A respiratory virus is surging across Florida and other parts of the country, causing health experts to warn of a potential “tripledemic” during the next several months.
Some hospitals are reporting an increase in the number of small children becoming infected with respiratory syncytial virus (RSV), which is akin to the common cold. Although adults and older healthy children typically only experience mild symptoms from the illness, children under 5, and others that may have weak immune systems, are at risk for more severe infection.
Dr. Shelley Collins, a pediatrician and professor of pediatrics at the University of Florida College of Medicine, said that although UF Health has not seen the same increase in RSV cases as other places, there has been a noticeable rise in respiratory diseases in general such as rhinovirus and enterovirus.
“Historically, we lag a bit behind the Northeast in terms of numbers of patients with respiratory illnesses, including RSV,” she said. “But we are anticipating increased numbers for sure, just like they’re seeing (up north).”
RSV usually doesn’t appear in most areas in Florida until around January or February. This year, cases started rising last month.
In fact, during September, the number of emergency room visits for RSV among young children were higher than in past years, according to the Florida Department of Health.
The Centers for Disease Control and Prevention says infants and young children with the virus may experience a decrease in appetite before any other symptoms appear, and a cough will usually develop one to three days later.
Sneezing, fever and wheezing may also occur. In very young infants, irritability, decreased activity and/or sleep apnea may be the only symptoms of infection.
RSV season
In most regions nationally, RSV usually circulates during fall, winter and spring, but the timing and severity of RSV season in a given community can vary from year to year.
Florida has the longest RSV season in the country, with several distinct regions created by the Department of Health.
Alachua County, a part of the North Florida region, has an RSV season that runs from September through March.
Devin Frison, lead epidemiologist at the Alachua County Health Department, said the county has fortunately not yet seen a rise in RSV cases.
“We’re still kind of unsure of what future is going to hold, but we are keeping an eye on the number of cases we see,” she said.
Possible “tripledemic”
Some experts are concerned that RSV, coupled with COVID and the flu, may result in what’s being dubbed as a “tripledemic” this winter.
Collins said that health care providers are most concerned about this triple threat occurring in people who have not been vaccinated against COVID and the flu, and that some kids are already enduring two respiratory viruses at once.
“We are seeing kids with multiple virus already,” she said. “Sometimes it’s a combination of flu and RSV, and sometimes it’s a combination of RSV and other common viruses that are out in the community … which can tend to make the patients a little bit sicker.”
Hospital overflow
While most cases involving COVID, flu and RSV are likely to be mild, the viruses combined could result in millions of Americans falling ill, which could overload hospitals, according to a recent report from The New York Times.
Already multiple children’s hospitals in the Tampa area, Virginia, Maryland and Washington, D.C., are overflowing with RSV patients, the Tampa Bay Times reported.
RSV was discovered in 1956 and has since been recognized as one of the most common causes of childhood illness, though annual outbreaks are spread across all age groups.
Specifically, in the U.S., RSV most commonly causes bronchiolitis (inflammation of the small airways in the lungs) in children younger than 1 year old and sends approximately 58,000 children under 5 to the hospital annually, according to the National Institute of Allergy and Infective Diseases.
Why RSV is on the rise
Health experts say that the lockdown during pandemic is likely to blame for RSV’s uptick.
During extensive lockdowns, children and adults were mostly shielded from common infections, which may have been counterproductive, especially for small kids.
“Since everyone was at home for COVID, you didn’t have individuals outside being exposed to the flu or other viruses,” Frison said. “So, once you get people coming back out and interacting, it’s a possibility that you could contract a combination of (respiratory) viruses, but it’s unpredictable at this point.”
The CDC said that while there currently isn’t an RSV vaccine, like that of the flu and COVID, researchers are developing several vaccines, monoclonal antibodies and antiviral therapies to help protect infants and young children, pregnant women (to protect their unborn babies), and older adults from severe RSV infection.
Like most respiratory diseases, the virus is primarily spread through droplets from the infected.
Collins said to help prevent the spread of RSV, health care providers recommend the same precautions they do with influenza and other contagious illnesses: wash your hands thoroughly and stay home if you’re sick.
“If your aunt or grandmother is sick, that’s not the time to come see your newborn baby,” she said. “Because it’s really in our smallest babies that tend to get the sickest with RSV.
“Older children certainly can (become sick too), but as you get a bit older, your airways are bigger and so they tend to handle the virus a bit better.”
