Most children get RSV by the time they’re 3 years old. But because of COVID-19 prevention efforts, the number of RSV cases dropped the last two years. That means a large group of children who had no previous exposure to the virus are now getting infected and becoming sick. “The RSV data show that the number of infections with the virus is nearly double what we would normally see, and that’s because of that basically double-sized susceptible pool,” says John Williams, MD, chief, Pediatric Infectious Diseases, and director, Institute for Infection, Inflammation, and Immunity in Children, UPMC Children’s Hospital of Pittsburgh. “We’re not seeing 10 times the RSV cases we normally would. While we usually see mostly babies, we’re now seeing the babies and the toddlers who didn’t get RSV last year.” For the same reason, Dr. Williams says the flu and metapneumovirus — another common respiratory illness — are also concerns in pediatrics this season. A larger group of children are vulnerable to those illnesses this season because they haven’t experienced them the past two years. After a first infection, people continue to get RSV, the flu, metapneumovirus, and other respiratory illnesses throughout their lives, Dr. Williams says. But the first illness often is the most severe. “There’s a big difference between some immunity and no immunity,” he says. Most cases of RSV are mild and go away within a week or two. But some people are at greater risk, including:
Infants (including premature babies) and young children.
Immunocompromised people.
Older adults.
People with underlying health conditions like heart disease or lung issues. “From a pediatrics standpoint, it’s really all about the small number of severe cases,” Dr. Williams says. “Most children are going to get these infections fairly early in childhood and most will be fine, but a small number of otherwise healthy children will have severe disease.”