Last winter, pediatricians were surprised and relieved to see fewer respiratory illnesses circulating. Both in pediatric offices and in hospitals, influenza and respiratory illnesses were almost nonexistent, and the strains of COVID-19 prevalent at the time did not affect children often. The lower numbers of respiratory illnesses last year was often attributed to mask-wearing in public spaces.
This year, however, is expected to be a different story. With the delta variant circulating and fewer people masking, health care authorities expect to see a return of respiratory illnesses.
The delta variant infects children more often and more severely, the 2021-22 influenza season is expected to be rough, and children are already presenting with what’s usually a cold-weather virus – respiratory syncytial virus.
RSV is a highly contagious virus that most children have had by the time they turn 2. Common RSV symptoms are those consistent with an annoying head cold – nasal congestion, sore throat, mild headache, fever, general malaise and poor appetite.
However, some children do develop such more serious symptoms as bronchiolitis (inflammation of the airways in the lungs) or pneumonia (infection of the air-exchanging sacs in the lungs). Children whose RSV turns to bronchiolitis or pneumonia sometimes require hospitalization and, more rarely, intensive care. Most RSV illnesses last about one week, although symptoms may persist longer.
RSV is diagnosed clinically by taking a good history and noting on the physician exam suggestive signs such as wheezing. There are specific tests to differentiate RSV from influenza and from COVID-19, but the RSV test is usually not necessary unless a child has underlying health conditions or is sick enough to require hospitalization.
Treatment for RSV involves support with fluids, good attention to the significant amount of nasal congestion these children often experience and oxygen, if needed. Because RSV is a viral infection, antibiotics have no role in treatment. Currently, there is no vaccine to prevent RSV for healthy children, although a vaccine does exist to prevent RSV in seriously ill, immunocompromised babies.
To prepare for the winter ahead, be sure you and your children both get the flu vaccine this season. Additionally, adults who haven’t already had the COVID-19 vaccine should do so as soon as possible, and children should also get a COVID-19 vaccine as soon as they’re eligible.
To schedule your COVID-19 vaccination, please visit mercy.net/movaccine.
Dr. Joseph Kahn is president of Mercy Kids (mercykids.org), an expansive network of pediatric care dedicated to meeting the needs of every child, every day.