As US pediatric hospitals report being “overwhelmed” with respiratory syncytial virus patients, cases are on the rise in Canada as well.
Respiratory syncytial virus, or RSV, is a common and contagious respiratory virus that often affects young children. According to the US Centers for Disease Control, “virtually all children get an RSV infection by age 2.”
The virus generally causes mild cold-like symptoms such as a runny nose, sneezing, cough and fever, but it can lead to more serious illnesses such as pneumonia and bronchiolitis, which is inflammation of the small airways in the lungs. Children under six months of age and those with pre-existing conditions such as asthma and congestive heart failure are among those most at risk of severe complications, which may require hospitalization.
In the US, several hospitals are currently reporting that they are “overwhelmed” by the increase in young patients with RSV.
“This is our March of 2020,” Dr. Frank Belmonte of Advocate Children’s Hospital in Chicago told ABC News. “So this is the pediatric version of the beginning of the pandemic.”
Connecticut Children’s Medical Center is even considering bringing in the state’s National Guard to help expand the hospital’s capacity.
“I’ve been at Connecticut Children’s for 25 years and I’ve never seen an increase like this, especially with RSV,” their chief medical officer, Dr. Juan Salazar, told CNN.
‘ABOVE EXPECTED LEVEL’ CASES IN CANADA
The Public Health Agency of Canada, meanwhile, is reporting a growing number of cases across much of the country, particularly in Quebec, at a time when many Canadian emergency services are already struggling with long wait times and capacity issues.
“Respiratory syncytial virus activity (486 detections; 3.5% positive) is above expected levels for this time of year,” according to the agency’s latest weekly respiratory virus report dated Oct. 15. Like the flu, RSV infections usually come in a seasonal wave that lasts from fall to spring.
The current rise in RSV cases is largely linked to measures to stop the COVID-19 pandemic. In Canada, lockdowns, masks and social distancing have contributed to RSV numbers plummeting to 239 confirmed cases in the 2020-21 season, according to the Public Health Agency of Canada; down from 18,860 confirmed cases in 2019-20. Experts say the lack of exposure for about two years left more young children vulnerable at the same time.
“I think their immune systems just haven’t seen as many viruses that a typical child would have seen before the pandemic,” Yale School of Medicine pediatric infectious disease specialist Dr. Thomas Murray told CNN.
Speaking to CTVNews.ca in a phone interview Monday, McGill University in Montreal infectious disease specialist Dr. Donald Winn explained that RSV is similar to COVID-19 and other respiratory viruses, is highly contagious and is easily spread in schools.
“We’re seeing a return to pre-pandemic levels with these respiratory viruses, except it’s not just pre-pandemic respiratory viruses — there’s COVID added to the mix,” Vinh told CTVNews.ca. “And so the capacity of our health care system to absorb people who get sick from RSV and the flu, on top of people who get sick from COVID, well, there’s not a lot of wiggle room there.”
At the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa, they are testing twice as many children for the virus now than they were at the end of August.
“CHEO had the busiest emergency department from April to September in its history; so we’ve never had this much activity in over 30 years,” Dr. Chuck Hui, the hospital’s chief of infectious diseases, told CTV National News. “We’re certainly seeing more activity and more admissions across the province.”
‘HOW A TERRIBLE VIRUS’
Although there is no vaccine and nothing to specifically treat RSV, most cases do not require a doctor’s visit or hospitalization and usually clear up in one to two weeks with plenty of rest and fluids. In more severe cases, children may be given oxygen or intravenous fluids if they are struggling to breathe or are dehydrated.
“RSV is not as serious as COVID was in the adult population,” said Salazar of Connecticut Children’s Medical Center. “We can take care of these kids.”
Michelle Maguire’s three-year-old son James was sent home from preschool last Monday with a fever. When he tested negative for COVID-19 and his symptoms worsened, his parents took him to the hospital where they were told he had RSV.
“His symptoms started with a fever and poor appetite and quickly included congestion, a runny nose, pink eye in both eyes and a terrible cough,” Maguire told CTVNews.ca in Calgary. “He has asthma so it’s very worrying to hear him coughing and wheezing so often.”
After eight days of resting at home with Tylenol, fluids and plenty of chicken soup, James is finally feeling better.
“He has a one-year-old sister at home and it’s impossible to keep them apart, but she hasn’t been affected so far,” Maguire said. “What a horrible virus.”
Lauren Kelly’s daughter Madeline is almost two years old. Normally healthy and happy, she was admitted to the pediatric intensive care unit late last week, sick and with breathing difficulties that were diagnosed as RSV.
“She couldn’t get enough oxygen in the emergency room so she had to go on a BiPap,” Kelly told CTV National News from Winnipeg. “I cried all the way to the hospital because I felt so guilty about coming here, knowing how busy everyone is and how stressed the system is.
With files from CTV Los Angeles National News Bureau Chief Tom Walters and CTVNews.ca writer Michael Lee