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Utah doctors are on the lookout for possible summer cold seasons

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In normal years, the cold seasons of Utah and the rest of the United States are about to end. But not everyone needs to remember that this year is not a normal year.

Colds are widespread and are believed to be an indirect result of the COVID-19 pandemic. Also, RSV (the respiratory syncytial virus that causes the common cold) is annoying to most of us, but it can be serious for newborns, toddlers, and the elderly.

Utah experienced the typical cold and flu seasons in the fall and winter of 2019-2020. Until the COVID-19 protocol came into force in March 2020 and everything else disappeared.

The flu is gone. RSV is gone, “said Per Gesteland, a pediatrician at the University of Utah Health and Mountain Primary Children’s Hospital and an associate professor of pediatrics at the US School of Medicine. “And we saw almost nothing throughout the respiratory season last year.”

It’s impossible to say for sure, but it seems that the mask and social distance helped prevent colds and the flu.

“Well, that’s the best explanation,” said Andrew Pavia, head of the Department of Pediatric Infectious Diseases at the University of Utah. “It’s often difficult to prove things with a virus because so much is happening, but it’s very likely that your baby isn’t exposed to many other people. I traveled less. … But perhaps the main thing that stopped it was the use of masks and physical distance. ”

Until mid-April this year, cases of RSV began to recur, with coughing, sneezing, stuffy nose, and headaches recurring.

The greatest danger is that, like in other cold seasons, older children and adults can catch it and bring it back to newborns and families with weakened immune systems or heart or lung disease. ..

“Being able to have a mild cold for one person can be a serious infection for someone at risk,” said Gesterand.

Looking down

Doctors in Utah and across the country are worried about what’s happening in Australia. In Australia, contrary to normal, RSV has risen in the summer months of the country.

“Australia has a season in front of us, so it helps us to know what’s coming,” Gesterand said. “Immediately after they lifted the COVID restrictions, they experienced a fairly large summer RSV outbreak. This is quite unusual.”

There have been surges in some Australian cities, but “still doesn’t seem to be consistent across the continent,” Pavia said. “And in the United States, we’ve seen a mess of local increases in RSV, but there’s no clear pattern yet … to see if the Australian experience can be repeated so far. Because of that, everyone is bothered and watching very carefully. We haven’t seen it yet, and we just don’t know. “

The common cold and flu season occurs when temperatures are low, humidity is high, and people are indoors together, but this is not the case in Utah today.

“So we’re doing some of them to avoid a big RSV outbreak this summer,” he said.

But if people get together in a large group and the kids return to jumping into the ball pits of a local pizzeria, these factors may not be important.

Gesteland said he was “at risk, especially during these very rare times,” when trying to predict what would happen with RSV. But what I say, yeah, we didn’t have RSV throughout the season. The virus has not disappeared. And we have a lot of sensitivity to it. “

So even if people get together in a big group, “It’s probably still possible. I don’t really know because I haven’t actually seen an outbreak of RSV in the summer, but in Australia. The story needs to remind us a little that this causes and can cause a significant amount of illness this summer. “

How bad is it?

Tracking an outbreak of RSV is difficult at best — the Utah Department of Health does not track it, the Centers for Disease Control and Prevention has limited information.

Less than 12 cases were reported in Utah last winter. Intermountain Healthcare tracks RSV on the GermWatch website. We have recorded about 70 cases in the last 6 weeks, peaking at 30 cases in the last week of May.

(Not everyone has a cold. Obviously, only patients test positive for RSV.)

It’s not that many — there are 300-500 cases a week during the typical Utah winter — but “it’s very rare to see it in the summer,” Pavia said. “We suspected that things were on the verge of getting going.”

But then the numbers have returned to 10 and 15 in the last two weeks.

“It’s not exploding, but it’s there and smoldering,” Gesterand said. Intermountain is a virus that is not normally found in the heat of summer and has hospitalized many young children, and even slightly older children.

“These are fairly low numbers and we haven’t seen a big surge, but something is happening with RSV that needs to be closely monitored.”

This is all the more so because RSV, unlike influenza, is a “moderately predictable” virus.

“In Utah, it’s coming pretty much as expected around the first week of December,” Pavia said. “There are bad years and bad years, but it’s pretty predictable that they will appear, last for 8-12 weeks, and begin to disappear. Therefore, this is because the world has no ability to predict when RSV will appear. It’s a very unusual situation of watching RSV. “

Twice as sensitive as babies

Whether or not the cold season returns to Utah earlier this year, when it arrives, doctors expect it to be more difficult than usual for the youngest inhabitants of the state. Every year, newborns are more susceptible to RSV. Also, because there was virtually no epidemic of RSV in the past year, babies who would normally have been exposed were not infected.

“If they aren’t exposed to it throughout the season, you just increase the size of the pool for sensitive children,” Gesterand said.

Therefore, in theory, twice the sensitivity and twice the hospitalization of a normal year can occur.

Most people become infected with RSV when they are babies and “begin to boost their immunity and reduce their severity,” Pavis said. “And you repeat it over and over again, and you develop more immunity. Well, now we have no immunity to it and expect to get 1 and 2 years old I have a group of children who may get sick rather than being. “

Gesterland agreed that it was possible.

“I don’t know,” he said. “But usually, if you had it before, it’s not that bad. So older children and adults can get terribly cold in the head and cold in the chest, but usually they get so sick. It will never be. “

Although immunity to RSV weakens over time (and therefore continues to catch colds each year), the fact that most people have not been exposed to a cold in the past year does not necessarily mean that the next cold will be the last cold. It doesn’t make it worse.

“People over the age of 5 with a functioning immune system will not be hospitalized for RSV until they are quite old,” Pavia said, adding that people over the age of 75 are at some risk. ..

Others at risk include those who have had an organ transplant, drugs that suppress the immune system, and patients who are receiving some type of cancer treatment.

Be vigilant

Medical advice on colds hasn’t changed. Wash your hands, sneeze on your elbows, and stay away from others if you feel unwell.

Gesterand advised parents of newborns and toddlers to watch for signs of dyspnea and dehydration. “And if you’re worried about them, check in with your pediatrician.

“It’s a real shame to experience the entire COVID pandemic and get really sick from the last RSV if you’re a little cautious.”

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