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Cold weather virus troubles doctors in summer, parents worry


The recent emergence of a virus that usually sickens babies during the colder months has baffled US pediatricians and left many infants hospitalized with coughs and trouble breathing.

RSV, or respiratory syncytial virus, is a common cause of cold-like symptoms, but it can be serious for infants and the elderly. Cases dropped dramatically last year, with people staying home and social distancing, but began to crop up as pandemic restrictions were eased.

“I’ve never seen anything like this before,” said Dr. Kate Dutkiewicz, medical director of Beacon Children’s Hospital in South Bend, Indiana, recently after treating two RSV-infected babies. Both required oxygen treatment to help them breathe. ‘I have never seen cases in July or close to July.’

Laranda St. John became concerned when her 6-week-old son, Beau, got a bad cough a few weeks ago. The mother, from Matoon, Illinois, has a medical background and suspected RSV when she opened her sleeper and saw her chest with difficulty breathing.

“The doctors’ office couldn’t take me in because they were full of people,” St John said, calling about children with similar symptoms.

A positive test in the ER confirmed RSV. The infant developed a rapid heart rate and had to be hospitalized overnight. His 16-month-old sister, LuLaBelle, had also contracted the virus, but she was not as ill and did not require hospitalization.

St John said he wondered whether it could be COVID-19 as it is the wrong season for RSV.

“I can’t say I’m relieved, because I know RSV is just as bad,” she said.

Children infected with either virus usually only develop mild illness but for some these infections can be severe.

Among US children under the age of 5, RSV typically causes 2 million doctor-office visits each year, 58,000 hospitalizations and up to 500 deaths – more than the estimated toll on children from COVID-19.

In adults 65 years of age and older, RSV can cause pneumonia and causes approximately 180,000 hospitalizations and 14,000 deaths annually. Cases in children and adults usually fall in early spring.

Dr. Larry Kociolek, an infectious disease specialist at Chicago’s Lurie Children’s Hospital, said off-season cases in Australia were a tip-off that the same could happen in the United States.

Typically, infants are exposed to RSV during the first year of life, often when older siblings become infected at school and bring the virus home, Kociolek said. But, he added, “There were many children and children who were not exposed to RSV in the winter of 2020 and the winter of 2021. This makes the proportion of susceptible babies very large.

In infants, symptoms may include fussiness, poor feeding, fever, and lethargy. Children may have runny nose, loss of appetite, cough and wheezing.

But in very young infants and those born prematurely, the virus can cause the small airways in the lungs to swell and fill with mucus. Babies who develop this condition, called bronchiolitis, may need hospitalization and oxygen or ventilator treatment.

There is no approved treatment for RSV, although a once-monthly injection of an antibody-based drug is sometimes prescribed before and throughout the RSV season to treat severe RSV in premature infants and other children at risk of serious disease of the lungs. to help prevent problems.

Re-infections are common but usually cause milder symptoms than the initial illness.

Kociolek said the recent unusual increase in cases could be partly due to more testing due to COVID-19 fears. In normal times, parents might not consider the symptoms of RSV to be anything serious, but now they may fear that they are indicating a pandemic virus.

RSV is spread by contact with airborne droplets from an infected person, but it is more likely to live on other surfaces, including skin and toys, than COVID-19, which can also be a source of transmission.

RSV is one of the reasons why daycare centers and preschools often have strict policies about keeping children with whooping cough home from school.

“A lot of parents think, ‘Oh well, it’s just a cold, they’re fine to go to school,'” said Diana Blackwell, director of children’s programs at the Auburn University-Harris Early Learning Center in Birmingham, Alabama. Director.

Despite strict sanitation measures, several children at her center have become ill with RSV in recent weeks, including her own 4-month-old son. He had violent coughing spells and was often prescribed medication to treat the breathing problems in asthma, but did not require hospitalization.

She called the outbreak of summer at its center “simply strange.”

“It didn’t even pop into my mind that it would be anything like RSV,” Blackwell said.

Dr. Mary Caserta, a member of the American Academy of Pediatrics’ infectious diseases committee and professor at the University of Rochester, said parents should be aware of virus activity at unusual times and if children appear very ill or have difficulty breathing. If problems arise, they should seek medical care.

RSV is one reason why pediatricians often caution parents of young children to avoid colds and congestion during cold weather.

“COVID has made people so hungry to be with other people that it would be hard to recommend the same now,” Caserta said.

Whether the abnormal summer virus activity reflects a lower-than-normal RSV this coming winter is uncertain, she said.

“I’ve given up trying to predict the future by any means,” Caserta said.

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Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.

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The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. AP is solely responsible for all content.

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