RSV Cases Surge Across the U.S., What To Know and How To Protect Your Kids

The Centers for Disease Control and Prevention (CDC) is reporting an increase in cases of RSV as well as a rise in RSV-associated emergency room visits and hospitalizations. For the week ending October 15, 2022, there were more than 8,500 new cases across the country. In fact, the number of cases has been steadily on the rise since May.

While RSV is typically seen during the fall, winter, and spring—the U.S. last saw a troublesome surge in the summer of 2021 as more people started getting vaccinated against COVID-19. Mask-wearing was also decreasing as COVID numbers came down. Once again, with life returning to more of a sense of normalcy, RSV cases jumping.

RSV Symptoms In Kids 

RSV is a common respiratory virus that usually causes mild, cold-like symptoms. It's so common that the CDC says nearly all children will catch an RSV infection by age 2. In most cases, it’s fairly harmless and recovery is quick. But it can be more dangerous in infants and older adults.

“RSV can cause mild cold-like symptoms, including runny nose, sore throat, cough, fever, fatigue, wheezing, and headache. It can also cause more serious illnesses like pneumonia,” says Christopher Baliga, MD, infectious disease specialist at Virginia Mason Medical Center in Seattle. He adds that while RSV is typically found mostly during fall, winter, and spring, outbreaks can occur all year long.

According to the CDC, “RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States.”

RSV is treated by managing the symptoms and letting the virus run its course. It should clear up within a week or two. Symptoms can be treated with over-the-counter fever reducers. Make sure the patient is drinking enough fluids. Researchers are working on vaccines for RSV and anti-viral medications.

Hospitalizations From RSV on the Rise

Each year, about 58,000 children younger than 5 years old are hospitalized with RSV. The CDC says it doesn't track hospitalizations as it does with the flu, but some hospitals say they are "overwhelmed" earlier than normal.

A paper published in Pediatrics in 2021 showed that about two-thirds of infants and children who tested positive for RSV at Maimonides Children’s Hospital in New York City between March 1 and May 8, were admitted. Of those, 81% were put in intensive care and six children were put on ventilators.

"Our data indicates more severe disease in younger infants possibly due to diminished immunity from lack of exposure to RSV in the previous season," wrote authors Rabia Agha and Jeffrey Avner. "Continuing closures of daycare centers and virtual schooling may have resulted in less spread of the disease to older children."

In 2021, Carol Winner, MPH, public health expert and founder of social distancing brand Give Space, said the unseasonably high spike in RSV infections in kids was due to the relaxation of protective health behaviors that started in March of 2021 right around the time people started to get vaccinated. "Many people voiced their exhaustion with all of the hand-washing, mask-wearing, and social distancing. As a result, RSV was delayed, but not eradicated," she said.

Who is Most At Risk for Severe RSV?

Infants and young children are most at risk for more serious RSV infections. That includes preemies, babies less than 6 months of age, and those less than 2 years of age with heart or lung disease, Dr. Baliga says. Children with weakened immune systems or neuromuscular disorders that make it more difficult to clear their secretions are also at risk for more serious illnesses.

Severe RSV infections can lead to bronchiolitis or pneumonia. RSV can also make chronic problems like asthma even worse.

How Long Are You Contagious With RSV?

According to the CDC, those infected with RSV are contagious for about three to eight days. But they say some babies can spread the virus even after their symptoms go away, for as long as four weeks.

Like many viruses, RSV spreads when a person coughs or sneezes. Those droplets can get in your eyes, nose, or mouth. RSV can also survive on hard surfaces for several hours. So if you touch a surface with the virus on it and then touch your face, you can catch RSV. You can also catch RSV from direct contact with the virus. For parents, that could mean kissing the face of their child who is sick.

Protecting Yourself and Others From RSV 

As with all viruses, good hygiene and common sense are required. “Stay home if you are sick, and keep your kids out of school or daycare if they are ill,” Dr. Baliga says.

By now, we're all used to giving each other space to reduce the spread of COVID, but it's a measure that keeps all types of viruses at bay. "We know social distancing can prevent infection," Winner says. "COVID has rightly taught us the significance of protective health behaviors so what better population to continue to protect than our most vulnerable?"

To keep newborns safe from RSV, Winner recommends waiting for a couple of weeks before introducing the baby to people outside the immediate family. "Those loving family visits should include hand washing before holding the baby and no kissing on the face or hands," she adds.

Children with compromised immune systems or heart or lung disease can be protected by regular environmental cleaning, mask-wearing, and distancing from those outside the home. If you have an infant or child who falls into this high-risk group, your child's pediatrician may prescribe a preventative antibody medicine, Dr. Baliga says.

Because some of the symptoms of RSV overlap with those of COVID, parents might want to test their children first. If the test result is negative but the child is still displaying the symptoms, Winner advises requesting an RSV test from your doctor. "Knowing RSV is present in the family will allow for necessary precautions, such as cleaning surfaces and isolation. Mask-wearing can help stop you from touching your face when you‘re providing care to someone with RSV," she explains.