RSV Virus: What We Know and What You Can Do

Photo by bady abbas on Unsplash

Recent CBC News postings have offered information on the RSV virus which has been affecting young children in Canada this autumn and, more recently, the sharp increase of cases of Influenza A in children with an early start to flu season this year.

Earlier this autumn, CBC News reported that children’s hospitals in Canada were seeing an increase in cases of Respiratory syncytial virus (RSV), which causes infections of the lungs and respiratory tract, and which can result in severe infection in some people, including babies under two and older adults with pre-existing conditions.

Hospitals throughout Canada and in the USA reported increased numbers of cases of RSV through the early autumn. CBC News reporter Benjamin Shingler interviewed Dr. Earl Rubin, director of the infectious disease division at the Montreal Children’s Hospital, and Dr. Anna Banerji, an infectious disease specialist and associate professor at the University of Toronto’s faculty of medicine. Both Banerji and Rubin told the reporter that there were fewer RSV cases when public health measures were in place because of COVID-19, but there was a spike last autumn and again this year as young children were exposed to more people.

Young children who have limited community exposure to build immunity – especially if they have any predisposing conditions such as asthma or allergies that will predispose them to RSV – are most at risk.

RSV is spread mostly by aspirated droplets. Regular hand washing is recommended and, for older children, ensuring they sneeze into their elbow and cover their mouth when they cough. But it can also spread through contact. Dr Rubin says, “If you touch a contaminated surface and then rub your eye, pick your nose, you can infect yourself.” The article notes that, whilst people infected with RSV are usually contagious for 3 to 8 days, people with weakened immune systems can spread RSV for longer.

Those with pre-existing conditions, particularly those born prematurely, can be vulnerable to the most serious infections.

Dr. Banerji says that parents can do their best to manage symptoms with fever medications and by ensuring their baby is adequately hydrated. If symptoms increase, doctors may also prescribe oral steroids or an inhaler to make breathing easier, and in serious cases, hospitalized patients may get oxygen, a breathing tube, or a ventilator. She notes, “If a child needs to be admitted to the hospital, it’s because their oxygen levels are low or they’re having a really hard time breathing on their own and may need to be ventilated or they’re not feeding well.”

On December 5th, B.C. Health Minister Adrian Dix and Dr. Bonnie Henry gave an update on the situation in the province. Dr. Henry report that rates of the common cold and RSV in B.C. now appear to have levelled off somewhat, however, influenza A has become more common. She said that B.C. is seeing a “dramatic increase” in cases of influenza A, a strain which can cause severe illness in children. “I cannot stress enough the import of influenza vaccine right now, this year in particular,” she told reporters at the new conference. “There are more children now who have not been exposed to influenza in the last two years … so more of them are getting sick now.” B.C. Vaccine Operations reported that, as of December 5th, only 20% of children under five have received their flu vaccination so far. They are sending invitation texts and emails to families of about 150,000 children under five to encourage parents to bring their children in to receive the vaccination.

Wait times at B.C. Children’s hospital have been up to 12 hours recently, as staff deal with high numbers of patients requiring prolonged attention and care from staff. Sarah Bell, the hospital’s chief operating officer, told the CBC that parents should only bring children with a respiratory illness to the emergency room if they’re having trouble breathing, noting that children under three months who have a fever and are dehydrated with diarrhea or vomiting should also be brought to the ER.