RSV Activity Up In VA: 5 Things To Know About ‘Tripledemic’ Threat

VIRGINIA — Respiratory syncytial virus, or RSV, a cold-like illness that can cause breathing difficulties in young children, is having an increased impact in Virginia 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 Centers for Disease Control and Prevention.

On Monday, the Virginia Department of Health said emergency department and urgent care visits related to diagnosed RSV cases have quadrupled since September in Virginia. While emergency department and urgent care visits for diagnosed RSV were below 100 for the first few months of 2022, visits climbed from around 200 in late August to between 800 and 900 by late September and early October.

Virginia health officials also cautioned residents about a potentially worse flu season, as urgent care centers and hospital visits for flu-like illness are higher at this point in flu season than past years.

In the weekly flu activity report, the Virginia health department said the most visits by age group were among children below 1 to age 4. Among this age group, 14.1 percent of all emergency department and urgent care visits in the week of Oct. 9 to 15 were for flu-like illness. Among all age groups, 3.6 percent of emergency department and urgent care visits were for flu-like illness from Oct. 9 to 15.

As for COVID-19, the latest modeling report showed cases continue to plateau at 12.2 cases per 100,000 people. Current hospitalizations associated with COVID-19 across the state stand at a five-month low of 478.

However, COVID-19 models suggest the weather is affecting transmission rates. The report cautions that a "significant surge is possible" due to factors of weather and new variants. Due to impacts of variants and weather, the new bivalent boosters are recommended to protect residents against hospitalization and death from COVID-19.

Health officials in the U.S. 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. Flu vaccines and COVID-19 vaccines in Virginia can be found at www.vaccinate.virginia.gov or www.vaccines.gov.

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.