Doctors are on high alert for rising cases of a potentially serious respiratory virus in parts of the United States, which could signal a serious nationwide outbreak.
The Centers for Disease Control and Prevention warned medical professionals that rising rates of respiratory syncytial virus (RSV) in Florida and Georgia in recent weeks mark the beginning of respiratory virus season.
And the Food and Drug Administration (FDA) has advised health professionals to brace themselves for what could be a “triple-demic” of RSV, flu and Covid-19 cases this winter.
RSV infects the lungs and airways and typically causes cold symptoms, although it can be deadly for seniors with weaker immune systems and for infants whose already narrow airways fill with mucus, making it difficult to breathe.
RSV is the leading cause of hospitalization for infants one year old or younger in the US. Each year, the virus causes up to 80,000 hospitalizations and 300 deaths in children under the age of 5.
And in seniors, the virus can cause up to 160,000 hospitalizations and 10,000 deaths annually.
Treatments and preventive measures for RSV have become more widely available in the past year, and so has the CDC encourage doctors to stock up on vaccines for adults and pregnant women and monoclonal antibodies for infants as they become available.
RSV is the leading cause of hospitalizations for infants one year old or younger in the US. Every year, the virus causes up to 80,000 hospitalizations and 300 deaths in children under 5 years old
The chart above shows the recent increase in hospitalizations of children in Georgia due to RSV. The RSV-associated hospitalization rate increased from two hospitalizations per 100,000 children in the week ending August 5 to seven hospitalizations per 100,000 children in the week ending August 19
In Florida, the positivity rate for RSV diagnostic tests was over three percent in July, which would be a normal rate. Since then, test positivity has consistently remained above five percent
This summer, however, marked the most substantial victory for infant protection against RSV, with the Food and Drug Administration (FDA) approval of a monoclonal antibody to protect against RSV called Nirsevimab, which will become available in October.
Nirsevimab is a monoclonal antibody that has been shown to reduce the risk of a serious RSV infection requiring hospitalization by nearly 75 percent in clinical trials.
For seniors 60 years and older there are now two new vaccines to help fend off the virus, one of which has been shown to be 80 percent effective in preventing RSV infection.
But the vaccines for older adults aren’t like a traditional flu shot that’s available to anyone who wants one. Doctors must decide, after consultation with their patients, whether the rare but potentially serious health risks associated with the vaccine, such as atrial fibrillation and neurological complications, outweigh the benefit of protection.
Regional increases early in the season, such as those currently taking place in the Southeast, offer health officials a glimpse of what lies ahead for the rest of the country in the coming months.
Agency officials monitor diseases test results in Florida found that the rate of diagnostic tests returning positive for RSV was more than five percent for about a month. The typical test positivity rate for RSV is around three percent this time of year.
In Georgia, the CDC noted an increase in hospitalizations due to RSV. About two in every 100,000 children in Georgia were hospitalized for RSV in the week ending Aug. 5. By August 19, that number had risen to seven hospitalizations per 100,000 children.
The increase in cases at this time of year would otherwise not be remarkable, as seasonal RSV, along with influenza, typically starts in early fall and peaks in winter.
But recent years have been an exception to that rule thanks to pandemic-era social distancing measures like masking and isolation. The measures were designed to stave off Covid and have also largely eradicated seasonal virus outbreaks as we knew them.
But as the world gradually reopened in 2021 after Covid-19 vaccines became available, seasonal viruses also returned.
Last year’s RSV season was one of the worst.
Covid, flu and RSV began to circulate with some overlap, sparking fears of a ‘triple-demic’.
Now there are renewed concerns about a new ‘tripledemic’, a situation in which three diseases join forces and overwhelm the healthcare system, which has so far failed to have the devastating impact on the scale many epidemiologists feared.
Still, the CDC is recommending that doctors ramp up testing for RSV, as well as Covid and the flu, in schools, daycare centers and long-term care facilities, and stock up on the latest medications.
The health authority also recommends that all babies under eight months of age born during RSV season should receive the antibody within their first week of life, while babies born outside of the normal season should receive Nirsevimab before the next RSV season begins.
While the shot has been shown to be extremely effective, the CDC acknowledges that not all hospitals will immediately have it in their arsenal due to high demand.
Pregnant women can also receive a vaccine that confers immunity on their unborn babies for continuous protection for six months after birth.