RSV Cases Rise In MD: 5 Things To Know About 'Tripledemic' Threat

MARYLAND — Respiratory syncytial virus, or RSV, a cold-like illness that can cause breathing difficulties in young children, is having an increased impact in Maryland and across the country. Infectious disease experts are monitoring trends of RSV, along with COVID-19 and the flu as winter approaches.

Nationally, some 7,334 RSV tests came back positive for the week ending Oct. 15, up from 6,518 the week before that and 5,210 the week before that, according to data from the U.S. Centers for Disease Control and Prevention.

In Maryland, the five-week average for RSV detections climbed to 59.7 as of Oct. 15, up from a five-week average of 14.0 detections at the start of September, according to CDC data.

For influenza, Maryland had reached the "moderate" level by Oct. 15, the CDC reported. Virginia was in the upper "moderate" level for influenza as of Oct. 15, while the District of Columbia was in the "very high" stage.

As of Monday, the seven-day positive rate for COVID-19 in Maryland was 6.73 percent, up from the 2022 low of 1.43 percent on March 21, but down from the 2022 high of 13.05 percent on Aug. 3. For hospitalizations, 459 people were hospitalized with COVID-19 in Maryland on Monday, an increase of 14 patients from Sunday, according to the Maryland Department of Health.

Like other children's hospitals in the mid-Atlantic and Northeast, Johns Hopkins Hospital in Baltimore is seeing a strong wave of RSV cases.

“Johns Hopkins Children’s Center is experiencing a surge of patients due to an increase in cases of RSV, as well as other reasons, and many surrounding hospitals are facing the same,” Dr. Margaret R. Moon, the hospital’s co-director, told DCist. “Throughout our hospital, this issue is a top priority for the leadership team, who is carefully managing the increase.”

Health officials are warning of a possible “tridemic” or “tripledemic” if the RSV peak coincides with seasonal peaks in influenza and COVID-19. The three illnesses have similar symptoms.

There are no inoculations against RSV, as there are for both the flu and COVID-19, but a couple of pharmaceutical companies are working to develop vaccines.

RSV cases fell dramatically two years ago when schools, day cares and businesses shut down to control the spread of COVID-19. Doctors saw an alarming increase in what is normally a fall and winter virus when coronavirus restrictions were eased in the summer of 2021.

Here are five things to know about RSV:

How Common Is RSV?

Almost all U.S. children catch an RSV infection by the time they are 2. Symptoms include a runny nose, cough and fever, and people who are infected are typically contagious for three to eight days.

However, babies and people with weakened immune systems can spread RSV for up to four weeks.

Who Is Most Susceptible?

RSV poses the biggest threat to infants, older adults and people with suppressed immune systems, and can cause serious airway and lung infections.

“You and I get it as a common cold,” Dr. Elizabeth Mack, a pediatric critical care physician at Medical University of South Carolina, said in a news release.

“But babies with any viral illness are more likely to struggle with it because their airways are smaller. It's hard to clear the secretions,” Mack continued. “They’re obligate nose breathers, meaning they mainly breathe through their noses. So when their noses are stopped up, it causes problems with their breathing.”

Breathing problems can interfere with a baby’s ability to eat.

“And that’s really when we start to worry,” Dr. Melanie Kitagawa, of Texas Children’s Hospital in Houston, told the Associated Press.

“They’re breathing fast, breathing deep. We see them using muscles in their chest to help them breathe,” Kitagawa said. “These are kids who are having difficulty taking a bottle because their breathing is being impacted, and they can't coordinate both at once."

In typical years, 2.1 million children 5 years and younger are treated, and 58,000 of them are hospitalized. RSV is responsible for between 100 and 300 deaths in children younger than 5, according to the CDC.

Among adults 65 and older, about 177,000 people are hospitalized every year, resulting in 14,000 deaths.

Why Are Cases Surging Now?

Babies and children were sheltered from common bugs during COVID-19 lockdowns, and that leaves them highly vulnerable, according to health experts.

Mack said after two years of masking, which protected children from all respiratory viruses, it’s unclear if immune systems are reacting differently to viruses people have not encountered in recent years.

Also, the babies’ mothers may not have been infected with RSV during their pregnancies, which could have offered some immunity to their children.

How Is RSV Treated?

There is no specific treatment for RSV; rather, it’s a matter of managing symptoms and allowing the virus to run its course. Doctors may prescribe oral steroids or an inhaler to make breathing easier.

In serious cases requiring hospitalization, patients may be put on oxygen, a breathing tube or a ventilator.

What Should You Do?

To prevent the spread of RSV, health care providers recommend the same precautions they do with influenza and other contagious illnesses: Wash your hands thoroughly and stay home if you’re sick.

But if you’re worried your child is having a severe breathing problem, “do not hesitate” to go to an emergency department or call 911, Dr. Russell Migita, of Seattle Children’s Hospital, where RSV is on the rise, told the AP.

Less serious symptoms can usually be handled by regular health care providers, including those available in telehealth appointments, or by going to urgent care.

Also, doctors advise, get flu shots and COVID-boosters.

“We don’t want a triple whammy, a triple pandemic,” Chicago physician Dr. Juanita Mora, who on Saturday saw a family of five kids, all with RSV, told the AP.

The Associated Press contributed reporting.