Soaring cases of respiratory syncytial virus, or RSV, among young children are threatening to overwhelm already struggling pediatric hospitals, as experts warn the common infection—largely benign but potentially lethal to infants and the elderly—could collide with expected spikes in flu and Covid to devastating effect. Here’s what parent’s need to know about RSV:
RSV is a common respiratory virus that can cause mild, cold-like symptoms including runny nose, coughing, sneezing, decreased appetite and fever, according to the CDC.
Symptoms usually appear within four to six days of infection and usually appear in stages, not all at once, the agency said, adding that for very young infants the only noticeable symptoms might be irritability, decreased activity and breathing difficulties.
Though most infections clear within a week or two, RSV can cause serious problems in very young infants under the age of one, older adults and those with weakened immune systems and can trigger more severe infections like bronchiolitis (inflammation of small airways of the lung) and pneumonia.
There are no specific treatments for RSV beyond managing symptoms and the CDC recommends keeping children hydrated and over-the-counter drugs like ibuprofen and acetaminophen (or paracetamol, which is sold under brand names like Tylenol and Panadol) to help with pain and fever, with especially ill children possibly needing hospital to help with breathing like oxygen or mechanical ventilation.
People infected with RSV are usually contagious for three to eight days, according to the CDC, and the virus—which can survive for hours on hard surfaces like tables and door handles—spreads through coughing and sneezing.
There is no approved vaccine for RSV and experts say the best way to avoid infection is to avoid the virus itself with measures including frequent hand washing, teaching children to cough into tissues or elbows, sanitizing frequently touched surfaces and objects like toys, door handles and sinks and avoiding contact with sick people.
Children’s hospitals across the U.S. are battling a surge of RSV infections and many are struggling to cope with the influx of patients. It is not unusual for hospitals to face a surge of RSV infections in winter, but the dramatic spike is both unseasonably early (RSV usually circulates November through March) and unusually severe. It is also on a collision course with a number of other dangerous respiratory viruses like flu and Covid, a “tripledemic” many experts feel will further strain the country’s already stretched healthcare system. Though highly contagious and ordinarily ubiquitous—the CDC says “virtually all children” have had an RSV infection by the time they are two years old—many children under the age of three haven’t encountered the virus owing to the infection prevention measures put in place during the Covid-19 pandemic. Experts believe this gap in immunity and recent drop of most pandemic curbs is driving the explosive and possibly out-of-season growth of RSV and other respiratory viruses around the world.
2.1 million. That’s how many outpatient visits stem from RSV in children younger than five each year, according to the CDC. The infection kills for between 100 and 300 children under five each year and hospitalizes 58,000 hospitalizations, the agency estimates. Worldwide, RSV is one of the most common reasons for infants to be admitted to the hospital and is the biggest killer of young infants after malaria.
RSV is also a huge problem for older adults. In the U.S., the virus is responsible for 14,000 deaths in adults aged 65 and over every year, according to CDC estimates, as well as 177,000 sickened to the point of needing hospital care.
What To Watch For
Scientists have struggled for decades to create a vaccine to combat RSV but after years of setbacks, several candidates are racing towards the finish line backed by some of pharma’s biggest players. Moderna, Johnson & Johnson, Pfizer and GlaxoSmithKline are among those with vaccines undergoing late-stage testing, with the latter two the furthest along and expected to seek regulatory approval in the near future. Though trials have predominantly focused on older adults, who are also at risk from RSV, Pfizer is trialing the shot on pregnant people with the hopes of passing protection on to the unborn child. Other firms, such as AstraZeneca, are testing whether antibody treatments could help protect infants against RSV. There is already one antibody treatment on the market to help protect children against RSV through preventative injections, called Synagis, though it does not teach the body how to fight off the virus itself, is expensive and access is limited to a small subset of at-risk children.
Full coverage and live updates on the Coronavirus