Wave of RSV, particularly dangerous for babies, sweeps across U.S.

A wave of highly contagious respiratory syncytial virus is spreading across the United States, sending more babies and toddlers into hospitals, recent data shows.

The onset of RSV comes as the country heads into the broader fall and winter season of respiratory viruses, which also typically sees increased circulation of diseases such as COVID-19 and influenza. But RSV, a leading cause of hospitalization for infants nationwide, poses a particular risk to the youngest children, which is the main reason health experts recommend that pregnant women either get vaccinated shortly before giving birth or have their newborns immunized.

“This is the ideal time to get the RSV vaccine if you have never received it,” the Los Angeles County Department of Public Health said in a statement to The Times.

RSV can be spread through coughing or sneezing, and touching Health officials warn: Contaminate a surface, such as a doorknob, and then touch your face before washing your hands.

For the week ending Oct. 11, about 1.2% of emergency department visits nationwide among infants younger than 1 year were for RSV — up from 0.4% the month before, according to the data. published by PopHIVEa project led by the Yale School of Public Health.

“The wave of RSV is beginning to spread,” epidemiologists Caitlin Jetelina and Hannah Totte wrote in the journal blog Your local epidemiologist.

According to the US Centers for Disease Control and Prevention, RSV can be dangerous to infants, older adults and people with certain medical conditions. According to the California Department of Public Health, RSV can cause pneumonia as well as severe inflammation of the small airways of the lungs known as bronchiolitis.

“The problem with children is that their airways are so small that when it causes airway inflammation, it's just very difficult for them to breathe,” said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco. “So they come wheezing… and that’s why they’re in trouble.”

Nationally, RSV kills up to 300 children under 5 each year and can send up to 80,000 people to hospital. Among older people aged 65 and over, the virus could cause up to 10,000 deaths a year and up to 160,000 hospitalizations, according to WHO. CDC.

“I think it was undetected mainly because until recently… people weren't testing—we couldn't test for RSV until the era of molecular diagnostics,” Chin-Hong said. “So it was kind of an invisible epidemic.”

RSV is “kind of the bronze medalist for respiratory viruses, with COVID and influenza No. 1 and No. 2 fighting it, and RSV being No. 3 for older people,” he added. In general, during the fall and winter virus season, RSV appears first, followed by influenza and then COVID, Chin-Hong said.

Before immunization became available, 2% to 3% of young children were vaccinated. hospitalized for RSV annuallyAccording to the CDC. Most children hospitalized for acute respiratory illness caused by RSV were previously healthy, according to a study published in the journal. Pediatrics.

They may need oxygen or intravenous fluids or even be placed on a ventilator to help them breathe, according to the CDC.

Unlike influenza and COVID-19, there are no antiviral drugs to treat RSV once the infection has begun.

Currently combined activity The incidence of respiratory illnesses caused by RSV, influenza and COVID-19 in California is considered “very low,” state health officials said.

But “we are starting to see the start of respiratory virus season,” the Los Angeles County Department of Public Health said.

Health officials in Santa Clara County, Northern California's most populous county, are already reporting “average” levels of RSV in wastewater from San Jose, Palo Alto and Sunnyvale.

Now is the time to get vaccinated if you haven't already — “especially before respiratory virus activity potentially increases further,” said Dr. Regina Chinsio-Kwong, Orange County's health officer.

RSV immunization is recommended for pregnant women between 32 and 36 weeks' gestational age (about one to two months before their expected due date), as well as anyone 75 years of age or older, and people 50 to 74 years of age with underlying health conditions such as diabetes, cancer, kidney disease, a weakened immune system, asthma, or heart disease. Vaccines are also recommended for people living in a nursing home or long-term care facility.

If a pregnant woman has not been vaccinated against RSV, officials recommend that her baby be vaccinated.

The RSV vaccine is fairly new and will be introduced in 2023. There are currently three vaccines. brands – Pfizer's Abrysvo and GSK's Arexvy were licensed in May 2023, and Moderna's mResvia in June 2024. All three drugs can be used in older people, but only Pfizer vaccine available for pregnant women.

Babies could also receive immunized starting this year using monoclonal antibodies, which are not technically vaccines but work in a similar way in this case.

Older people who have already received the RSV vaccine usually do not need to get another one.

The arrival of these vaccines follows a particularly brutal 2022-2023 respiratory virus season, when California was hit by a hospital-cruel “triple pandemic” of RSV, influenza and COVID.

Unlike RSV vaccinations, flu and COVID vaccinations are generally recommended before each fall and winter respiratory season. According to the California Department of Public Health, seniors 65 and older can get a COVID vaccine every six months.

People can get RSV, flu and COVID vaccinations during one doctor's visit, Chinsio-Kwong said.

“Receiving all eligible vaccines at the same time is considered best practice as it helps avoid missed opportunities due to scheduling issues,” she said.

Studies have shown that immunization against RSV is effective.

During last year's respiratory virus season, there was a significant decline in hospitalization rates for infants with RSV. data shows. The data also shows that RSV vaccines have been effective in the prevention of symptomatic diseases in older people.

Chin-Hong said he suggests “everyone should get it” if they're 75 or older, but for those ages 50 to 74 with heart or lung disease or very immunocompromised, “I think the juice is worth the squeeze.”

Annual routine influenza vaccination is recommended for everyone over 6 months of age.

As for COVID, the vaccine can be given to anyone who wants it. Specifically, the California Department of Public Health recommends The shots are given to everyone age 65 and older, infants 6 to 23 months, children and teenagers who have never been vaccinated, and people with certain health risks and their close contacts.

The California Department of Public Health also recommends that pregnant women get the COVID vaccine.

After concerns earlier this season about how difficult it would be to get a COVID shot, pharmacists and health officials in California now say the shots are relatively easy to get.

The controversy emerged in late summer amid confusing guidance from agencies overseen by Health and Human Services Secretary Robert F. Kennedy Jr., who has been cavalier about vaccinations.

There was a period when the Food and Drug Administration belatedly approved COVID-19 vaccines only for people 65 and older and younger adults with underlying health conditions. The unprecedented delay in the Centers for Disease Control and Prevention's (CDC) issuing its own guidelines has led to vaccination difficulties for many.

In some states, that meant people were being turned away from getting a COVID vaccine at their local pharmacy, including older adults, even as cases surged in late summer. And at one point, the CDC's powerful Advisory Committee on Immunization Practices near recommended that the COVID vaccine be sold only by prescription.

On Oct. 6, acting CDC Director Jim O'Neill formally rescinded the agency's recommendation that adults under 65 receive an updated COVID-19 vaccine, saying instead that it should be based on “individual decision-making” and consultation with health care providers.

Now, “patients can go to the pharmacy” and discuss whether to get the COVID-19 vaccine with a professional, Allison Hill, director of professional affairs for the American Pharmacists Association, said during a recent webinar.

California also recently clarified state law to allow pharmacists to administer the COVID vaccine themselves, according to Dr. Erica Pan, director of the state Department of Public Health.