Pediatricians around the country are concerned about the number of children coming down with severe cases of respiratory syncytial virus, or RSV.
Emergency rooms, urgent care clinics, and ICUs are filling up earlier than usual this fall — a trend doctors believe is due in part to kids reentering school and daycare with COVID restrictions relaxed.
But little kids aren’t the only ones catching RSV right now — their infections are just especially noticeable. RSV can cause dangerous cases of bronchitis and pneumonia in young children, which make it a leading cause of hospitalization for babies younger than 1. At least 100 children die from RSV every year, according to the Centers for Disease Control and Prevention.
One reason the illness hits babies so hard is because they have little to no immunity built up against the virus. In addition, their small size makes them extra vulnerable.
“They get into wheezing and difficulty breathing — the tiny little airways are filled with mucus,” Dr. Per Gesteland, a pediatric hospitalist at the University of Utah Health and Intermountain Primary Children’s Hospital, told Insider.
You’ve probably had RSV before, and you’ll probably get it again
Normally, kids get RSV at least once by the time they’re two years old, but that didn’t reliably happen during the pandemic, as many daycares shuttered and caregivers masked up. That means that some toddlers, too, are getting severe cases of RSV right now — though most still have mild infections that can be managed at home. In addition to infants, RSV can also be deadly for adults over 65, whose immune systems weaken as they age.
School-going kids, teens, and younger adults, on the other hand, may catch RSV and never know it. They might remain completely asymptomatic, or else their symptoms are so mild they mistake the illness for a common cold.
RSV symptoms often arrive in stages, and may include:
- Cough
- Runny nose
- Fever
- Loss of appetite
- Sneezing
- Wheezing
“There’s often that spread from the younger kids that pick it up in school and in the community, and then bring it home,” Gesteland said. “The baby may get the brunt of it, and the parent may have just a little bit of an annoying cold, and the school-aged child may have a moderately significant upper respiratory infection.”
Immunity doesn’t last forever, and it is possible, though unusual, to get RSV twice in the same year. Typically when that happens, the second infection is milder.
Mothers may pass some RSV immunity on to their babies — but there’s no vaccine for it yet
It’s not just kids who’ve avoided RSV infections over the past few years. Many parents also spent at least a year avoiding RSV while masking and distancing for COVID, and that may have dampened the immunity that mothers would typically pass to their children.
Dr. Behnoosh Afghani, a pediatric infectious disease specialist at UCI Health in Orange County, California, suspects that many babies and toddlers are getting exposed to RSV for the first time — without the usual protective antibodies their mothers might’ve passed on in utero or via breast milk if they’d had RSV recently.
There are some RSV vaccines in late-stage development for pregnant women and elderly adults, but for now, RSV prevention is relegated to the basic hygiene tips we’ve all heard before: good handwashing, staying away from sick people, and exercising caution around the most vulnerable among us. Avoiding kissing babies during cold and flu season is key, doctors say.
“I don’t have a sort of golden piece of advice to prevent all of this,” Dr. Melanie Kitagawa, medical director of the pediatric intensive care unit at Texas Children’s Hospital, told Insider. “I just have to help the kids through, and give their bodies time to fight this virus.”