Oregon Medical Group Experts Discuss This Year’s Headlining Respiratory Illness: RSV

December 5, 2022

Even before the temperatures dropped here in western Oregon, the nation was poised for an active season of respiratory illness, with a convergence of COVID, flu and RSV – respiratory syncytial virus. Oregon Medical Group’s Chief Medical Officer Stacy Chance, MD and pediatrician Laura Sanderson, MD confirmed that RSV has found a foothold in our area and offer the following information for patients and community members. 

We’ve heard of RSV affecting small children. Is this virus exclusive to children? Or is everyone at risk of contracting it?

RSV has received attention because it hits children – especially very young children – harder. It’s also very contagious, so it can spread through childcare and daycare centers quickly, even with good hygiene measures in place.

But it’s certainly not limited to children. We have seen quite a few adults with RSV. It’s likely that a lot of the ‘colds’ that we’re hearing about – illnesses that people tolerate without a doctor visit – are RSV.

Is RSV a new illness?
No, RSV has been circulating for years. It’s a common seasonal virus and most children have had it by age two. But this year it arrived earlier and hit harder than usual. Many of us suspect that many children who would have experienced it earlier simply weren’t exposed during the COVID years, and that has worsened its impact. Still, even in “normal” years RSV is the leading cause of hospitalization for infants. In the US, 58,000 children under five are hospitalized each year.

How dangerous is RSV? Should we be concerned about another pandemic?

RSV can be dangerous for premature infants and those under six months, and for people with chronic heart or lung disease, who are immunocompromised, and those 65 and up. The virus itself is not the danger, but the complications that can arise from it are a concern.

RSV is not a pandemic, but because those it affects are the same who we were concerned about during COVID, especially during the early months of it, it can be alarming to some.

What are the symptoms of RSV?

Most people experience RSV as a cold, with a cough, sneeze, runny nose and/or fever. It can be difficult to tell the difference between RSV, COVID and the flu. Only a test can tell for certain, but management is similar for all three – keeping fever down, reducing symptoms, staying hydrated and watching for breathing issues.

Why are people hospitalized for RSV?

RSV can lead to lung infections, including pneumonia and bronchiolitis, but severe RSV can lead to congestive heart failure. Hospitalizations are intended to help avoid that level of reaction and typically to alleviate breathing problems.

When should I call my provider?

You should call immediately if someone is having trouble breathing, is very and untypically inactive, is very dehydrated or not getting better after two weeks. 9-1-1 is the way to go if someone is not breathing or unresponsive.

How do I tell if someone is dehydrated?

If their urine is dark yellow, or diapers are drier and lighter for longer than usual, increase fluids. Pedialyte is a good option for people of all ages. Avoid sodas and juice in a case like that. If someone is sick, fluids should be encouraged hourly, at minimum.

What can be done to prevent RSV?

The same actions that prevent the spread of other illnesses, like COVID, apply here. Wash your hands frequently and thoroughly, don’t touch your face, disinfect frequently touched surfaces, cover coughs, wear a mask if you feel ill. Most of all, stay home if you have symptoms – especially at the beginning.

What advice to you offer those with infants at this time of year?

With so many illnesses circulating, we recommend you avoid crowds and continue to keep your circle small. We’re not telling you to go into lock-down mode – socialization is important for children – but be aware of your exposures.

How long should someone stay home if they have RSV symptoms?

People with RSV are usually contagious for three to eight days. They might even be contagious for a day or two before showing symptoms. This makes your ‘stay home’ timing variable. But no matter what illness it is, you should always stay home until you have been without a temperature of 100.4 degrees for at least 24 hours.

This is where we really count on people to use common sense. For example, a child who doesn’t have a fever but still feels unwell should stay home. If in doubt, call your provider’s office.

Is there a vaccine for RSV?

A vaccine is in progress but because the danger is primarily limited to infants and young children, older adults, and adults with compromised immune systems, it is likely to be one that is given only to these people. The best prevention will continue to be hygiene and isolation when ill.