Why children have out-of-season RSV

Local doctors are concerned about an increase in cases of common respiratory illnesses that primarily affect children. COVID-19 precautions almost eradicated last winter, but in that typical season, masking and distance loosened, returning to revenge.

Respiratory syncytial virus (RSV) is a very common virus that infects almost all children before the age of two, but does not affect everyone in the same way. As we learned at the mass level at COVID-19, RSV tends to cause serious illness in more vulnerable groups, such as newborns, premature babies and immunocompromised babies, and common colds in other groups. I will pull it.

Doctors throughout the federation reported a strange year of RSV, There are few cases in winter, and bursts occur in summer. One of the main reasons is that small children did not have the opportunity to boost their immunity.

Boston.com asked two healthcare professionals in Boston about why doctors are concerned about the severity of RSV, how to treat it, and the increased incidence of common illnesses.

How RSV Appears in Children

RSV is a common respiratory virus that often manifests as a mild cold, but can cause pneumonia and bronchiolitis in vulnerable populations. According to the Centers for Disease Control and Prevention.. Unlike COVID-19, adults infected with RSV from children often have mild colds and are not at risk of serious illness.

Dr. Eileen Costello, director of outpatient pediatrics at the Boston Medical Center, saw RSV “tons” and symptoms usually started with a runny nose and cough, worsened in 3-5 days, and most recovered after 7-10 days. I said I would start. days. RSV, like COVID-19, is diagnosed as a nasal swab. Dr. Ben Nelson, a Massachusetts general pediatric pulmonologist who treats patients with RSV in many situations, said he doesn’t even know that he has RSV because doctors don’t test for RSV unless he has a serious illness.

“Symptoms range from fever, cough, runny nose to respiratory failure,” Nelson said. “The majority of patients develop only mild symptoms.”

According to Costello, children at high risk of serious illness due to RSV usually receive monoclonal antibody therapy called SYNAGIS. This is a series of injections for 5 months during the RSV season. The early onset of RSV this year meant that BMC began delivering antibody therapy in the spring rather than in the fall or winter.

According to Costello, children are usually hospitalized when they do not get enough oxygen and nutrients, most commonly with oxygen and infusions, with intermittent fluid aspiration and humidification. In rare cases, the child can be placed on a ventilator to help the lungs heal.

How COVID-19 Affects the Epidemic of RSV and Why Doctors Are Concerned

Like the flu, the height of the RSV season is from November to March or April, but last year it was clearly different.

“Every year, we find that the virus requires patients to be hospitalized,” Nelson said. “But this year is quite different. Now we see more children with RSV than usual … and they are more seriously affected. Now it’s very rare to see so many RSVs. It’s rare. “

Data collected by the Centers for Disease Control and Prevention show how typical patterns of RSV were destroyed by COVID-19 quarantine precautions. RSV cases and tests surged in the fall and early winter of 2019-2020 and declined in the summer, but unusually, there was no increase in cases in the fall and winter months. Tests increased because doctors knew they were wary of the virus, but cases did not, but instead began to skyrocket from May 2021 to the summer months.

“We believe that the mitigation strategies used to prevent COVID also prevented RSV and influenza,” Costello said. “As soon as we started to wear masks and relax and the kids started cheeky back to day care, we started watching RSV in the spring and summer. That’s when we usually don’t see it. That’s an interesting epidemiological fact. “

According to Nelson, most children exposed to RSV build innate immunity over time, plus low circulation levels, which means that RSV does not spread much during this time. However, with people quarantining and closing schools and day care, innate immunity is now much less.

“Now, nurseries and schools are reopening, children are spending more time around each other, and they are starting to spread these viruses among themselves again, due to lack of exposure last year. The level of innate immunity is low. These children are now exposed to these viruses for the first time and are quite ill, “Nelson said. “That’s why the number of children infected with RSV is increasing. In fact, for the same reason, I’m worried that many viruses will come back with revenge this fall and winter.”

She didn’t have available hospital data, but Costello speculated that BMC was managing more RSV hospitalizations and said there were some this year.

“I’m more worried. Almost every child in the world was infected with the virus between the ages of 0 and 2, and so many children in that age group were at home and interacting with each other. I didn’t. Others … I think the number is very high, as the entire cohort of children that wasn’t available last year will be available this year, and some children are between the ages of 0 and 1. ” Said. “I don’t have the answer yet, no one does, whether or not they get tougher.”

Costello and Nelson encourage families to protect themselves, their children, and others by being vaccinated against the flu, washing their hands, and taking standard public health precautions when their children are ill. I urged you.

“I really believe in wearing a mask, and I learned a lot about how safe the world is, especially for infants who are not COVID or vaccinated,” Costello said. “For me, it makes a lot of sense for a child who can wear a mask to wear a mask.”