Cedars-Sinai and other hospitals nationwide are seeing a surge in cases of pediatric RSV (respiratory syncytial virus) that are showing up earlier than expected this year. Healthcare providers are worried about the onset of the virus combined with the additional threats of the flu and COVID-19 as we head into the winter season. The Cedars-Sinai Newsroom spoke with two pediatric experts about RSV and the coming virus season: Priya Soni, MD, Cedars-Sinai pediatric infectious disease specialist at Guerin Children’s, and Ira Wardono, MD, pediatric hospitalist, Providence Cedars-Sinai Tarzana Medical Center.
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What is RSV?
Soni: RSV stands for respiratory syncytial virus, which is a respiratory virus that can severely affect young infants and babies who are less than 6 months old.
How does RSV present in infants and young children?
Soni: Young babies can start looking a bit more lethargic and have poor feeding. That can be the first signs that they are in distress. They may or may not have a fever, and they can start having some trouble breathing. Those are the early signs parents need to look for—lethargy, loss of appetite and trouble breathing.
Why is RSV most dangerous for infants?
Wardono: The virus dramatically increases secretions in the airways. Older pediatric and adult patients are able to cough or sneeze out the extra secretions, but that is not the case for infants. Their muscles are not strong enough to cough up all the extra fluid. It’s almost like they are drowning in their secretion, and that’s what causes the trouble breathing. Parents or healthcare providers need to do the job for them by suctioning the airways, either at home or, if needed, in the hospital.
How is RSV treated?
Wardono: The care is all supportive. If a child needs suctioning, we clear the airway. If they're so stuffy that it's hard for them to feed, they may become dehydrated. In that case, we have to support them with IV fluids. From time to time, they may need oxygen support as well. The most important thing is to know when to get help for your child: if they’re having trouble breathing, not able to eat or appear more tired than usual.
Is there an RSV vaccine?
Soni: There is a monoclonal antibody called palivizumab that we recommend for high-risk babies, including infants who are premature or have chronic lung disease or a significant congenital heart condition. The antibody treatment would be a preventive series of vaccines as we head into the full RSV season. It would be important for parents to talk to their child’s provider to see if the falls into these categories and would benefit from the treatment.
As we head into winter, can babies be infected with RSV and other viruses at the same time?
Soni: Healthcare experts are worried about the confluence of RSV, flu and COVID-19 as we move into the winter. The overlap of these three viruses, as well as others, is definitely a big concern for the next few months.
Wardono: We are already seeing patients testing positive for more than one virus. We are worried about patients clogging up the Emergency Department as well as inpatient beds. One thing parents can do is make sure their children get their flu shots and COVID-19 boosters where appropriate.
What else can parents do to minimize the risk for RSV and other viruses?
Wardono: Parents need to enforce hand hygiene. Make sure your children wash their hands frequently. Another suggestion is to have the children who are in school or play group change their clothes when they come home before interacting with infants because some viruses can stick to clothing as well.