It’s called respiratory syncytial (sin-sish-ul) virus, or RSV, and it causes infections of the lungs and respiratory tract.
Dr. Ryan Smith, the chief of pediatrics at Soldiers' Memorial Hospital, recently said the department is at 120 per cent capacity due to an 'unprecedented surge' of issues among local children. (Click here to read that story).
“Every kid through their lifetime probably gets infected with RSV multiple times over. In most school-aged kids, it just presents as a cold,” Dr. Leah Bartlett, chief of pediatrics at Royal Victoria Regional Health Centre (RVH), said.
But it’s nonetheless stressing out our health-care system and the people who work within it. This year, the rate of infection is worse, Bartlett said, at a time when the hospital typically sees an uptick in RSV infections anyway.
“This particular year, though, has been particularly bad and it has been particularly early,” she said, “so we were even seeing RSV early in the summer, so July, August … where typically we wouldn’t see RSV until later in September after kids start school.
“The peak of RSV tends to be later in the winter, around December through February,” Bartlett said. “I don’t think we’re through the thick of it.”
She said RVH’s emergency department is seeing a large number of patients with viral symptoms, about 60 per cent, and most are 18 and younger.
“Between six months and five years is the age where we’re seeing most of the RSV, or severe RSV symptoms,” Bartlett added.
Last week, federal Health Minister Jean-Yves Duclos said more children need to get their COVID-19 and influenza shots to contain surging hospital admissions, and that Canada’s in the throes of a so-called “tripledemic” — with COVID-19, flu and RSV in circulation.
Bartlett says patients with viral symptoms have helped make RVH very busy for her department, and that during the first three weeks of November about 1,200 people came to the ER with cold and flu symptoms.
“I think over the last month we’re sort of fitting around 125 per cent capacity on average and we have a pediatric surge plan in place for this pandemic or triple pandemic,” she said. “That would be to have the ability to surge up to 12 beds or 150 per cent capacity for our pediatric department.”
Bartlett said RVH is also seeing co-infections of influenza and RSV.
“Thinking about what we can vaccinate against, like influenza, we can vaccinate any child over the age of six months against flu,” she said. “If we can combat influenza, that’s 50 per cent of the issue, so that would certainly be helpful for the community to become vaccinated against flu.”
Staying home when you are sick is a common preventative measure, as is masking in public.
“Certainly masking around people that are more vulnerable, both those that are very young and very old, makes a lot of sense,” Bartlett said. “That’s a hard one I think for people to hear again, isn’t it? We feel like we just came out of the woods.”
She also said RSV specifically tends to be a virus that stays on surfaces, so wiping them down, making sure surfaces are clean can be helpful, as can washing hands.
And there is medicine to help prevent RSV.
“It’s not exactly a vaccination,” Bartlett said. “Typically, a vaccine would be where you’re giving a small protein to the body so that the body’s immune system develops an immune response and recognizes that protein as foreign, and creates antibodies or fighter cells against it. So that’s how our typical vaccine works, you know COVID vaccine and flu and all of the vaccinations that we get as young infants.
“The RSV shot, we’ll call it … it’s actually using antibodies from people who already had RSV, taking those antibodies and giving it to patients. It’s almost like giving those fighter cells directly into a patient.”
But this medicine is for young infants.
“It’s provided and funded by the Ontario government to give to babies who are born prematurely, because they’re the ones that are at the most risk of developing severe RSV infection,” Bartlett said, mentioning it’s also for developmental disorders such as Down syndrome. “It’s a very, very expensive shot, a very expensive medicine we’ll call it, and so it’s only given to those who meet certain criteria.”
RSV can be of particular danger to infants.
“It tends to infect these little ones because their airways are so tiny and RSV particularly … it causes a lot of mucus secretion, a lot of secretions,” she said. “So when you have those tiny narrow airways, those passages get clogged with mucus very easily.
“So as you grow those passages get bigger and it’s not as much as a risk. With tiny babies, they’re probably the highest risk,” Bartlett added. “Sometimes the disease is just severe ... and if kids have problems with their breathing, difficulty breathing, or feeding issues, then they need hospital care.”
Meanwhile, Duclos has said the previously announced one million units of imported kids' pain relievers are starting to arrive on pharmacy shelves, while an additional 500,000 units have been ordered and are expected during the next few weeks.
A separate shipment of kids' pain relievers from Australia is headed for hospitals and domestic production has ramped up, Duclos said.
Parents across Canada have been scrambling to manage their children's fever and pain as rates of RSV and influenza skyrocket amid a dire shortage of pediatric acetaminophen and ibuprofen. Health Canada said the one million imported units will be almost identical to the medications that are authorized in this country, typically known by the brand names Tylenol and Advil.
RSV can also cause severe infection in older adults, those with heart and lung disease, or anyone with a weakened immune system.
Signs and symptoms of RSV infection most commonly appear four to six days after exposure to the virus. In adults and older children RSV usually causes mild, cold-like signs and symptoms, including a congested or runny nose, dry cough, low-grade fever, sore throat, sneezing, and headache.
RSV infection can spread to the lower respiratory tract, causing pneumonia or bronchiolitis, which is the inflammation of the small airway passages entering the lungs.
Most children and adults recover in one to two weeks.
The Simcoe Muskoka District Health Unit, in a recent media release, said it's seeing higher and earlier-than-normal rates of RSV and influenza in communities, in addition to the ongoing spread of COVID-19 infection. To protect against this triple threat of infection and severe illness, the health unit strongly recommends using multiple layers of protection against these viruses this fall and winter.
“Young children, the elderly and those with medical conditions are at increased risk of serious illness from these respiratory viruses, and we are already seeing the impact on the health-care system with more medical visits and hospitalizations particularly for young children throughout the province including in Simcoe and Muskoka,” local medical officer of health Dr. Charles Gardner said in the release.
“These trends are expected to continue as more time is spent indoors,” he added. “By wearing a mask indoors and layering protective measures, we can help prevent viral spread and lower the risk of illness impacting our schools, workplaces and (the) local health-care system.”
The health unit salso trongly recommends that people wear masks in all indoor public settings, including schools and child care settings. Mask use, combined with other protective measures, can help to reduce the risk of becoming ill and protect others.
