RSV, a common respiratory virus that usually causes mild, cold-like symptoms, is on the rise. While usually innocuous in adults, RSV cases in children and the elderly can be far more serious.
According to the Center for Disease Control and Prevention (CDC), RSV is the most common cause of bronchial infections and pneumonia in children at the age of one. The virus is responsible for over 58,000 hospitalizations and 100 deaths among children under the age of five annually. This year, RSV cases are more numerous, more severe, and, perhaps most alarming, since they’re occurring out of season.
In November of 2022, the CDC reported a 300% increase in RSV cases. This staggering statistic has far reaching societal impacts. When children are diagnosed with RSV, they are not the only affected, they miss school, and their caretakers miss work. Healthcare facilities across the U.S., already taxed from the pandemic, are again feeling once again impacted. According to the American Academy of Pediatrics, roughly three-quarters of U.S. hospital beds for children were filled last fall, while some had to set up tents to accommodate the additional patients.
In addition to the spike in cases, RSV is also more severe, and cases are occurring strangely out of season. In April of 2021, The Washing Post reported the case of Eli, a 6-year-old boy who spent his childhood inside a socially distanced bubble triggered by COVID-19. After going years with not so much as a runny nose, Eli sadly became part of the nationwide trend of critical and unseasonable RSV cases.
After only two weeks of playing outside with other kids his age, tests showed Eli was infected with two viruses at once. This diagnosis shocked his pediatrician, Jennifer Shu, as it was the first case of springtime RSV she had seen in her two decades of practice.
This unseasonable pattern continued into Summer 2022. Unfortunately, the year-round presence of RSV did little to lessen the severity of the virus this winter. In turn, RVS combined with high rates of flu and COVID-19 to create what the media termed a “Tripledemic.”
What is the reason for this severity?
There is a common misconception that our immune systems need to be trained in order to function. Proponents of this “hygiene hypothesis” feel that enforced masking and social distancing has made us weak against viruses and is to blame for the current severe and unseasonable RSV. This perspective has traces of truth. The social-distancing mandates did delay the many young people’s normal exposure to the virus.
Specialist in infectious diseases at Children’s Hospital in Los Angeles, Doctor Pia Pannaraj, verified that since social restriction measures prevented doctors from seeing RSV as they usually would, many children who would have contracted the virus did not as well.
However, professor and chair of Johns Hopkins Environmental Health and Engineering, Marsha Wills-Karp, has spent two decades exploring the hygiene hypothesis. Wills-Karp disagrees with the assessment that lack of exposure has weakened immune systems. Wills-Karp believes that while there is a link between allergic disease and infection, this does not extend to viruses. In fact, according to Wills-Karp, exposure to viruses actually increases the severity of other types of infection.
As there is currently no vaccine for RSV, how does one best avoid contributing to the “tripledemic?”
According to the CDC, public health measures that have helped keep us safe from COVID-19 can also help limit the spread of RSV. Cover your mouth when coughing or sneezing, keep hands clean by washing them with soap and water or using alcohol-based hand sanitizer frequently, and clean and disinfect frequently-touched surfaces or items routinely. These practices can help ensure that now that our masks are down, our tissues won’t replace them.
