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Baystate Children’s Hospital sees respiratory virus recurrence as COVID measures have been lifted

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SPRINGFIELD — Community mitigation efforts enacted to curb the spread of COVID-19 are believed to have reduced infections with other respiratory viruses, but when safety measures are lifted, these viruses are released. There is a possibility of resurrection.

Centers for Disease Control and Prevention Health alert network On June 10, we issued a recommendation that the most common seasonal respiratory syncytial virus activity in the United States in the fall, winter, and spring is increasing in parts of the South.

Dr. Christine A. McKiernan, director of the Pediatric Intensive Care Unit at Baystate Children’s Hospital, said the warning only made pediatricians aware of the increasing prevalence of RSV, which hospitals approximately 58,000 children annually in the country. Not other people such as day care providers.

“This allows day care providers and others to recognize that other respiratory viruses may be found and need to be prepared, even though the COVID rate is declining.” McKiernan said. “Are we going to test these kids? How does that affect the quarantine protocol?”

“The country has transitioned from everyone masked to everyone without a mask very quickly,” McKiernan said, and as a pediatrician, “there may be a surge in other respiratory viruses.” I’m worried. ” When field learning begins again in the new semester, she sees safety measures such as masks as “things to consider at this point.”

“I think about what it means for kids to go back to school in the fall,” McKiernan said. “What does this mean for masking and some interventions done to reduce the risk of COVID-19? Not only to reduce the risk of COVID, but at least to reduce the risk of all these respiratory viruses. You need to continue with them until your children are vaccinated with COVID. “

The Baystate Children’s Pediatric Intensive Care Unit saw the first case of RSV at the end of May this year, McKiernan said. In general, all other such “Virus infection All precautions taken against COVID have been much lower in the last 15 or 18 months. “

RSV infection Generally causes mild cold-like symptoms, Severe in infants and the elderly.. The CDC encourages testing for RSV among patients with acute respiratory illness who are negative for COVID-19. RSV result is about 2.1 million Outpatient visit It can be transmitted to children under the age of 5 each year, but to children of all ages.

“Usually, from November to March in winter, we see 5 to 10 cases of RSV per week in the pediatric intensive care unit,” says McKiernan. “The floor is more visible. In January and February, there can be 15 to 20 babies between the two units on a particular day, not to mention those coming from the emergency department. This year’s ED There were no swabs positive for RSV or influenza A or B this winter. “

She referred to a recent report of RSV cases from Australia, located in the Southern Hemisphere, where summer is December-January. Researchers there analyzed data showing a decrease in RSV cases in children in the western part of the country when safety measures against COVID-19 were implemented. Increasing number of cases As these measures have been lifted, “the median seasonal peak from 2012 to 2019 has been exceeded.”

The reasons cited, including the increase in median age from 12.5 months to 18.4 months, were that many infants had never been previously exposed to RSV and had overall weakened immunity.

“When they took off their masks in the summer, we saw a surge in respiratory virus. Our respiratory virus pattern was actually reflected six months later, so we in pediatrics prepare for it. I think we do, “says McKiernan. “It’s always a good idea to be prepared. If that doesn’t happen, you’ll feel better than being surprised when it happens.”

Besides that Recent surge For RSV, Australia Also reports Influenza-like illness activity has been steadily increasing since January, but at historically low levels for the country.

Vaccines against pandemic viruses over the age of 16 were approved in December and recently expanded to over the age of 12, significantly reducing the prevalence of COVID-19 in regions of the United States where vaccination rates are high.

However, McKiernan feels that the release as a result of safety measures and the potential for this to increase the circulation of other respiratory viruses poses a challenge, especially for children who are too young to be vaccinated with COVID-19. ..

“Parents aged 3-4 years with symptoms of a respiratory cold are not always in a hurry to a pediatrician, but parents need to know that RSV is there and is contagious. “McKiernan said. “It will be a little confusing for those traveling this summer or returning their children to day or summer care programs. Distinguish between RSV and COVID and when they have these symptoms and have not been tested for RSV. The situation is a little complicated when you think about keeping your child at home. “

McKiernan said the school year one year ahead would be “confused,” also in terms of precautions that should be taken specifically to protect people who are too young to be vaccinated. She urged her family to vaccinate members over 6 months with seasonal flu and consider COVID vaccination now and when expanded to include people under the age of 12.

“There may be an 8-year-old who has respiratory symptoms and comes to class and coughs,” said McKiernan. “Do you want to quarantine the entire class or test her for RSV? We know you can have RSV and COVID. This is because adults have not yet been vaccinated. It’s not just children who don’t have access to that protection. Continuing to wear masks when they’re back in school and nearby is another argument. “

According to the CDC’s recommendations, the circulation of seasonal RSV is diminished, so “older infants are more likely to have not been exposed to RSV at normal levels in the last 15 months, resulting in RSV-related weight It may increase the risk of serious illness. “

Some states other than the south Watching an increase Virus detection this spring is less than normal.

RSV is an RNA virus that spreads mainly through infected respiratory droplets when coughing or sneezing, and through direct contact with contaminated surfaces.that is Most common cause Development of pneumonia and bronchiolitis (an inflammatory condition of the small airways of the lungs) in children under 1 year of age in the United States.

“Slight inflammation of the baby’s airways can make it difficult to breathe and can start to block the airways,” says McKiernan. “RSV can be very severe in younger children and children with other medical conditions, children with premature birth or asthma, and children with other medical conditions.”

People infected with RSV are usually infected for 3 to 8 days, but can be infected with the virus for up to 4 weeks after the symptoms disappear. CDC for children Often exposed When infected with RSV outside the home, such as in a school or nursery, it can infect other members of the family with the virus.

The virus can survive for several hours on hard surfaces such as tables and crib rails.

According to the CDC, RSV causes approximately 58,000 hospitalizations each year in the United States, killing 100-500 children under the age of five and 177,000 and 14,000 adults aged 65 and over.

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