Addressing RSV in the Pediatric Population

The reemergence of respiratory syncytial virus (RSV) last year and its timing has been puzzling to clinicians and public health officials. There have been reports going back to last summer with pediatric patients being diagnosed and hospitalized with the virus, and certainly this past fall, a surge in RSV overwhelmed hospitals and the health care system in some areas of the US— which was out of the norm for this seasonal virus.

The Centers for Disease Control and Prevention (CDC) has noted on their website the increased incidence rates. “CDC surveillance has shown an increase in RSV detections and RSV-associated emergency department visits and hospitalizations in multiple US regions, with some regions nearing seasonal peak levels. Clinicians and public health professionals should be aware of increases in respiratory viruses, including RSV.”

And although the exact cause has not been defined, some point to the COVID-19 pandemic disrupting the typical seasonal cycle of viruses.

“The pandemic really did change the pattern with which the respiratory viruses circulate,” Tina Q. Tan, MD, professor of Pediatrics at the Feinberg School of Medicine, Northwestern University, and a pediatric infectious diseases physician at the Ann & Robert H. Lurie Children’s Hospital, Chicago, Illinois. “We don’t really understand why that occurred, but we do know RSV, influenza, and even COVID [and that] these surges are occurring much earlier than they normally would.”

This along with the rise of other viruses has made diagnosis difficult, Tan explains. The surge in these viruses has impacted treatment and created shortages of Albuterol and antibiotics. “The problem is that when some of these kids and infants present to an emergency room that is not pediatric or to an urgent care many [providers] will take a look at them and think, ‘will they develop a bacterial infection?’ And this has really led to the shortage of antibiotics because these kids are being placed on antibiotics unnecessarily.”

Contagion spoke to Tan about these existing RSV issues, including systemic changes, and the potential of RSV vaccines that could help address the pediatric population and infants.