• Cough
• Headache
• Weakness
• Fever

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Furthermore, RSV may predispose some adults (especially high-risk adults) to more severe conditions like pneumonia and may worsen serious ailments such as asthma, chronic obstructive pulmonary disease and congestive heart failure.

What treatment options are available?

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While there’s been some good news on the development of an RSV vaccine, there remains no definitive treatment for the infection.

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Antibiotics and prescription medicines don’t work against viruses and viral infections usually have to run their course, so most doctors recommend home care which involves hydration and rest. Infected people may also benefit from over-the-counter fever and pain medication. However, please note that Aspirin is not recommended for use in children.

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Caregivers with children over 6 months can arm themselves with fluids, fever and pain relievers, a trustworthy thermometer, a cool-mist humidifier, a nasal suctioning bulb with saline drops, as well as the contact information for their pediatrician, or any nearby urgent care facilities.

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Healthcare professionals advise parents to seek immediate medical attention if their babies show any of the following warning signs: difficulty breathing, grey or blue-colored lips or face, chest pain, belly breathing, rhythmic grunting while breathing, dehydration (dry mouth, sobbing without tears, or hours without urinating), or significantly decreased alertness or interaction when awake.

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You can find nearby hospitals and their wait time here.

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Adults, especially elderly, are encouraged to seek medical attention or even check themselves into an emergency department as soon as they begin to wheeze and feel short of breath.

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Premature infants and infants with underlying medical issues may benefit from Palivizumab (Synagis), a monthly monoclonal antibody medicine that doctors recommend for use during the RSV season to help prevent serious RSV disease in the little ones. Parents can check with their healthcare provider to see if their children qualify to receive the medicine.

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How to stay safe during the holidays

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Prevention remains the best way to steer clear of RSV. Here are some recommended preventive measures health professionals

• Wash your hands regularly and properly with soap and water for at least 20 seconds.
• Cover your coughs and sneezes into your arm or with a tissue and dispose right away
• Stay home and wear a mask if you’re sick and avoid close contact with those who are ill.
• Disinfect frequently touched surfaces often
• Avoid touching your face especially your eyes, nose and mouth

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Furthermore, if you have young children or other high-risk adults nearby, it may be wise to refrain from close contact with someone who appears to be contagious until they feel better.

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High-risk individuals include:

• Premature babies
• Young children with chronic lung disease or a congenital (from birth) cardiac condition
• Children with neuromuscular problems
• Young children whose immune systems have been impaired (compromised) as a result of a medical ailment or medical treatment
• Adults with weakened immune systems
• Elderly folks, especially those with a heart or lung condition

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It’s important to note that RSV is not just a kid’s problem, as there’s been an increase in infection and hospitalization rates in adults and elderly folks. We all must hence take the necessary steps to stay protected this season.

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