For Kids, Increased Respiratory Viruses Could Be on the Horizon

Although mask-wearing as protection from COVID-19 transmission may be back on the forefront, many other restrictions surrounding the virus are loosening. A new study predicts that fewer restrictions may mean an increase in respiratory viruses in children. Published in the Canadian Medical Association Journal, the study notes that a lack of immunity because of COVID-19 pandemic precautions may account for the jump in RSV cases.

The Resurgence

Researchers with BC Children’s Hospital Research Institute and the University of British Columbia studied data on RSV cases in Australia. They found a decrease in cases last year, in the midst of the COVID-19 pandemic. Experts say measures like social distancing and mask-wearing likely contributed to the lack of transmission. However, vaccines and even COVID-19 fatigue are leading to a loosening of rules that helped curb viruses from spreading. Those factors may create a dangerous breeding ground for RSV.

“As those restrictions were released in many communities in late spring and early summer, we have seen an increase in the transmission of these winter respiratory viruses, including RSV, in the middle of the summer. I have never seen this before. We have seen a similar effect on other viruses,
such as influenza, parainfluenza, and adenovirus,” notes Juan A. Dumois, MD, a pediatric infectious diseases physician at Johns Hopkins All Children’s Hospital.

The study centered on numbers in Australia and the likelihood of an RSV spike in Canada, where the number of cases dwindled into the hundreds during the pandemic. The United States is also experiencing a similar trend.

“We may expect that the winter RSV season might be more severe than the typical year, with more children requiring hospitalization and high-level care in pediatric intensive care units,” Dr. Dumois adds.

In fact, the CDC issued a health advisory in June, citing an increase in RSV activity across the southern portion of the United States.

Symptoms of early RSV can include a runny nose, coughing, sneezing, and decreased appetite. Infants younger than 6 months old may also experience decreased activity, lethargy, fever, and pauses while breathing.

Respiratory Viruses

RSV stands for respiratory syncytial virus infection. It's a common respiratory virus with symptoms similar to a mild cold. It can be serious for infants and older adults, and can lead to bronchiolitis and pneumonia. On average, the United States normally experiences over 2 million cases of RSV annually in children, with as many as 500 deaths in children under 5 years old. There are about 177,000 hospitalizations for RSV among adults ages 65 and older.

RSV can be transmitted through contact, not just through the air. However, it is not the only respiratory virus that may be making a problematic resurgence.

“There are a number of respiratory illnesses, especially rhinovirus and coronavirus—subtypes distinct from COVID-19—that are spread through the air and could become problematic. However, these viruses do not pose as severe a risk to infants as RSV,” explains Armeen Poor, MD, assistant professor of medicine at New York Medical College, attending physician in the Division of Pulmonary and Critical Care Medicine at Metropolitan Hospital, and Director of Critical Care Services.

Moving Forward

In-person schooling, the relaxing of social distancing, and removal of some guidelines for wearing masks can all create situations where viruses can spread more easily. The increase of several respiratory viruses is not only concerning now, but also for future implications.

“This might become a larger issue as we loosen restrictions, and infants and immunocompromised individuals may be exposed to this reemergence of common viruses that we may have been deprived of developing immunity to. The usual cyclical nature of exposure and immunity to these viruses, as children grow, may have been disrupted and we’re not sure how this will affect the population,” advises Dr. Poor.

Many of the CDC recommendations to protect children against the spread of RSV are familiar measures from the fight against the COVID-19 virus:

• Wash your hands for at least 20 seconds with soap and water
• If soap and water are not available, using an alcohol-based sanitizer is beneficial
• Avoid touching your face with unwashed hands to prevent the spread of germs
• Cover your mouth and nose when you cough or sneeze
• Disinfect commonly touched surfaces
• Avoid close contact with those who aren’t feeling well
• Stay home if you are sick

Practicing good safety and hygienic practices can help children stay healthy while dealing with a variety of ailments, both now and in the future.