UAlbany Public Health Experts Discuss Surge in RSV Cases

By Erin Frick

ALBANY, N.Y. (Nov. 3, 2022) — Children’s hospitals in parts of the U.S. are seeing a surge in respiratory syncytial virus (RSV) cases, a common respiratory virus that can cause severe breathing problems for babies and older adults.

RSV is one of the many viruses that cause a cold, with typical symptoms including a runny nose, sneezing, cough, fever, wheezing and reduced appetite. Those who develop severe symptoms may experience trouble breathing. Typically associated with young children, adults can also experience severe disease. Among those most at risk: premature babies, children with chronic lung diseases and heart defects, adults aged 65 and up and adult patients who are immunosuppressed.

RSV cases normally rise in the winter months, but this year’s surge is happening early, increasing the strain on an already overburdened public health infrastructure that is still reeling from the impact of COVID-19 and staff shortages.

“Prior to COVID, we would typically see RSV begin to increase around November,” said Danielle Wales, clinical assistant professor in the School of Public Health and internal medicine and pediatrics physician at Albany Medical Center. “However, in recent years, RSV cases are occurring much earlier — including summer months and early fall. One reason for the early start could be that our immune systems are ‘out of practice’ dealing with the full complement of respiratory viruses that surround us due to reduced exposure over the past two and a half years. Plus, now that masking and social distancing are less common, viruses can spread more easily.”

RSV is the leading cause of pneumonia and bronchial inflammation among children less than one year old. These conditions are especially dangerous for young children, whose bronchial tubes are very small. Wales advises: “If you have a newborn infant who was premature or may have lung disease or a heart defect, talk to your child's pediatrician about a monoclonal antibody called Synagis (palivizumab) that can help protect them from RSV.”

In general, like other respiratory infections, common preventive measures including handwashing, masking and staying home when ill, will help reduce risk of infection and transmission.

“If you are sick, stay home and especially stay away from folks who are vulnerable,” said Wales. “If you are immunosuppressed, wear a well-fitting mask when out in public in crowded spaces. It is also helpful to have a supply of home COVID tests to check that symptoms aren’t due to COVID.”

Which brings us to rising concerns over the so-called “tripledemic” of RSV, COVID and flu.

“As we have seen during the COVID pandemic, actions such as mask wearing, social distancing and more careful adherence to other hygiene measures have not only helped to prevent spread of SARS-CoV-2, but also of other common viruses, including flu and other respiratory viruses,” said Tomoko Udo, associate professor in the School of Public Health. “With those measures mostly removed, many of us are vulnerable to all respiratory infections. Receiving the appropriate vaccinations and boosters against COVID and flu will play a critical role in minimizing infections, especially as we head into the winter months.”

“Across the country and locally, we are seeing a concerning increase in pediatric illness from infectious diseases which are causing an increase in hospitalizations,” said Christine Bozlak, associate professor and co-director of the Maternal and Child Health Program at the School of Public Health. “It is critically important that we all take actions to stop the spread of illnesses to not only keep ourselves healthy, but to also reduce the spread of infections to children, and thus, alleviate the strain on our local healthcare system.”

This strain is especially acute among low-income and communities of color that have limited access to adequate medical facilities and healthcare resources.

“There are disparities in RSV hospitalizations associated with disadvantaged communities,” said Alvaro Carrascal, assistant professor emeritus in the School of Public Health. “RSV hospitalizations are proportionally more frequent among children, especially those one-year-old and under, from low-income families, which includes significant proportions of African American and Latino children. Ensuring access to needed medical resources among these communities is a critical public health challenge.”

“While we need to focus on what individuals and families can do to help stop the current spread of illness in our communities, it is also important to remember that families exist within larger contexts,” Bozlak concludes. “Consequently, it is key for not only the healthcare sector to be working to assist families, but it is also critical for all those settings where our families ‘live, work, learn, play and pray’ to offer support and resources. Monitoring efforts to track who is getting sick can help optimize this resource allocation.”