By JANELLE HOM
Recently, the Centers for Disease Control and Prevention (CDC) issued a health advisory about an increase in Respiratory syncytial virus (RSV). According to the CDC, health officials have seen an increase in RSV cases in Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee and Texas. The advisory encourages physicians to test for RSV in patients who are negative for COVID-19.
Here in Florida, the increase in cases over the last year is staggering. In July 2020, there was a 3-week average of 1.2 positive RSV antigen tests, and in late May 2021, that number rose to 33.
RSV is a common respiratory virus that can infect people of all ages. It is so common that most children have been infected with the virus by age two. Most people, including infants, usually develop only mild symptoms similar to that of a common cold, with congestion, runny nose and cough. But for some (especially infants ages 6-12 months), it can be severe and even life-threatening.
RSV is typically a disease we see in the winter months, so why are doctors seeing more cases this summer? American Lung Association Chief Medical Officer Dr. Albert Rizzo said this is possibly due to loosening COVID-19 restrictions like social distancing and mask wearing. He said that because of these restrictions, we saw fewer respiratory infections in the last year such as RSV and influenza, but as the states are opening back up, more viruses are being transmitted.
Local moms are feeling the stress and fear of RSV. Emmalee Smith’s son, who is now three, was diagnosed with RSV at just six months old. Since her son’s bout with RSV, any time he has had even a little cold, it turns into bronchitis and/or upper respiratory infection. Now he is on long-term medications to help treat these infections. Because of this, Smith still follows strict COVID protocols like wearing masks, social distancing, and disinfecting.
Another local mom, Kristina Crossland, expressed concerns about doctor’s offices and hospitals not testing for RSV since the course of treatment is symptom management. This means the RSV cases could be higher than what is reported to the CDC.
“Symptoms that occur from respiratory viruses such as RSV are virtually indistinguishable from COVID. Given that children below the age of 12 are not eligible for the COVID vaccine, they are at increased risk for COVID, however, they continue to be susceptible to other viruses like RSV as well, and this should be taken into consideration when testing these patients,” said Dr. Shreya Patel, local allergy and asthma physician and Lung Association volunteer.
The CDC’s advisory recommends that physicians be aware of symptoms for RSV, that they should consider testing patients for RSV who present symptoms and are negative for COVID-19, report all RSV cases to the local health department, and watch RSV trends in their area.
The Lung Association urges parents to watch for symptoms of RSV in their children, which include:
Mild cold symptoms like congestion, runny nose, fever, cough and sore throat. Very young infants may be irritable, fatigued and have breathing difficulties. Normally these symptoms will clear up on their own in a few days.
A barking or wheezing cough can be one of the first signs of a more serious illness. In these instances, the virus has spread to the lower respiratory tract, causing inflammation of the small airways entering the lungs. This can lead to pneumonia or bronchiolitis.
Infants with severe RSV will have short, shallow and rapid breathing. This can be identified by "caving-in" of the chest in between the ribs and under the ribs (chest wall retractions), "spreading-out" of the nostrils with every breath (nasal flaring), and abnormally fast breathing. In addition, their mouth, lips and fingernails may turn a bluish color due to lack of oxygen.
When to Call a Doctor: You should call your doctor if you or your child is having trouble breathing, has poor appetite or decreased activity level, cold symptoms that become severe, or a shallow cough that continues throughout the day and night.
For more information about RSV, visit https://lung.org/rsv.
Janelle Hom, is Executive Director, American Lung Association in Florida.