WHEN SHOULD I WORRY ABOUT...

What the Off-Season Rise of RSV Cases Means For Kids & Adults

Aug. 17, 2021 - Katie McCallum

There's nothing like an offseason comeback story. Unless you're talking about the comeback of respiratory syncytial virus (RSV) this summer, of course — a common cold virus that we don't usually have to worry about until the fall.

"What's interesting is that last fall we essentially saw no RSV whatsoever. We had masks and social distancing to thank for that," says Dr. Wesley Long, director of diagnostic microbiology at Houston Methodist.

But when mask mandates and other restrictions were lifted this past March, RSV made an offseason comeback.

"It's not something you develop lifelong immunity to, so — after going a year without being exposed to it — we had a hugely susceptible population. Once it was reintroduced, it started to come back," explains Dr. Long.

Similar spikes in RSV cases have been seen elsewhere around the world, too, such as after COVID-19 restrictions were lifted in Australia.

But, what does this mean for us? Summer colds aren't really anything new, after all.

"Right now, RSV spreading through the population matters more since COVID-19 cases are also rising again. People need to be aware that this cold virus is out there and could be the cause of respiratory symptoms. But, if you have symptoms, do not assume that it's 'just a cold' — you need to take the appropriate measures, like getting a COVID test and isolating at home," says Dr. Long.

Plus, with back-to-school season in full swing, having an out-of-season virus lingering the same time as COVID-19 is yet another reason to take extra precautions in schools and at home.

Here are three things Dr. Long wants us to know about RSV:

1. RSV is most concerning for kids, but adults can get pretty sick, too

"RSV can be a particularly nasty cold for kids, and it can actually cause severe disease in premature babies or some kids," warns Dr. Long. "There's also the concern that a child might come down with both RSV and COVID-19 at the same time, and what having two respiratory viruses might mean for symptom severity."

So, with yet another virus looming that passes easily from person to person, continue to remind kids of the behaviors that help prevent the spread of germs — especially as they head back to school.

"The good news is that the everyday precautions you and your family take to stay safe from COVID-19, such as wearing a mask, social distancing, hand hygiene and avoiding crowds, will also help protect you from RSV," says Dr. Long.

And since you can pass it to someone more vulnerable, it's always important to stay home if you're sick.

As for adults, RSV usually isn't of huge concern, but it can cause a really annoying cold that all of us would rather avoid.

"It can be one of those two- or three-week, hacking-cough types of colds," adds Dr. Long.

2. It's impossible to know if you have a cold or COVID-19 without getting tested

Speaking of a cough — those put us all on high alert these days, especially as the Delta variant continues to spread throughout our communities.

How do you know if it's a cold or COVID-19? Unfortunately, you probably can't.

Dr. Long's advice: If you have any respiratory symptoms at all, get a COVID test so you can make sure it's not COVID-19.

"The symptoms of an RSV cold and COVID-19 are going to overlap, so it's near impossible for someone to self-diagnose which you have at home," says Dr. Long. "A scratchy throat could be a cold, or even just allergies. But, it could also be COVID-19 — even if you've been vaccinated, although this is rare."

Whether it's RSV or COVID-19, consult with your doctor or your child's pediatrician if your symptoms are getting worse or not improving.

3. Masks protect us from more than just COVID-19

Masks will continue to be a must during this pandemic. But the rapid resurgence of RSV as soon as mask mandates were lifted show us that masks might just always be a nice-to-have — regardless of how COVID-19 is currently spreading in your area.

For instance, perhaps we continue to wear masks while:

  • In a hospital, clinic or doctor's office
  • Running errands, particularly if a store is crowded
  • Traveling or using public transportation
  • Visiting with someone with a weakened immune system

"Those who didn't get COVID-19 can probably look back over the last year or so and realize they really didn't get sick at all," says Dr. Long. "And we saw this in our flu and cold virus tracking, too. Flu cases were at an all-time low. Rhinovirus and enterovirus, two of the other cold-causing viruses, popped back up in Fall 2020 as schools reopened, but cases were still well below the typical average."

And replicating this dramatic decrease in flu cases is especially enticing for public health experts like Dr. Long since, during the 2019-2020 U.S. flu season, the CDC estimates that influenza caused 18 million medical visits, 410,000 hospitalizations and 24,000 deaths.

"Beyond this pandemic, there may be some times and/or places where simply wearing a mask could help reduce the risk and burden that the flu and other infectious diseases place on ourselves and our health care systems," Dr. Long adds.

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