Respiratory virus cases tick upward: What parents should know

During the fall and winter months, we pediatricians think a lot about respiratory syncytial virus, or RSV. While it gives most people just a bad cold, it is the leading cause of bronchiolitis and pneumonia in children under a year old.

Once spring and summer come, we stop thinking about RSV when a baby comes in with a bad cough. This year, though, is different — because according to the Centers for Disease Control and Prevention (CDC), there has been an increase in reported cases of RSV this spring and summer, especially in southern US states.

What are the trends for RSV?

Starting in April of 2020, cases of RSV fell here, as one might expect at the end of a winter. They stayed down through all of fall 2020 and the following winter instead of going back up. The measures that we use to prevent COVID-19, such as social distancing, wearing masks, and doing lots of washing of hands and surfaces, prevent all sorts of viruses. Not only did we see less RSV, but we also saw less flu and other common viruses.

But in March of 2021, cases of RSV began to rise. It’s hard to know exactly why, but it likely has something to do with us beginning to take off masks and congregate around other people again, as people began to be vaccinated against COVID-19. That’s not the whole reason, though, because Australia and South Africa also noticed more RSV than expected during their summer months (which are our winter months).

Fortunately, cases of RSV in those countries didn’t rise as high as their typical fall and winter levels. Hopefully the same will be true here in the US. But until we know what will happen, it’s important for parents to keep RSV in mind — and be on the lookout for the problems it can cause.

What are the symptoms of respiratory distress?

In practical terms, this means that parents of young children, especially those who were born prematurely or have lung or heart problems, should be watchful of their children should they develop cold symptoms. In particular, they should be watchful for any signs of trouble breathing, such as

• a very frequent cough
• audible wheezing
• sucking in around the ribs with breathing
• flaring of the nostrils
• trouble talking, or a weak cry
• pallor or a blue tinge to the skin
• unusual sleepiness or weakness.

If any of those happen, seek medical attention immediately. If none of these are happening but the child has a bad cough or high fever, it’s worth a call to the doctor to check in. Parents should do that anyway, because COVID-19 could also cause a cough or fever.

As much as we all want to get our lives back to normal, the rise in RSV cases may be a reason for families with young children to keep their masks on in public rather than taking them off. Talk to your doctor about cases of RSV — and COVID-19 — in your community, so that you can make the best decision for you and your family.

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