Hasbro Children’s Hospital in Rhode Island is one of many pediatric care facilities being strained by the recent uptick in cases of RSV. We spoke about the situation with Dr. Michael Koster, a pediatric infectious disease specialist at the hospital.
Michael Koster: RSV stands for respiratory syncytial virus, and for most people that’s a common cold. For really young infants and for elderly, it can be a severe lower respiratory tract fissure, what I call a chest cold. And in kids, we have a specific name for that called bronchiolitis, which is inflammation of the smaller airways of your lung. That just makes it really hard for kids to breathe. We do know that kids who have prematurity, heart disease, lung disease and chronic illnesses like that are at higher risk, especially under the age of two. But for the most part, kids get exposed to it every year, just like they get exposed to every other virus – influenza, parainfluenza, metapneumovirus. There’s a whole laundry list of viruses that cause colds and lower respiratory tract infections and kids.
Luis Hernandez: What’s been happening that we’re now seeing stories from around the country and here in Rhode Island where your beds are filled with kids with RSV? What’s been happening?
Koster: A couple of things. One is what people call the immune gap for kids. So for the last three years, we’ve had both Omicron replacing every other virus, and we haven’t seen the flu. We also didn’t see RSV. So you got three-year-old kids who have never been exposed to something like RSV, they’ve been living in a bubble. Everybody was masked and living in their house and shrinking their social circle. So people were being very careful, washing their hands a lot more and using face coverings and things, and so all that led to less and less exposure to kids. And so now, instead of four million kids, which is the cohort of kids born every year being exposed to the virus, we have 12 million kids exposed and affected by the virus. And these kids didn’t have that buildup of immunity over the last three years. One additional theory that I have is that pregnant women were not exposed to RSV, or other viruses like influenza and other respiratory viruses. So when babies are born, they’re born with their mom’s immune system. The mom actually transmits the immune globulin to the kid through the placenta, and the baby’s born with protection that wanes over six months to a year. So the kids that we’re seeing that are super sick in the hospital are kids who are under the age of three months. And I think that has a lot to do with lack of moms’ antibodies. This has happened across the country with RSV because we’ve had just a huge number of kids and they’re more sick.
Hernandez: What is it that parents should know?
Koster: Parents need to watch for signs of severe respiratory distress, and that’s where you know they’re working really hard to breathe. You can see their ribs outlining and you can see the notch above their sternum or around their collarbones really sucking in as they’re using extra muscles to breathe. Or something that’s the most severe, which is head bobbing and grunting – so every time they breathe out [demonstrates labored breathing sound] there, I mean, that should be a sign for the parents to call rescue.
