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RSV Cases Are on the Rise in Children, Here’s What to Know

In recent weeks, many children have headed back to in-person learning, sports and afterschool activities. While this has given many families a bit of normalcy back in their lives, it’s unfortunately also presented new challenges—namely germs.

One highly contagious winter virus, respiratory syncytial virus (RSV), is on the rise, and it has health care professionals concerned. Hospitals across the country are reporting an unexpected rise in infant hospitalizations and sick children caused by RSV. To further complicate the schoolyear is the COVID-19 Delta variant, which is also taking a considerable toll on kids – especially those under the age of 12 who aren’t eligible for vaccinations yet.

To better understand the surge in RSV and COVID-19 cases in children, we spoke with Helene Felman, MD, a pediatrician with Diamond Children’s Multispecialty Services Clinic in Tucson, AZ, to explain what RSV is, why there’s a rise in the number of cases and what parents should know to protect their children.

What is RSV?

Respiratory syncytial virus (RSV) is a common lower respiratory tract infection that’s highly contagious that affects children. While adults can also develop RSV infections, it’s most common in young children, especially premature infants and children who have underlying lung disease, heart disease or problems with their immune systems.

“In older children and otherwise healthy adults, RSV often acts like another common cold, with symptoms like a cough, congestion, fever, sore throat, headache and fatigue,” Dr. Felman said. “In infants, however, RSV can cause serious problems, such as pneumonia or bronchiolitis.”

Why has there been a rise in RSV in children?

Typically, RSV runs from late fall to early spring, much like the flu, but the summer and early fall surge has doctors like Dr. Felman stumped. But loosening mask restrictions and more in-person events could be fueling this contagious virus.

“We aren’t completely sure why RSV is showing up now rather than in the winter when we usually see a spike, but we suspect it’s due to people being exposed to one another after a long period when we were all staying home and wearing masks consistently,” she said. “There is some research out there that in older coronaviruses (those pre-pandemic), kids were very likely to have co-infection of RSV and a coronavirus. This spike in RSV could very well be related to the new spike in COVID-19 cases due to Delta, but it’s hard to say for sure as we are just now noticing this trend.”

Another reason that may be contributing to the rise in RSV is how it’s passed around. “It’s contracted via respiratory droplets, much like COVID-19, but it also can live on surfaces and objects,” Dr. Felman said. “While it may not last on your hands for long, it can live on counters, handles and even clothes for hours.”

Is it RSV, COVID-19 or something else? How can you tell the difference?

RSV and COVID-19 are very hard to tell apart because many of their symptoms overlap. Both can cause fevers, coughing, shortness of breath, a runny nose, sore throat and headache.

However, RSV doesn’t have some of the gastrointestinal symptoms, like vomiting, diarrhea and abdominal pain, that can be seen in children with COVID-19. As well, it’s never been associated with multisystem inflammatory syndrome (MIS-C) in children, a severe illness causing rash, fevers and typically hospitalizations after an acute COVID-19 illness.

Should I have my child tested for RSV, COVID-19 and other respiratory illnesses?

If your baby or child is showing symptoms of RSV and COVID-19, get them tested so they don’t potentially spread the infection to others in their community outside of your household. Because not all testing sites test children for COVID-19, it’s a good idea to reach out to your child’s health care provider for help.

“It can be hard to distinguish between COVID-19 and other respiratory viruses,” Dr. Felman said. “Getting tests to rule out COVID-19 and other illnesses is something we advocate for as health care providers.”

Dr. Felman shared the following recommendations that may provide added help if you’re on the fence whether or not to get your child tested:

  • For school-aged children: If your school-aged child has COVID-19 symptoms, get them tested right away, with or without known exposure. If your child has been exposed at school but has no symptoms, wait at least five days before being tested so you can prevent a false negative.
  • For infants: If your baby has a known COVID-19 exposure and has symptoms, get them tested right away. If there are already household members with COVID-19 and your baby has mild symptoms that can be managed at home, then testing probably wouldn’t be helpful. As well, your baby and any symptomatic household members should avoid contact with others for 10 days. Ask your provider if you have any concerns or questions.

What actions can I take to keep my child safe?

Prevention, prevention, prevention.

“I know we in health care sound like a broken record right now, but it’s so important to get vaccinated if you can; wear a mask when indoors, regardless of your vaccination status; stay home when you aren’t feeling well; and avoid close contact with those who are sick,” Dr. Felman said. “These preventive measures will protect you and your family from COVID-19 and RSV.”

In addition, frequent handwashing and disinfecting high-touch surfaces are encouraged. “Viruses like RSV can stay on hard surfaces for several hours, so make sure your kids are washing their hands with soap and water often and you’re regularly disinfecting high-touch surfaces like door handles and countertops,” she said.

For helpful tips to encourage good hygiene and health in your children, check out these helpful blogs:

Are you concerned your child has RSV or COVID-19?

If you’re concerned about your child’s behavior or they’re showing any of the described symptoms, reach out to your child’s health care provider immediately. They can help triage anyone who needs to be seen and how urgently. However, if your child is having difficulty breathing , please call 911 or take them immediately to the closest pediatric emergency room.

Children's Health COVID-19 Cold and Flu Parenting

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