The risk of contracting respiratory viruses tends to increase as temperatures drop. This year, though, health care systems are being overwhelmed by earlier-than-anticipated surges of respiratory syncytial virus, or RSV.
An abnormally high number of RSV infections, particularly among infants and children, is clogging hospitals already pushed to capacity. Health officials are now warning winter could bring a "tripledemic."
In Missouri, the five-week average for cases of RSV recorded by the Centers for Disease Control and Prevention was 440, up from about 395 cases the week prior.
But what can parents do about the virus, and how concerned should Kansas City residents be about the spike? Here's what various local health officials say about best practices this winter.
Who is most vulnerable?
RSV was first recorded in 1956. The virus shows as a mild, cold-like illness in adults but can be particularly dangerous for children, for whom pneumonia and bronchiolitis are common side effects.
"In most children, we consider it a rite of passage which means in the first year of life or it's certainly in the first two years of life," said Marianne Jackson, Dean of the University of Missouri Kansas City School of Medicine, during a recent appearance on KCUR’s Up to Date. "Virtually 100% of children will experience this viral infection."
In a typical year, the CDC reports approximately 58,000 hospitalizations of children under five years old with RSV. Among adults 65 and older, about 177,000 are hospitalized each year with RSV.
While children may not contract the virus as often, they are more at risk. Their smaller lungs and muscles are not strong enough to cough or sneeze out the mucus filling their airways.
Why is RSV spiking so early?
Typically, RSV is prominent from mid-November through April.
But this year, experts have documented an unprecedented spike in cases beginning in summer. While the exact reasons for this are unclear, Jackson noted it might have to do with restrictions imposed for COVID-19.
She said very few cases were detected during the first year of the pandemic, but now with more people out and about, the virus is spreading more easily.
"The truth of the matter is, for many of the situations where children are showing up in emergency rooms, those visits could be a burden," Jackson said.
How is it diagnosed?
In mild cases of RSV, symptoms often present similar to the common cold. According to the American Lung Association, testing usually is not required to diagnose an infection.
A doctor may suspect RSV based on medical history, a physical exam, or the time of year and will often run lab tests to confirm the diagnosis. The most common test is a mouth swab or a blood test to check white blood cell counts.
At-home tests are not widely available except through a health care provider or health department.
The Missouri Department of Health and Senior Services will provide drive thru RSV, flu and COVID-19 testing in two St. Louis locationsstarting Nov. 10.
What can parents do to keep their children healthy?
As with COVID-19 and influenza, health officials recommend washing your hands often, being mindful of how you feel, and cleaning surfaces when possible.
University Health pediatrician Jennifer McBride recommends that parents of sick children keep them hydrated and using a humidifier or nasal sprays.
"What that does is it helps keep that mucus thinner so it's easier for the baby to breathe," McBride said.
McBride said if a child's ability to breathe is significantly hampered or they are not drinking enough, it may be time to go to the hospital.
What about a vaccine?
There is no vaccine for RSV, but there are reasons to be optimistic that one is coming.
On Tuesday, Pfizer announced a large international study that found vaccinating pregnant moms was about 82% effective in preventing cases of RSV in their babies' first 90 days of life. At six months, the vaccine was still 69% effective.
There were no reported safety concerns for mothers or their babies.
However, health officials are recommending people still get vaccinated against COVID-19 and the flu to help reduce the load on hospitals and ensure those with severe RSV cases can be seen promptly.
"For those that are very young, RSV is certainly a problem," said Dana Hawkinson, medical director of infection prevention and control at the University of Kansas. "We know that influenza can cause very severe disease as well. And then of course COVID. So it's vitally important to protect yourself and get vaccinated against those."
Anyone over six months old can get a flu vaccine and a COVID-19 vaccine. The COVID-bivalent boosters became available to those ages five and older in September.
