The resurgence of the pediatric virus could put a strain on the ICU, experts warn

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After all, the pediatric virus has been resurrected, except that it disappears during the pandemic, and pediatric health officials are preparing for the expected tough years.

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The author of a commentary on the Canadian Medical Association Journal warns that the expected resurgence of RSV, a common and sometimes serious pediatric virus, “may expand resources in pediatric intensive care units across Canada.” increase.

Its off-season revival, which may begin this summer, has already addressed the growing mental health crisis among children and adolescents, as well as patients who were delayed in treatment and treatment during the pandemic. It happens because you are. Authorities are also monitoring the possibility of a fourth wave of COVID-19.

The relaxation of pandemic restrictions has led to a surge in RSV cases in Australia and parts of the United States.

In Ottawa, there are already signs that may happen.

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Dr. Lindy Samson, CHEO’s Chief Staff and Chief Medical Officer, said last week that the number of children appearing at the Brewer Assessment Center to be tested for COVID-19 has skyrocketed. The majority of those children do not have COVID-19. However, they carry the virus — a common species in children, but almost disappeared in the early stages of the pandemic. Last week, Brewer met up to 250 children a day.

In Ottawa, we have not yet seen cases of RSV (Respiratory Syncytial Virus), a common virus that affects the lower respiratory tract and can cause serious illness and even death. However, health officials need to be prepared and warn the authors of the commentary presented at the CMAJ last Monday.

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Canada needs to predict the recurrence of the respiratory virus “because the physical distance measurement of COVID-19 has been relaxed”. And that would put vulnerable children at risk, the author writes.

“The out-of-season resurgence of the seasonal respiratory virus can now pose a threat to vulnerable babies,” wrote Dr. Pascal Lavois and co-authors at the BC Children’s Hospital Institute.

According to Samsung, RSV is the most common reason for hospitalization of first-year-old infants and is often associated with bronchiolitis. Premature babies and infants with immunodeficiency are particularly vulnerable to the serious consequences of RSV infection.

Infants in Canada’s Arctic, including the Nunavut Territory, have the highest incidence of RSV in the world, requiring preventative treatment for all babies there. There is no vaccine against RSV, but there are preventative therapies given monthly to the most vulnerable babies, usually beginning in late autumn, at the peak of the viral season. Many babies in the Nunavut Territory who become seriously ill are taken to CHEO for treatment and often use ventilators.

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For most children and adults who have antibodies, the virus causes mild cold-like symptoms.

November-January is usually the busiest period of RSV in CHEO, with more than 200 infants hospitalized each year.

But this year was not a typical year.

In 2019-2020, CHEO recorded a positive test for RSV 455. From autumn to winter 2020 to 2021, when mobility was restricted and public health restrictions were in place, the RSV test was positive six times and there was no hospitalization, Samson said.

In Canada as a whole, there were 239 RSV-positive cases from August 29, 2020 to May 8, 2021, compared to 18,860 cases in the same period last year (August 25, 2019 to May 2, 2020). was. According to the CMAJ commentary.

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“The virus seems to have disappeared.”

Samsung is concerned that this year’s resurrection will create a “double cohort” of vulnerable children, as few have been exposed to it since the pandemic began.

“We have two birth cohorts that would not have been infected.”

With the resurgence of RSV in Australia, the median age of infected children was 18.4 months, compared to 7.3-12.4 months in the previous year.

“This may suggest that infants who were not exposed to RSV in the first year did not develop sufficient immunity and thus remained susceptible until the second year,” CMAJ commented. The author writes.

In addition, the authors write that the baby was not exposed to the boosted antibodies in the womb, which could lead to illness if infected this summer. They suggest that prophylactic treatment of the highest-risk babies is given in the summer if the cases increase to the levels normally seen in the fall.

CHEO Samson said the big message from the rise of RSV in other parts of the world is that people do not go to work because of illness, even if they do not have COVID-19, but with great care. It means that you have to keep washing. To prevent the spread of the infection.