Why Is Respiratory Syncytial Virus (RSV) Surging?

As we prepare for the upcoming cold and flu season, what’s on top of mind for many Americans is the unusual activity of the respiratory syncytial virus (RSV), a respiratory virus that can be dangerous for children and older adults. RSV typically occurs in the fall and winter, but for the second year in a row, health experts are seeing an unprecedented spike in cases beginning during the summer months. 

This surge is already pushing hospitals to capacity and children are getting hit the hardest. And because little to no restrictions are in place and travel and socializing are back in full swing, health experts warn of a “tripledemic,” as RSV could be added to the mix with COVID-19 and influenza cases expected to rise this winter. 

While RSV mostly presents with cold-like symptoms in adults, it can be life-threatening to infants, children, and older adults with weakened immune systems and chronic health conditions. 

Let’s take a look at RSV and why the virus is surging across the United States.

What Is Respiratory Syncytial Virus (RSV)?

Respiratory syncytial virus (RSV) is a common virus that affects the upper and lower respiratory system, i.e., the nose, throat, and lungs. Most people recover in a week or two, but RSV can be severe, especially for infants, young children, and older adults with weakened immune systems and chronic health conditions like diabetes, heart disease, and lung disease. RSV is also the most common cause of bronchiolitis and pneumonia in children younger than one year of age in the United States. 

People who have RSV are usually contagious for three to eight days, but infants and people with weakened immune systems can continue to spread the virus for as long as four weeks and are most at risk for serious infection. Moreover, RSV is a highly transmissible virus, spreading from person to person through:

• The air by sneezing or coughing
• Direct physical contact
• Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands. 

RSV symptoms usually appear gradually within four to six days after infection says the CDC. These symptoms include:

• Fever
• Cough
• Runny nose
• Decrease in appetite
• Wheezing

RSV can also present as irritability, decreased activity, and breathing difficulties in infants and young children.

Why Is Respiratory Syncytial Virus (RSV) Surging Now?

The virus is occurring in a highly vulnerable population of infants and children who were sheltered from common illnesses during the pandemic lockdowns. Health experts agree that these unusual RSV surges are due to a lifting of COVID-19 precautions which protected the public from getting sick with a variety of illnesses. 

“Because people wore masks, sheltered in place, and washed or sanitized their hands frequently during the 2020 pandemic, rates of all viruses plummeted,” Says Dr. Vandana Madhavan, director of advanced pediatrics at Mass General Brigham in Boston. “Once restrictions loosened in the spring of 2021, health experts began seeing unusual patterns of circulation of respiratory viruses like RSV.”

Another factor that could be causing the unprecedented number of infants and children in hospitals across the U.S. is that children born just before or during the pandemic were not exposed to RSV which would have helped build up an immunity to the virus. According to the CDC, children usually have an RSV infection by their second birthday.

Is There a Vaccine for Respiratory Syncytial Virus (RSV)?

Although there is currently no vaccine, by next RSV season the U.S. may have its first. 

Pfizer says it has promising data on its RSV vaccine and is ready to submit for US Food and Drug Administration approval by the end of 2022. If approved, Pfizer’s vaccine will be the first maternal vaccine available to help prevent RSV in young infants.

In the trial, the vaccine was given to pregnant people and had an efficacy of 81.8% against severe lower respiratory tract illness in infants from birth through the first 90 days of life, with an efficacy of 69.4% through the first six months of life. 

The vaccine was also shown to be well-tolerated with no safety concerns for both vaccinated individuals and their newborns; it also cut an infant’s risk of needing to see a doctor for an RSV infection by half, a benefit that will ease stress on the healthcare system.

In regard to current treatment options, a drug called palivizumab is available for those at high risk of severe disease. And while it can’t prevent infection, it can alleviate symptoms. If you or your child is at high risk of severe RSV disease, talk with your primary care physician to see if palivizumab is right for you.

How to Stop the Spread of Respiratory Syncytial Virus (RSV)

• Avoid close contact, e.g., shaking hands, kissing, and sharing cups and utensils with others
• Wear a mask in public spaces
• Wash your hands with soap and water for at least 20 seconds
• Clean frequently touched surfaces such as doorknobs and mobile devices
• Cover your coughs and sneezes but not with your hands

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