Health officials alarmed over rise in RSV cases

The Pinellas County Department of Health and doctors at St. Petersburg’s Johns Hopkins All Children’s Hospital are monitoring an unusual spike in a respiratory virus ahead of its typical winter peak.

Respiratory syncytial virus (RSV) cases are soaring nationally, and All Children’s Hospital recorded over 350 through September and October. Doctors believe Covid is the likely cause of the shift in viral seasons.

RSV is highly contagious and affects the lungs and breathing. While most adults with the virus will attribute symptoms to a severe cold and forgo testing, the virus is much more serious in newborns, children and people with asthma or respiratory issues.

Dr. Allison Messina, an infectious disease physician with All Children’s, said the hospital now records 35 to 45 cases weekly – numbers usually seen during a severe winter outbreak.

“It could go higher,” said Messina. “I mean, there’s no telling how high it could go.”

In the past, explained Messina, health officials would see cases begin to rise in November and peak in January and February. She said respiratory virus seasons have been significantly more unpredictable following the pandemic and noted the situation is similar to the local spike in flu cases in June.

Messina said that All Children’s noticed more pediatric patients testing positive for RSV in May and persistently above-average rates since the onset of summer, which she called “really unusual.” Health officials are wary of what the winter months could bring and are unsure how the virus could collide with Covid and flu season.

“There’s nothing stopping it from getting worse, I suppose,” said Messina. “It’s hard to predict, especially in these times.”

She relayed that health officials reported a record number of RSV cases in Colorado, numbers that “they’ve never seen before.” The influx of patients, said Messina, has led to hospitals in the state opening tents outside their facilities. She noted called that an unusual measure during regular RSV seasons.

Messina explained that healthy adults with the virus would experience symptoms similar to a severe cold. However, babies and small children have smaller airways and lungs, and she said any amount of swelling makes breathing difficult.

RSV constricts airways, and Messina compared its effects on pediatric patients to drinking a milkshake through a tiny straw.

“It makes it very, very difficult for them to get air into their lungs,” she said. “Particularly really young babies, much more dramatically than older people.”

Messina added that RSV can have the same impact on elderly patients for similar reasons and said the virus is “not something to trifle with.”

Allison Messina, M.D., chair of the Division of Infectious Disease at Johns Hopkins All Children’s Hospital.

Staff at All Children’s have a heightened concern about spreading RSV to the babies they encounter daily, said Messina. The highly contagious virus spreads through droplets or contaminated surfaces, and doctors conduct a nasal swab to determine positive cases.

Messina noted that during Covid, pediatric hospitals would take older patients from other facilities to ease overcrowding. She said health officials could implement an inverse process if the situation worsens, where pediatric hospitals send older kids to facilities typically reserved for adults.

One benefit of the pandemic, said Messina, is the experience health officials gained in creatively addressing capacity issues. She said flu cases are rising, and “it looks like Covid might be picking up a little bit too.”

“I think that we will almost certainly see flu cases go up,” she said. “The million dollar question is how bad is it going to get. We know that we are going to be stretched thin.”

As a respiratory virus, preventative measures for RSV are the same as with the flu and Covid. Messina said regular handwashing is critical, especially before touching a baby.

While there is no vaccine for the virus, she encourages everyone to get a flu shot. Doctors have therapies to ease the RSV’s symptoms, said Messina, but the lack of a vaccine is another reason it is critical to help prevent its spread.

“Go back to hose basic hand hygiene principles and cough etiquette principles,” she said. “And staying home when you’re sick principles. That’s the way to stop the spread of RSV.”