Early symptoms of RSV infection might be mild. It could take a...

Early symptoms of RSV infection might be mild. It could take a few days into the illness for more severe symptoms to evolve.  Credit: TNS / Andrey Popov

Hospitals and pediatrician’s offices on Long Island are seeing a surge in cases of a common respiratory virus that can cause serious illness in some young children and infants.

The growing number of respiratory syncytial virus cases mirrors a national trend that has overwhelmed hospitals across the United States.

Experts have said COVID-19 pandemic restrictions, such as masking and social distancing, limited the usual spread of respiratory viruses — including RSV and influenza — in recent years. Easing of those precautions might also have opened the door to a resurgence of those viruses. 

“We are seeing a lot more of it this year,” said Dr. James Schneider, chief of pediatric critical care at Northwell Health’s Cohen Children’s Medical Center in New Hyde Park. “We're also seeing a lot of older kids too, whether they have asthma or other types of respiratory illnesses that have been triggered by RSV as well. It's definitely putting a strain on all hospitals, including ours.”

And it’s coming earlier. RSV usually peaks around December, January and February.

According to the Centers for Disease Control and Prevention, RSV is a common respiratory virus that usually causes mild, cold-like symptoms. But for very young children and older adults, it can cause bronchiolitis, the inflammation of the small airways in the lung.

The agency said RSV leads to about 2.1 million outpatient visits, 58,000 hospitalizations and 100 to 300 deaths every year for children younger than 5 years old.

Schneider said some of the symptoms seen in children with RSV include fevers and labored breathing.

“This can make it more difficult for them to eat well or drink well and if that’s not taken care of they can become dehydrated,” he said.

Dr. Leonard Krilov, chief of pediatrics and an infectious disease specialist at NYU Langone Hospital — Long Island in Mineola pointed out that RSV “evolves very quickly.”

“They may have a stuffy nose but 12 or 24 hours later they’re breathing faster,” he said. “You need to keep a good eye on them.”

Krilov said his hospital is also seeing a major uptick in RSV cases. About one-third or one-half of the hospital’s pediatric inpatients have the virus.

“That’s the tip of the iceberg,” he said. “A lot of children and babies get the virus and, fortunately, aren’t sick enough to need to be admitted. But still, it’s a week or two long illness with cough and decreased feeding … so even on the outpatient side, it’s a significant illness.”

Experts say the unusual timing and caseload of RSV is likely linked to the COVID-19 pandemic.

“The release from the non-pharmaceutical interventions, such as masks, and people making up for lost time, getting out and socializing, provided a vector for spread,” Krilov said.

In addition, the natural immunity that adults and children have when coming in contact with common seasonal viruses was diminished during the pandemic, due to measures like social distancing and staying home.

“I think there are more cases because kids haven't had it in the past few years and they're more susceptible to it,” said Dr. Aaron Glatt, chairman of medicine and chief of infectious diseases at Mount Sinai South Nassau hospital in Oceanside. “So you may get a 2-year-old, a 3-year-old and a 4-year-old when in the past, you would only have the 2-year-old … I also think that we have better tests and a better ability to identify it.”

Glatt said while his hospital has not seen a surge in young patients with RSV being admitted, there is an upward trend in kids being treated in emergency rooms, urgent care sites and pediatric offices. 

Dr. Eve Meltzer Krief of Huntington Village Pediatrics said she is also seeing an increase in RSV cases and worries about a possible severe influenza season, which has been predicted by some experts, as well as another COVID-19 winter wave.

“We are concerned because flu hasn’t fully hit yet and we are expecting a likely COVID-19 uptick,” she said. “With pediatric hospitals already filling up at this early date, we are very concerned about what the winter will look like.”

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