Public Health Watch: Pediatric RSV on Decline Amid Omicron Surge

It seems, at best, counterintuitive to highlight positive trends with one respiratory virus in pediatric populations during the surge in cases and hospitalizations among children fueled by the emergence of the Omicron variant of SARS-CoV-2.

However, the dramatic decline in confirmed cases of respiratory syncytial virus (RSV) Infection in the United States after a concerning spike last summer is worthy of note, if only for potential public health-related lessons.

After consistently seeing approximately 4500 laboratory-confirmed cases per week nationally from the middle of August—not coincidentally when many schools opened for in-person learning for the 2021-22 academic year—through the mid-December, the numbers have dropped precipitously, according to the Centers for Disease Control and Prevention (CDC). From the week ending December 11, 2021, when there were 4404 laboratory-confirmed cases across the country, there were 744 during the week ending January 15, an 83% decline.

True, the decrease coincides, at least in part, with holiday-related school closures. However, it also likely parallels the implementation of more stringent public health measures—mask-wearing, social distancing—at least in some school districts nationally in response to the aforementioned Omicron-related surge in pediatric cases and hospitalizations.

Of course, not everyone is happy that schools have reopened, or remained open, with Omicron still in circulation. Students in New York City recently staged a walkout over safety concerns caused by the surge, and teachers in Chicago just ended a work stoppage organized, they said, in protest over the resumption of in-person learning during the pandemic’s most recent phase.

However, the CDC remains adamant that it is safe to keep schools open provided COVID-19 protocols are in place and enforced. And doing so has the added benefit of keeping RSV cases among school children low as well.

As reported by Contagion, a study published by JAMA Network Open predicted that cases of RSV would be much lower this winter, due at least in part to COVID-19 mitigation.

Given that, with or without the pandemic, RSV poses a significant public health threat, with roughly 60,000 hospitalizations among children age 5 years and younger annually, according to the CDC, a reduction in cases should mitigate any concerns parents and educators have regarding the social and learning implications of mask-wearing for school-children.

And there’s more good news as well. A potential new immunization to protect against RSV, nirsevimab, is currently in clinical trials and performing well.

Such positive news during the pandemic is all too rare.