'Tripledemic' Warning As Respiratory Illness Cases Rise In MA

MASSACHUSETTS — Respiratory syncytial virus, or RSV, a fairly common illness that can cause breathing difficulties in young children, is surging early across the country, and infectious disease experts are worried whether local hospitals will be unable to keep pace.

Nationally, some 7,334 RSV tests came back positive for the week ending Oct. 15, up from 6,518 the week before that and 5,210 the week before that, according to data from the Centers for Disease Control and Prevention.

In Massachusetts, PCR tests have detected a recent uptick in RSV. Over the first week of October, about 8.6 percent of about 1,000 PCR tests were positive — but both the number of tests and the positive percentage have risen since then, according to CDC data.

Here's how RSV has risen in Massachusetts in recent weeks:

• Oct. 8 — 11.3 percent positive out of 1,136 tests
• Oct. 15 — 15.1 percent positive out of 1,174 tests
• Oct. 22 — 17.2 percent positive out of 1,204 tests

There's also anecdotal evidence of a local rise in RSV cases, with Boston hospitals even seeing cases from children who live in neighboring states.

Health officials are warning of a possible “tripledemic” if the RSV peak coincides with seasonal peaks in influenza and COVID-19. The three illnesses have similar symptoms.

There are no inoculations against RSV, as there are for both the flu and COVID-19, but a couple of pharmaceutical companies are working to develop vaccines.

RSV cases fell dramatically two years ago when schools, day cares and businesses shut down to control the spread of COVID-19. Doctors saw an alarming increase in what is normally a fall and winter virus when coronavirus restrictions were eased in the summer of 2021.

Here are five things to know:

How Common Is RSV?

Almost all U.S. children catch an RSV infection by the time they are 2. Symptoms include a runny nose, cough and fever, and people who are infected are typically contagious for three to eight days.

However, babies and people with weakened immune systems can spread RSV for up to four weeks.

Who Is Most Susceptible?

RSV poses the biggest threat to infants, older adults and people with suppressed immune systems, and can cause serious airway and lung infections.

“You and I get it as a common cold,” Dr. Elizabeth Mack, a pediatric critical care physician at Medical University of South Carolina, said in a news release.

“But babies with any viral illness are more likely to struggle with it because their airways are smaller. It's hard to clear the secretions,” Mack continued. “They’re obligate nose breathers, meaning they mainly breathe through their noses. So when their noses are stopped up, it causes problems with their breathing.”

Breathing problems can interfere with a baby’s ability to eat.

“And that’s really when we start to worry,” Dr. Melanie Kitagawa, of Texas Children’s Hospital in Houston, told the Associated Press.

“They’re breathing fast, breathing deep. We see them using muscles in their chest to help them breathe,” Kitagawa said. “These are kids who are having difficulty taking a bottle because their breathing is being impacted, and they can't coordinate both at once."

In typical years, 2.1 million children 5 years and younger are treated, and 58,000 of them are hospitalized. RSV is responsible for between 100 and 300 deaths in children younger than 5, according to the CDC.

Among adults 65 and older, about 177,000 people are hospitalized every year, resulting in 14,000 deaths.

Why Are Cases Surging Now?

Babies and children were sheltered from common bugs during COVID-19 lockdowns, and that leaves them highly vulnerable, according to health experts.

Mack said after two years of masking, which protected children from all respiratory viruses, it’s unclear if immune systems are reacwting differently to viruses people have not encountered in recent years.

Also, the babies’ mothers may not have been infected with RSV during their pregnancies, which could have offered some immunity to their children.

How Is RSV Treated?

There is no specific treatment for RSV; rather, it’s a matter of managing symptoms and allowing the virus to run its course. Doctors may prescribe oral steroids or an inhaler to make breathing easier.

In serious cases requiring hospitalization, patients may be put on oxygen, a breathing tube or a ventilator.

What Should You Do?

To prevent the spread of RSV, health care providers recommend the same precautions they do with influenza and other contagious illnesses: Wash your hands thoroughly and stay home if you’re sick.

But if you’re worried your child is having a severe breathing problem, “do not hesitate” to go to an emergency department or call 911, Dr. Russell Migita, of Seattle Children’s Hospital, where RSV is on the rise, told the AP.

Less serious symptoms can usually be handled by regular health care providers, including those available in telehealth appointments, or by going to urgent care.

Also, doctors advise, get flu shots and COVID-boosters.

“We don’t want a triple whammy, a triple pandemic,” Chicago physician Dr. Juanita Mora, who on Saturday saw a family of five kids, all with RSV, told the AP.

The Associated Press contributed reporting.