Brace for resurgence of ‘nasty’ winter bug in kids
Common cold virus has potential to be life threatening
Parents in Canada should prepare for an off-season surge of a virus other than COVID, a potentially “nasty bug” that has all but disappeared since the beginning of the pandemic.
Respiratory syncytial virus, or RSV, is a common cold virus that the vast majority of healthy children shake off. In severe cases, the infection can be life-threatening, causing so much congestion in fragile babies they need intensive care and ventilator support.
Since COVID-19 revealed itself to the globe, numerous countries have seen a “near total disappearance of RSV,” along with exceptionally low influenza cases, researchers report in a recent issue of the Canadian Medical Association Journal.
But as pandemic restrictions are lifted, Canada should expect a rebound of RSV this summer, they wrote, an off-season resurgence that “potentially poses a threat to vulnerable infants.”
RSV has been on the rise in Australia and South Africa. Both saw summer surges typically seen in the winter.
In June, the Centers for Disease Control and Prevention issued a health advisory warning of “increased inter-seasonal” RSV activity scattered throughout the Southern U.S. since March. The agency is recommending broader testing for the virus in children and older adults with symptoms of an acute respiratory illness who test negative for SARS-COV-2, the virus behind COVID.
RSV is the leading cause of bronchiolitis, congestion of the small airways in the lungs. Common symptoms include runny nose, fever, cough and wheezing. Children don’t feed as well, and can be fussy and irritable. With no vaccine, the virus poses a particular threat to high-risk children under age two, including premature babies and those with “sick hearts or sick lungs,” said Dr. Pascal Lavoie, a neonatologist at B.C. Women’s Hospital and clinician scientist at B.C. Children’s Hospital Research Institute. Canada recorded only 239 positive cases of RSV between August 2020 and May 2021, compared with 18,860 cases in a similar period the previous year.
RSV season typically runs from late fall to early spring, but “for months we have seen 0 cases every week in many jurisdictions,” the authors of the CMAJ commentary wrote. Reports from around the globe show up to a 98 per cent reduction in RSV cases, “an unexpected positive outcome” of masking and social distancing, doctors from a Brooklyn, New York hospital wrote recently in the journal Pediatrics. Newborns depend on antibodies passed from their mothers, antibodies that wane within six months. Many pregnant women were sheltering in place during the pandemic, meaning they were less likely to be exposed to RSV, “and thus less likely to boost their RSV antibodies to levels usually seen in the winter,” Lavoie and his co-authors wrote in the CMAJ.
“This raises a possibility that infants are less protected than usual and could become sicker if they are infected this summer.”
Australia saw a dramatic spike in severe cases of RSV in the first four months of 2021. Health officials in England have also cautioned parents to look out for symptoms. “I remember the long nights in hospital when my eight-week-old daughter fought off RSV,” Health Minister James Bethell told the Guardian. “The image of her tiny body plugged into those machines and gasping for air will not leave me. I would not wish those moments for anyone.”
“I urge all parents and carers to be alert to the signs of RSV, particularly among young children,” Bethell said. “It’s a nasty bug, so watch out for it.”
New York City is showing the same trend, with more severe disease in younger infants. Daycare closures and virtual schooling likely meant less spread of the disease to older children, the authors of the Pediatrics study said.
Typically, high-risk children are given an expensive preventive treatment, monoclonal antibody. The problem is many RSV programs in Canada were “paused, shortened and even suspended” as cases seemed to disappear.