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U.S. hospitals ‘overwhelmed’ with young RSV patients; is Canada seeing the same trend?

Electron micrograph of Respiratory Syncytial Virus

As U.S. pediatric hospitals report being “overwhelmed” with respiratory syncytial virus patients, cases are also on the rise in Canada.

Respiratory syncytial virus, or RSV, is a common and contagious respiratory virus that often affects young children. According to the U.S. Centers for Disease Control, “virtually all children get an RSV infection by the time they are 2 years old.”

The virus mostly causes mild cold-like symptoms like runny nose, sneezing, coughing and fever, but it can lead to more serious illness such as pneumonia and bronchiolitis, which is the inflammation of small airways in the lungs. Children under six months and those with pre-existing conditions like asthma and congestive heart failure are among those most at-risk for severe complications, which can require hospitalization.

In the U.S., several hospitals currently report being “overwhelmed” by a surge of young RSV patients.

“This is our March of 2020,” Dr. Frank Belmonte from the Advocate Children’s Hospital in Chicago told ABC News. “So, this is the pediatric version of the beginning of the pandemic.”

At the Connecticut Children’s Medical Center, they’re even considering bringing in the state’s National Guard to help expand the hospital’s capacity.

“I have been at Connecticut Children’s for 25 years, and I have never seen this level of surge, specifically of RSV,” their physician-in-chief, Dr. Juan Salazar, told CNN.

CASES ‘ABOVE EXPECTED LEVELS’ IN CANADA

The Public Health Agency of Canada meanwhile is reporting a rising number of cases in much of the country, and particularly in Quebec, at a time when many Canadian emergency rooms are already struggling with long wait times and capacity issues.

“Respiratory syncytial virus activity (486 detections; 3.5% positive) is above expected levels for this time of year,” the agency’s most recent weekly Respiratory Virus Report from Oct. 15 stated. Like the flu, RSV infections typically come in a seasonal wave that lasts from fall through spring.

The current increase in RSV cases is widely being linked to measures to stop the COVID-19 pandemic. In Canada, lockdowns, masks and social distancing contributed to RSV numbers plummeting to 239 confirmed cases in the 2020-21 season, according to the Public Health Agency of Canada; down from 18,860 confirmed cases in 2019-20. Experts say a lack of exposure for approximately two years has left more young children vulnerable at the same time.

“I think their immune system just hasn’t seen the number of viruses a typical child prior to the pandemic would have seen,” Yale School of Medicine pediatric infectious disease specialist Dr. Thomas Murray told CNN.

Speaking to CTVNews.ca in a telephone interview on Monday, infectious disease specialist at Montreal’s McGill University Dr. Donald Vinh explained that RSV is similar to COVID-19 and other respiratory viruses, is quite contagious and can be easily transmitted in schools.

“We are seeing a return to what it was before the pandemic with these respiratory viruses, except it’s not just those respiratory viruses from prior to the pandemic — added to the mix now is also COVID,” Vinh told CTVNews.ca. “And so, the capacity for our health-care system to absorb people getting sick from RSV and flu, superimposed on people getting sick from COVID, well, there’s not much room to maneuver there.”

At the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa, they are testing twice as many children for the virus now than they were in late August.

“CHEO had the busiest April to September in its emergency department in its history; so over 30 years, we have never had that much activity,” Dr. Chuck Hui, the hospital’s chief of infectious disease, told CTV National News. “We’re certainly seeing more activity and more admissions across the province.”

‘WHAT A HORRIBLE VIRUS’

Although there is no vaccine and nothing to specifically treat RSV, most cases don’t require a doctor’s visit or hospitalization and usually clear up in one to two weeks with lots of rest and fluids. In more severe instances, children may be given oxygen or intravenous fluids if they are struggling to breathe or are dehydrated.

“RSV is not a serious as COVID was in the adult population,” Salazar from the Connecticut Children’s Medical Center said. “We can take care of these kids.”

Michelle Maguire’s three-year-old son James was sent home from preschool last Monday with a fever. When he tested negative for COVID-19 and his symptoms got worse, his parents took him to a hospital where they were told he has RSV.

“His symptoms started with a fever and poor appetite and quickly included congestion, a runny nose, pink eye in both eyes, and a horrible cough,” Maguire told CTVNews.ca from Calgary. “He has asthma, so it’s very worrisome to hear him coughing and wheezing so frequently.”

After eight days resting at home with Tylenol, liquids and plenty of chicken soup, James is finally starting to feel better.

“He has a one-year-old sister at home and its impossible to keep them separated, but she hasn’t been affected thus far,” Maguire said. “What a horrible virus.”

Lauren Kelly’s daughter Madeline is nearly two years old. Normally healthy and happy, late last week she was admitted to pediatric intensive care, sick and with breathing difficulties that were diagnosed as RSV.

“She couldn’t get enough oxygen in the emergency department so she had to go on BiPap,” Kelly told CTV National News from Winnipeg. “I cried the whole way to the hospital because I felt so guilty that I was coming here, knowing how busy everyone is and how stressed out the system is.”

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