Friday, November 11, 2022

What is RSV, and why is it everywhere right now?

RSV is probably the commonest childhood illness you bave never heard of. 

Respiratory Syncytial Virus - pronounce it "sin-SISH-ul" - is a recurring seasonal virus like influenza. It is highly contagious, and spreads through sneezing, coughing, kissing, and touching contaminated surfaces and transferring to the face (sound familiar?). It usually remains contagious for three to eight days, although this can be longer in the immunocompromised. Just for information, "syncytia" is a medical term for the large cells that form when infected cells fuse together.

The main symptoms of RSV are similar to those of the common cold or a mild flu: a runny nose, nasal congestion, cough, sore throat, low-grade fever and headache. A barking or wheezing cough may signal that the infection is getting worse and spreading to the lower respiratory tract, where it can cause more serious infections like bronchiolitis (an infection of the small airways of the lungs) or pneumonia (infection of the lungs). Usually, it is merely an inconvenience, but it can be dangerous, even  life-threatening, for babies under twelve months and the immunocompromised, for whom an infection in the lungs and breathing passages can result in seriosu illness, hospitalization, even death.

Like COVID and influenza, both of which are also rife among children right now (the so-called "/tripledemic"), RSV is a viral infection, so the current shortage of antibiotics like amoxicillin is not a major problem (or at leaat not for RSV). Unlike COVID and the flu, though, there is no readily-available vaccine for RSV, so the shortage of children's formulations of ibuprofen (Advil/Motrin) and acetaminophen (Tylenol/Tempra) IS a problem, because they are the main first-line treatments available. Pharmacologically, pretty much all you can do, much like with other viruses, is try aad keep down the fever. Take plenty of fluids, rest, you know the drill. Sy.ptoms should go away on their own within a week or two.

And, yes, adults can get RSV too, although this is less common just because most adults have already had RSV as kids, usually by age two and often more than once, whether they knew it or not, so they tend to have a level of protective antibodies against the virus.

During the height of COVID-19, in 2020 and 2021, health authorities saw a sharp drop in RSV cases compared to previous years, due to COVID measures like masking, social distancing, hand-washing and staying home when sick, which remain the best protections against it. This year, though there has been a knee-jerk reaction against commonsense measures like masking (not me!), which has led to a wave of respiratory infections and an unusually early flu season (get your vaccination!) 

Babies and children who have been sheltered from many common bugs by COVID precautions and lockdowns are only now catching RSV and other infections, so we are seeing two or three years' worth of respiratory infections almost at once, making it seem like a tsunami of illnesses. This does not mean that the masking and social distancing was wrong, just that it has had some unintended and unforeseen consequences.

Oh, and by the way, RSV is not being caused by COVID or the COVID vaccine, whatever Facebook might want you to believe.

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