RSV Season: Local expert weighs in on virus that’s putting parents on edge

The rise of Respiratory Syncytial Virus, or RSV, has parents on the edge. According to the CDC, more than two million children under five years old are hospitalized with RSV in any given year. This year, the CDC estimates that number to be seven times higher.

“It’s unprecedented how early the virus arrived,” says Jacob Maciejewski, MD, a pediatrician at ProMedica Physicians – Oregon Pediatrics, adding that the virus usually peaks in February and that the influx of cases happened both last year [2019] and this year [2022] . ”

Dr. Maciejewski
Dr. Maciejewski has been practicing for 14 years and has never seen this many RSV cases.

What is RSV?

RSV is a viral infection that causes bronchiolitis – an infection in the small airways (bronchioles) that is seen mostly in children under two years of age. Those airways are lined by smooth muscles that provide an easier route for the virus, as opposed to bronchitis in adults where those airways are lined with cartilage. In children, those smooth muscles are more prone to mucus production and clogged airways that lead to wheezing (one of the more common symptoms of RSV).

The virus is transmitted by touching a contaminated surface and then touching eyes, mouth, or nose, or by being near an infected child or individual who sneezes or coughs. Symptoms generally begin to show within four to six days after being infected. Dr. Maciejewski says children’s bodies can usually fight it off in a week or two, but 50 percent of kids carry a cough for two weeks and 10 percent can carry it for a month after onset.

The Reason for the Influx of Cases

The rise of RSV can be directly correlated to children and infants not being exposed to common respiratory viruses, according to Dr. Maciejewski – something that carried over from the pandemic. “Parents and caregivers kept their children home and kept them out of daycare, so this could be the first time they’re exposed to the virus.”

Dr. Maciejewski says that close to 100 percent of people get infected with RSV in the first two years of their life, so kids who may have been staying home for a large part of the pandemic may not have ever been exposed. “We’re seeing more cases because kids who should have gotten it last year didn’t get it… couple that with this year’s kids who are just now getting it, and it’s the perfect storm.”

“When you look at the news and reports, everything is focused on children, but this [virus] affects everybody – from newborns to the elderly population.”

There is also a higher transmission rate from child to child. “Usually adults can shed the virus for three to seven days after onset of symptoms, but in children, they can shed RSV for several weeks. It’s a reason why this virus is so contagious.”

Confusing RSV with the Cold or Flu – The Symptoms Parents Need to Look Out For

Symptoms of RSV generally consist of a runny nose, coughing, sneezing, and the aforementioned wheezing. Some of the more severe cases are seen in premature infants, children under six months old, and children with underlying heart disease or cardiopulmonary diseases.

With COVID-19, the common cold and influenza all prevalent recently, it can be difficult for parents to tell the difference. Parents can use an over-the-counter PCR test kit to determine the illness. Depending on insurance, parents can secure a test at no cost. There is also a handy chart that lists all symptoms related to RSV, the cold and the flu, courtesy of Nationwide Children’s Hospital.

However, Dr. Maciejewski says parents’ first step should be to contact their family doctor or pediatrician if their child(ren) show symptoms. “If a child is having difficulties breathing, that’s a sign that they need to be seen right now.”

Once RSV is diagnosed, parents can begin a treatment plan. Antibiotics won’t be prescribed because this is a virus. Instead, a pediatrician may advise giving the child acetaminophen or ibuprofen if they’re under six months old, using a cool-mist humidifier and providing plenty of fluids to remedy some of the symptoms.

How Can Parents Keep Their Families Healthy

While there is no definitive way to completely avoid RSV, prevention measures are always possible. “It all comes down to hand washing,” says Dr. Maciejewski. The CDC recommends washing hands with soap and water for at least 20 seconds, covering coughs and sneezes with a tissue or your upper shirtsleeve, not your bare hands, and avoiding touching eyes, nose, and mouth with unwashed hands. Parents should also develop a habit of cleaning their child’s toys.

While a vaccine would provide the best defense against RSV, there is no vaccine, but Dr. Maciejewski says there is definitely “hope” on the horizon to get one produced.  He says if and when it happens, it would most likely be given to mothers in their third trimester of pregnancy, which is very similar to the Tdap vaccination, so the mother can develop antibodies that are passed through the placenta to the infant that would provide some protection.

Dr. Maciejewski reminds parents to remain patient with their family doctors. “Bear with us in our primary care offices, our urgent cares, and in our emergency rooms. We’re doing the best we can with the resources we have to help everybody.”