In June, the Centers for Disease Control and Prevention (CDC) issued a health advisory about an increase in respiratory syncytial virus (RSV) activity for this time of year across parts of the southern United States. Earlier this month, a local childcare facility reported concerns with the illness in Crawford County, too.
The facility posted on Facebook, “RSV is spreading like wildfire right now, especially in daycares. We have had 10 cases diagnosed in two days!” The childcare facility noted the illness had affected infants, toddlers, and a five-year-old, and urged caregivers to keep sick children at home, monitor symptoms, and take them to a medical professional for evaluation.
Crawford County Health Department Administrator Honor Evans noted RSV is not a reportable disease, so the local health department doesn’t have records of the cases in the area but encouraged parents to be aware of the symptoms related to the illness and, if needed, keep their child out of childcare, take them to a medical provider, and request RSV testing.
The CDC website notes people infected with RSV usually show symptoms within four to six days after getting infected. Symptoms of RSV infection usually include runny nose, decrease in appetite, coughing, sneezing, fever, wheezing. These symptoms usually appear in stages and not all at once. In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties. Almost all children will have had an RSV infection by their second birthday.
Most RSV infections go away on their own in a week or two. There is no specific treatment for RSV infection, though researchers are working to develop vaccines and antivirals (medicines that fight viruses). To relieve symptoms, the CDC recommends managing fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen (never give aspirin to children), drinking enough fluids to prevent dehydration (loss of body fluids), and talking to your healthcare provider before giving your child nonprescription cold medicines as some medicines contain ingredients that are not good for children.
RSV can also cause more severe infections such as bronchiolitis, an inflammation of the small airways in the lung, and pneumonia, an infection of the lungs. It is the most common cause of bronchiolitis and pneumonia in children younger than one year of age.
Healthy adults and infants infected with RSV do not usually need to be hospitalized. But some people with RSV infection, especially older adults and infants younger than six months of age, may need to be hospitalized if they are having trouble breathing or are dehydrated. In the most severe cases, a person may require additional oxygen or intubation (have a breathing tube inserted through the mouth and down to the airway) with mechanical ventilation (a machine to help a person breathe). In most of these cases, hospitalization only lasts a few days.
RSV can spread when an infected person coughs or sneezes, you get virus droplets from a cough or sneeze in your eyes, nose, or mouth, you touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands, you have direct contact with the virus, like kissing the face of a child with RSV.
People infected with RSV are usually contagious for three to eight days. However, some infants, and people with weakened immune systems, can continue to spread the virus even after they stop showing symptoms, for as long as four weeks. Children are often exposed to and infected with RSV outside the home, such as in school or child-care centers. They can then transmit the virus to other members of the family.
RSV can survive for many hours on hard surfaces such as tables and crib rails. It typically lives on soft surfaces such as tissues and hands for shorter amounts of time.
People of any age can get another RSV infection, but infections later in life are generally less severe. People at highest risk for severe disease include premature infants, young children with congenital (from birth) heart or chronic lung disease, young children with compromised (weakened) immune systems due to a medical condition or medical treatment, adults with compromised immune systems, older adults, especially those with underlying heart or lung disease.
In the United States and other areas with similar climates, RSV infections generally occur during fall, winter, and spring. The timing and severity of RSV circulation in a given community can vary from year to year.
To help prevent the spread of RSV, especially if you have cold-like symptoms, you should cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands, wash your hands often with soap and water for at least 20 seconds, avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others, clean frequently touched surfaces such as doorknobs and mobile devices.
Ideally, people with cold-like symptoms should not interact with children at high risk for severe RSV disease, including premature infants, children younger than two years of age with chronic lung or heart conditions, and children with weakened immune systems. If this is not possible, they should carefully follow the prevention steps mentioned above and wash their hands before interacting with such children. They should also refrain from kissing high-risk children while they have cold-like symptoms.
In the CDC’s June health alert, it was noted that, in the United States, RSV infections occur primarily during the fall and winter cold and flu season. In April 2020, RSV activity decreased rapidly, likely due to the adoption of public health measures to reduce the spread of COVID-19. Compared with previous years, RSV activity remained relatively low from May 2020 to March 2021. However, since late March, the CDC has observed an increase in RSV detections along with positive COVID-19 antigen and PCR testing in two southern regions of the U.S. including Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee, Arkansas, Louisiana, New Mexico, Oklahoma, and Texas.
The alert noted there was a reduced circulation of RSV during the winter months of 2020-2021 and that means older infants and toddlers might now be at increased risk of severe RSV-associated illness since they have likely not had typical levels of exposure to RSV during the past 15 months.