This Is the Actual Reason RSV Is Everywhere Right Now, Says a Johns Hopkins Pediatric ICU Doctor
For some parents, teachers, and doctors, it feels like 2020 all over again. Here's how it happened. Plus, country music artist Jimmie Allen shares his experience, along with health tips, following his toddler's recovery from the virus.
Respiratory syncytial virus, also known as RS virus or RSV, is a common respiratory infection affecting both children and adults in the lungs and respiratory tract. RSV typically presents like the common cold with symptoms so mild that most parents barely notice it, and in many cases, RSV symptoms can be managed with rest and self-care. It’s also common—according to The Centers for Disease Control, “Almost all children will have had an RSV infection by their second birthday.”
RSV can be more serious in older adults and infants younger than six months. While it’s true that most children get RSV and experience sniffles, fever, and a cough—typical cold symptoms—roughly 58,000 to 80,000 children are hospitalized due to RSV infection each year in the United States. This year, it’s much worse. COVID hasn’t completely gone away—though we have more ways to prevent, treat, and manage it—and respiratory viral season arrived early, creating something of what some specialists are calling a “tripledemic.”
Dr. Meghan Bernier, MD, medical director of the pediatric ICU at the Johns Hopkins Children’s Center, explains that COVID-19 pandemic lockdown is a major reason RSV in particular has grown so widespread this year. “Because people haven’t been circulating as much, children haven’t had the usual pathogen [exposure] that an average 18- or 24-month-old would have at this point in their lives.” Dr. Bernier says.
Dr. Bernier explains that the immune system builds itself thanks to continued exposure to pathogens—so when you’re re-exposed to an infection that your body has seen it before, you’re less likely to get sick. This is the same way vaccines work—we’re given a little bit of tetanus, diphtheria, pertussis, etc., so that our immune systems can react to it and build antibodies in case we run into it down the road. We don’t yet have an RSV vaccine approved in the US because it’s hard to develop vaccines for babies.
She adds that RSV isn’t a new disease—most of us have had it—and Bronchiolitis, which happens in more severe RSV cases, isn’t new either. But with a surge of RSV cases and demand on an already taxed healthcare system, it might feel like we’re back in 2020. However Dr. Bernier says, that’s not quite accurate. “With COVID, it was scary because we didn’t know how to treat it. But that’s not the case with RSV—we know what to do.”
Testing to obtain the name of a virus that an infant has is not something that’s generally recommended; your average, healthy baby or toddler gets a cold, and we don’t typically need to name it. “There’s no need to test them because they’re going to handle it just fine,” says Dr. Bernier. If they’re testing for influenza, that’s one thing because there are treatments. Testing isn’t recommended for babies who aren’t immunocompromised or don’t have a chronic condition because the treatment doesn’t change. It doesn’t alter the course or what parents and physicians need to look out for.
Dr. Bernier explained that many viruses they test for now are done through multi-virus tests—screening for flu, RSV, and COVID simultaneously—because it’s helpful to know if a patient requires isolation. In most cases, for the average, typical patient with community-acquired RSV, the treat with what they call bundled care, which includes oxygen therapy if the patient has low oxygen saturation, extra airflow to help with mucus or narrowed airways (this ranges from a nasal cannula to a ventilator), nasal suctioning to decrease secretions in the nose, and IV hydration.
“Parents want to take their children to be seen by physicians,” Dr. Bernier says, “They’re either seeking an intervention, or they’re seeking reassurance that things are OK and they can go home and monitor.”
Some of that reassurance can be done over the phone or via telemedicine—a silver lining on the pandemic is that telemedicine is so much easier—and parents will be told if the baby needs to be seen in person. Even though emergency rooms and urgent care centers are busier than usual, they operate on a triage system and are equipped to handle the higher volume.
It’s not wrong to want to know, but Dr. Bernier says the best thing for parents and caregivers to do is educate themselves on the signs and symptoms of respiratory distress. The bottom line is that parents should trust their gut when their baby is sick so they can gain reassurance that everything will be OK, or seek out supportive therapies if necessary.
The RSV recovery experience of Jimmie Allen, wife Alexis, and baby Zara
Grammy-nominated country music star Jimmie Allen and his wife, Alexis, spoke with The Healthy @Reader’s Digest during a break from Jimmie’s tour with Carrie Underwood about their health advocacy work during this RSV surge. The Allens report that at this time last year, their then-six-week-old daughter, Zara, became unresponsive after a coughing fit that left her unable to breathe. After being rushed to the hospital, she was diagnosed with RSV. The Allens say they were surprised to learn RSV is the leading cause of hospitalization in babies under age one.
With winter virus and the holiday seasons approaching, and hospitals already reporting unprecedented numbers of RSV cases this year, the Allens are on a mission to raise awareness of RSV and how to help prevent it, especially as families gather in large groups for the holidays. Here’s what they say they’ve learned:
To help prevent the spread of RSV and protect your baby you should:
- Wash your hands often.
- Clean and disinfect surfaces, including your child’s toys.
- Avoid close contact with anyone who has cold or flu-like symptoms.
- If you have cold or flu-like symptoms, avoid kissing or touching your baby as much as possible.
- Avoid sharing utensils if you have cold or flu-like symptoms.
- Cover your face when coughing or sneezing.
- Visit KnowingRSV.com to learn more.
Subscribe to The Healthy @Reader’s Digest newsletter. Follow The Healthy on Facebook, Instagram, and Twitter, and keep reading:
- The 9 Best Habits to Make Your Lungs Stronger, from Doctors
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- Eating These Foods Can Lead to Premature Death, Says New Study
The Centers for Disease Control, “Respiratory Syncytial Virus Infection (RSV)
Columbia University Irving Medical Center, “The Tripledemic Is For Real: What Parents Should Know”
The New York Times, "This Is Our March 2020’: Children’s Hospitals Are Overwhelmed by R.S.V.”
Dr. Meghan Bernier, medical director of the pediatric ICU at the Johns Hopkins Children's Center
Mayo Clinic, Bronchiolitis
Stanford Medicine Children’s Center, “Signs of Respiratory Distress in Children”