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Summertime RSV & What to Expect for Winter
Across the nation, health care providers are seeing more little ones contract respiratory syncytial virus, most commonly known as RSV. The virus typically peaks in winter months, but for the last two years, we have seen summer surges. RSV is extremely transmissible and can be dangerous for infants or young children. Most children will get RSV by the time they are two years old. Medical Director of Infection Prevention Dr. Nick Hysmith is here to explain why we are seeing more summer cases of RSV, what signs and symptoms to look for and what parents can expect this winter.
Featured Speaker:
Learn more about Nick Hysmith, MD, MS, FAAP
Nick Hysmith, MD, MS, FAAP
Nick Hysmith, MD, MS, FAAP is the Medical Director of Infection Prevention, Le Bonheur Children's Hospital.Learn more about Nick Hysmith, MD, MS, FAAP
Transcription:
Summertime RSV & What to Expect for Winter
Maggie McKay (Host): Across the nation, healthcare providers are seeing more little ones contract respiratory syncytial virus, most commonly known as RSV. The virus typically peaks in winter months. But for the last two years, we've seen summer surges. RSV is extremely transmissible and can be dangerous for infants or young children. Most children will get RSV by the time they're two years old. Medical Director of Infection Prevention at Le Bonheur Children's Hospital and Assistant Professor at the University of Tennessee Health Science Center, Dr. Nick Hysmith, is here to explain why we're seeing more summer cases of RSV, what signs and symptoms to look for and what parents can expect this winter.
This is The Peds Pod by Le Bonheur Children's Hospital. I'm Maggie McKay, Dr. Hysmith, thank you for being here today to explain what summertime RSV is and what to expect for the winter. We appreciate your time.
Dr Nick Hysmith: Yeah, thanks for having me.
Maggie McKay (Host): So what causes RSV and what are the symptoms for RSV?
Dr Nick Hysmith: So RSV is a pretty common virus. So it's a viral illness, much like any other viral illness that we see in the winter and summer months, like influenza virus or adenovirus. Unfortunately, RSV can cause pretty significant symptoms such as cough, difficulty breathing, runny nose, congestion, which is more severe in young kids, so kids less than two years of age.
Maggie McKay (Host): And what could be causing the summer surge of RSV?
Dr Nick Hysmith: So it's been interesting, over the last several years, we have seen this shift from RSV starting to rise in the late fall to early winter to seeing this in the summer months. And it's really all started since COVID-19 came into the picture. And the theory is that we were all masked for that 2020 season of RSV and we saw very little RSV in the winter. And then, we had these children who were born who had never seen RSV before and were very small about the time that we started to lift our masking restrictions across the country in the summer of 2021. And then, we saw that increase in RSV in 2021 during the summer. And then in the winter of 2021, we were all masking up again, as we were seeing another wave of COVID-19 come through. And it's sort of the same thing this year in 2022, we're starting to see the numbers increase in the summer again. And it's very interesting to see that happen, to see viruses switch seasons. But we're starting to see that happen. And it's a mystery to us in some way. As we look into the crystal ball of what's coming in the winter, it's kind of hard for us to know what it's going to do.
Maggie McKay (Host): Well, that was my next question. What do you expect for the fall and winter RSV season?
Dr Nick Hysmith: We go by precedent, what's happened in the previous years is what we look at. So we know that last year we had this big spike in the summer. I mean, numbers greater than we'd seen in the winter of several of the previous years or being seen in the summer of last year.
This summer has been sort of a steady increase and a plateau. And we're sort of plateaued right now with RSV. So it's a little bit unclear if we're going to just sort of stay at this plateau through the rest of the year or if we're going to see a plateau and then a dramatic increase in the winter. And like I said, looking into the crystal ball, I have no idea which one it's going to be. I sort of favor that we're going to stay at this plateau or just this gentle rise over the next several months into the winter. And then, hopefully, we won't see any flu as well, because if we start seeing influenza in the winter, which is what we usually see, but we haven't seen that either in the last two years, then that'll make it even more complicated.
Maggie McKay (Host): Right. Dr. Hysmith, what can parents do at home if their child does get RSV? So how can they help their child recover?
Dr Nick Hysmith: The biggest thing about RSV is it usually lasts for about five to six days. So you'll start to have symptoms on day one and you'll see the worst symptoms on day two or day three. And that really includes increased work of breathing, so kids having trouble catching their breath or parents will see what looks like struggling to breathe. So the big thing is for parents to recognize those symptoms and take their child to their primary care physician, their pediatrician, just get them looked at and make sure everything is okay, make sure they're getting enough oxygen, that sort of thing.
The majority of these kids will do fine at home. It just requires a lot of suctioning of the nose to get that mucus and snot out, so kids can breathe better and then really making sure that they stay hydrated. Unfortunately, several kids will also need to be admitted to the hospital. It's one of the most common reasons kids less than two get admitted to the hospital, usually during the winter months, but we've seen it more in the summer. So just keeping a close eye on that breathing and making sure you stay in contact with your pediatrician.
Maggie McKay (Host): Doctor, how should parents manage the fever part of RSV if their child has one?
Dr Nick Hysmith: Right. So many parents get really worried when they see fever and that's indicative of an infection. Fever is actually a good thing because your body is fighting the infection, but it can make your child feel pretty terrible. So we recommend giving Tylenol, as first line for fever, especially in kids around the one to two years of age. You can talk to your primary care provider about ibuprofen because we know that alternating Tylenol and ibuprofen can be beneficial. But before you go to that step, I would chat with your pediatrician.
Maggie McKay (Host): And so you said parents should take their child to the doctor pretty much right away when they see symptoms?
Dr Nick Hysmith: Yes, I would go ahead and get them checked out, especially, you know, if they're starting to see some trouble with their breathing, because like I said, it's around a five-day course. So if you're seeing that trouble day one, day two, you can go ahead and go to your PCP, your pediatrician, and they can see what's happening. And based on how they look in the office that day and where the child is in the course of the illness, you can roughly tell how sick the kid will get. So, you know, if you're having trouble breathing, a lot of stuff on day one, then you know that at day three, you're going to be probably needing some additional support maybe in the hospital setting.
Maggie McKay (Host): Wow. And something teachers always say, "Stay home if you're sick, no matter what you have," right? Don't your child to daycare or anywhere other than the doctor.
Dr Nick Hysmith: Right. I feel like we've really hammered that in over the last several years. But definitely if your kid is sick, running fever, do not take your child to daycare or to school. Get them checked out in their primary care provider's office to make sure it's not flu, RSV or, in the times of COVID, make sure it's not COVID either.
Maggie McKay (Host): Right. That's true. With science advancing so fast, do you know of any future prevention in the works?
Dr Nick Hysmith: So for several years, we've given a medication called Synagis, that is given to high risk children, so children with certain medical conditions or children who were born premature, and their lungs may not be fully developed during that first RSV season that they'll encounter. So we give that as sort of a prophylaxis prior to an RSV season in certain groups of kids. So in the majority of circumstances, a child's primary care provider will already know that and they'll have that medication available. We do see science really moving forward, and I'm hopeful that in the next several years, we'll have vaccines maybe for all kids or therapeutics for kids, medications that kids can take once they get RSV to help lessen the disease severity.
Maggie McKay (Host): Dr. Hysmith, thank you so much for this useful information, educating us on what summertime RSV is and why it's important for parents to know about it.
Dr Nick Hysmith: Yeah. Thanks for having me.
Maggie McKay (Host): Absolutely. Once again, that's Dr. Nick Hysmith. To learn more, check out our website at www.lebonheur.org, and read one of our most recent blogs, Five Facts About RSV Every Parent Needs To Know. And be sure to subscribe to The Peds Pod on Apple Podcasts, Google Podcast, or wherever you listen to your podcast. You can also check out lebonheur.org/podcast to view the full podcast library. And if you found this podcast helpful, please share it on your social channels. This is The Peds Pod by Le Bonheur Children's Hospital. Thanks for listening and be well.
Summertime RSV & What to Expect for Winter
Maggie McKay (Host): Across the nation, healthcare providers are seeing more little ones contract respiratory syncytial virus, most commonly known as RSV. The virus typically peaks in winter months. But for the last two years, we've seen summer surges. RSV is extremely transmissible and can be dangerous for infants or young children. Most children will get RSV by the time they're two years old. Medical Director of Infection Prevention at Le Bonheur Children's Hospital and Assistant Professor at the University of Tennessee Health Science Center, Dr. Nick Hysmith, is here to explain why we're seeing more summer cases of RSV, what signs and symptoms to look for and what parents can expect this winter.
This is The Peds Pod by Le Bonheur Children's Hospital. I'm Maggie McKay, Dr. Hysmith, thank you for being here today to explain what summertime RSV is and what to expect for the winter. We appreciate your time.
Dr Nick Hysmith: Yeah, thanks for having me.
Maggie McKay (Host): So what causes RSV and what are the symptoms for RSV?
Dr Nick Hysmith: So RSV is a pretty common virus. So it's a viral illness, much like any other viral illness that we see in the winter and summer months, like influenza virus or adenovirus. Unfortunately, RSV can cause pretty significant symptoms such as cough, difficulty breathing, runny nose, congestion, which is more severe in young kids, so kids less than two years of age.
Maggie McKay (Host): And what could be causing the summer surge of RSV?
Dr Nick Hysmith: So it's been interesting, over the last several years, we have seen this shift from RSV starting to rise in the late fall to early winter to seeing this in the summer months. And it's really all started since COVID-19 came into the picture. And the theory is that we were all masked for that 2020 season of RSV and we saw very little RSV in the winter. And then, we had these children who were born who had never seen RSV before and were very small about the time that we started to lift our masking restrictions across the country in the summer of 2021. And then, we saw that increase in RSV in 2021 during the summer. And then in the winter of 2021, we were all masking up again, as we were seeing another wave of COVID-19 come through. And it's sort of the same thing this year in 2022, we're starting to see the numbers increase in the summer again. And it's very interesting to see that happen, to see viruses switch seasons. But we're starting to see that happen. And it's a mystery to us in some way. As we look into the crystal ball of what's coming in the winter, it's kind of hard for us to know what it's going to do.
Maggie McKay (Host): Well, that was my next question. What do you expect for the fall and winter RSV season?
Dr Nick Hysmith: We go by precedent, what's happened in the previous years is what we look at. So we know that last year we had this big spike in the summer. I mean, numbers greater than we'd seen in the winter of several of the previous years or being seen in the summer of last year.
This summer has been sort of a steady increase and a plateau. And we're sort of plateaued right now with RSV. So it's a little bit unclear if we're going to just sort of stay at this plateau through the rest of the year or if we're going to see a plateau and then a dramatic increase in the winter. And like I said, looking into the crystal ball, I have no idea which one it's going to be. I sort of favor that we're going to stay at this plateau or just this gentle rise over the next several months into the winter. And then, hopefully, we won't see any flu as well, because if we start seeing influenza in the winter, which is what we usually see, but we haven't seen that either in the last two years, then that'll make it even more complicated.
Maggie McKay (Host): Right. Dr. Hysmith, what can parents do at home if their child does get RSV? So how can they help their child recover?
Dr Nick Hysmith: The biggest thing about RSV is it usually lasts for about five to six days. So you'll start to have symptoms on day one and you'll see the worst symptoms on day two or day three. And that really includes increased work of breathing, so kids having trouble catching their breath or parents will see what looks like struggling to breathe. So the big thing is for parents to recognize those symptoms and take their child to their primary care physician, their pediatrician, just get them looked at and make sure everything is okay, make sure they're getting enough oxygen, that sort of thing.
The majority of these kids will do fine at home. It just requires a lot of suctioning of the nose to get that mucus and snot out, so kids can breathe better and then really making sure that they stay hydrated. Unfortunately, several kids will also need to be admitted to the hospital. It's one of the most common reasons kids less than two get admitted to the hospital, usually during the winter months, but we've seen it more in the summer. So just keeping a close eye on that breathing and making sure you stay in contact with your pediatrician.
Maggie McKay (Host): Doctor, how should parents manage the fever part of RSV if their child has one?
Dr Nick Hysmith: Right. So many parents get really worried when they see fever and that's indicative of an infection. Fever is actually a good thing because your body is fighting the infection, but it can make your child feel pretty terrible. So we recommend giving Tylenol, as first line for fever, especially in kids around the one to two years of age. You can talk to your primary care provider about ibuprofen because we know that alternating Tylenol and ibuprofen can be beneficial. But before you go to that step, I would chat with your pediatrician.
Maggie McKay (Host): And so you said parents should take their child to the doctor pretty much right away when they see symptoms?
Dr Nick Hysmith: Yes, I would go ahead and get them checked out, especially, you know, if they're starting to see some trouble with their breathing, because like I said, it's around a five-day course. So if you're seeing that trouble day one, day two, you can go ahead and go to your PCP, your pediatrician, and they can see what's happening. And based on how they look in the office that day and where the child is in the course of the illness, you can roughly tell how sick the kid will get. So, you know, if you're having trouble breathing, a lot of stuff on day one, then you know that at day three, you're going to be probably needing some additional support maybe in the hospital setting.
Maggie McKay (Host): Wow. And something teachers always say, "Stay home if you're sick, no matter what you have," right? Don't your child to daycare or anywhere other than the doctor.
Dr Nick Hysmith: Right. I feel like we've really hammered that in over the last several years. But definitely if your kid is sick, running fever, do not take your child to daycare or to school. Get them checked out in their primary care provider's office to make sure it's not flu, RSV or, in the times of COVID, make sure it's not COVID either.
Maggie McKay (Host): Right. That's true. With science advancing so fast, do you know of any future prevention in the works?
Dr Nick Hysmith: So for several years, we've given a medication called Synagis, that is given to high risk children, so children with certain medical conditions or children who were born premature, and their lungs may not be fully developed during that first RSV season that they'll encounter. So we give that as sort of a prophylaxis prior to an RSV season in certain groups of kids. So in the majority of circumstances, a child's primary care provider will already know that and they'll have that medication available. We do see science really moving forward, and I'm hopeful that in the next several years, we'll have vaccines maybe for all kids or therapeutics for kids, medications that kids can take once they get RSV to help lessen the disease severity.
Maggie McKay (Host): Dr. Hysmith, thank you so much for this useful information, educating us on what summertime RSV is and why it's important for parents to know about it.
Dr Nick Hysmith: Yeah. Thanks for having me.
Maggie McKay (Host): Absolutely. Once again, that's Dr. Nick Hysmith. To learn more, check out our website at www.lebonheur.org, and read one of our most recent blogs, Five Facts About RSV Every Parent Needs To Know. And be sure to subscribe to The Peds Pod on Apple Podcasts, Google Podcast, or wherever you listen to your podcast. You can also check out lebonheur.org/podcast to view the full podcast library. And if you found this podcast helpful, please share it on your social channels. This is The Peds Pod by Le Bonheur Children's Hospital. Thanks for listening and be well.