What is causing this ‘amazing rise’ in RSV? Experts explain.

RSV is on the rise across the country. The Centers for Disease Control and Prevention (CDC) reports that an increase in both RSV detections and RSV-related emergency department visits and hospitalizations across the US, which are stretching pediatric hospitals thin.

“There is such an incredible increase this year,” Dr. John Carlpediatric pulmonologist at the Cleveland Clinic, tells Yahoo Life.

Although a common respiratory virus usually causes cold-like symptoms that usually go away in a week or two, RSV can be severe in infants and the elderlyaccording to the CDC, as well as in those who are immunocompromised.

While to some it may seem like this virus came out of nowhere, RSV is nothing new. It was the first discovered in 1956 and, according to the CDC, is considered one of the most common causes of childhood illness. “RSV has always had a big impact,” Dr. Pedro Piedra, professor of molecular virology and microbiology and pediatrics at Baylor College of Medicine, tells Yahoo Life. “So it’s not like it’s new. It is the main cause of hospitalization and infant mortality. In the elderly, it’s similar to the flu – it has a huge effect.”

However, the frequency of the disease seems to be particularly high this year. “Here’s this typical virus, but it comes in triple and quadruple the number and severity,” says Carl. “This is the pediatrician’s COVID, really.”

So what’s going on? Experts explain.

What is causing the rise in RSV this year?

The RSV season came early this year — it appeared in the summer, rather than the typical fall and winter season — and has continued, Piedra says — “and that’s unusual for the amount of virus we’re seeing for RSV.”

Adding fuel to the fire is the fact that RSV isn’t the only respiratory virus circulating — along with COVID, flu cases are “growing like wildfire,” Piedra says, creating a “triple epidemic.” “Never before have we had this many hospitalizations and cases at this time,” he says. “I think this is going to be a bad season because it caught a lot of people off guard in terms of [influenza] vaccines, because people tend to delay getting vaccinated.”

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While it was some discussion about “immunity debt” or the “immunity gap” — namely, that we’re seeing more respiratory infections after we calmed down in the first two years of the pandemic and limited our exposure to these viruses — experts say the pandemic played a role.

Almost all children experienced at least one RSV infection before they turn 2 years old. For babies in the first six months of life, RSV can be “particularly severe, leading to bronchiolitis — an infection of the lung passages — and pneumonia,” according to JAMA network. “Subsequent infections are usually milder and cause cold-like symptoms. But basically there was no RSV in 2020, and now the kids are paying for it.”

Carl explains that during the first two years of the pandemic, “people really stuck to isolation. We had nothing to offer him,” meaning that respiratory viruses, including RSV, didn’t have as many hosts to infect while people mostly stayed home. As the protections people used to avoid COVID began to fall apart, respiratory infections increased, and RSV “reared its ugly head,” Carl says.

Piedra agrees, saying that SARS CoV-2 has had a “tremendous” impact on the epidemiology of other respiratory viruses. “This could be because of the non-pharmaceutical interventions that have taken place — wearing masks, social distancing, reducing the amount of gatherings — that affect the incidence of all other respiratory viruses,” including RSV, he says.

However, as children returned to school, families began to travel again, and non-pharmaceutical interventions such as wearing masks were significantly reduced, “Mostly we saw the emergence of many respiratory viruses,” says Piedra.

COVID — which, like RSV, is spread by droplets from an infected person’s mouth or nose when they talk, cough or rain — has also made us more aware of respiratory viruses in general, including a better understanding of how they spread and how to prevent them. RSV cases “happened every year before COVID, but because of COVID, we’ve become much more aware of respiratory viruses,” says Carl.

What can people do to protect themselves from RSV?

Both Carl and Piedra recommend that children and adults stay up-to-date on their COVID and flu shots to reduce the risk of getting other competing infections. Pfizer is working on an RSV vaccine, but, as Carl points out, “it’s not in our hands right now.”

Therefore, in the meantime, experts recommend regular hand washing. For nurseries and schools, Carl says disinfecting hard surfaces also helps, as the virus can survive on objects such as doorknobs and toys. “Teach children if you have to cough, cough into your elbow,” he adds.

Experts recommend that children (and adults) stay home when they are sick. If your child has a stuffy nose and you’re hesitant to send him to school, Carl recommends wearing a mask for three to four days to prevent infecting others. They can “explain to classmates, ‘I have a cold and I don’t want to give it to you.'”

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