Jun 10, 2021 - Health

Doctors see a delayed seasonal surge of RSV in children

Data: CDC; Chart: Sara Wise/Axios

Children's hospitals and pediatricians across the country are bracing for pediatric emergency visits after seeing an unseasonably high spike in cases of respiratory syncytial virus, or RSV.

Why it matters: A year of masking and social distancing due to COVID led to an absence of other respiratory illnesses like RSV, which has no vaccine and can be dangerous in young children and the elderly. But that break appears to be over.

What's happening: Pediatricians in the U.S. have been treating handfuls of RSV cases in February and March but have seen increases in recent weeks as if it were peak season in winter, Matthew Linam, pediatric infectious disease doctor at Children’s Healthcare of Atlanta, told Axios.

By the numbers: Hundreds of RSV detections have occurred weekly since April with surges in May leading up to nearly 500 cases each week, according to the Centers for Disease Control and Prevention.

  • Cities around the U.S. including Tampa, Atlanta and Columbia, S.C. have seen case rates well above normal for the summer months.
  • Australia's warmer months last year also showed a delayed spike in RSV cases as COVID restrictions lifted. 
  • These viruses never totally go away, even in the warmer months, Gary Whittaker, a virology professor at Cornell University, told Axios. "As soon as there are new kids to infect, it’ll take off," he said.

Be smart: A pre-print paper published in Pediatrics on Wednesday showed about two-thirds of infants with RSV were admitted into Maimonides Children’s Hospital in New York City between March 1 and May 8 of this year.

  • 81% of those admitted were put in ICU. Six children were put on a ventilator.
  • “Our data indicates more severe disease in younger infants possibly due to diminished immunity from lack of exposure to RSV in the previous season," Pediatrics authors Rabia Agha and Jeffrey Avner write. "Continuing closures of daycare centers and virtual schooling may have resulted in less spread of the disease to older children."

What's next: As more schools and daycare centers reopen in person for the fall, doctors also see a benefit for rapid COVID testing in homes and schools to help rule out coronavirus outbreaks and identify other respiratory infections like RSV rather than guess and send children home.

  • Though experts are unsure how long the surge will last or how many more children it will affect, these early indications show parents should try to keep kids home and away from others if they are sick.

The bottom line, per Agha and Avner: "Institutions should plan ahead for an increase in pediatric emergency visits and potentially a need for increased pediatric ICU capacity in the coming weeks."

Go deeper: Get ready for the return of regular sicknesses

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