Why is the US Experiencing a Surge in RSV Infections Out of Season?

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SUMMARY

The United States is experiencing a 60% surge in respiratory syncytial virus (RSV) infections during atypical months, with significant increases noted since late August 2022. This rise is attributed to an "immunity gap" resulting from Covid-19 mitigation measures, which reduced exposure to RSV and flu, leaving many children without developed antibodies. Current RSV vaccines show promise but are not yet available, and hospitals are facing high occupancy rates due to the influx of RSV cases alongside Covid-19 and flu infections.

PREREQUISITES
  • Understanding of respiratory syncytial virus (RSV) and its impact on public health.
  • Familiarity with the concept of immunity gaps and their implications for infectious diseases.
  • Knowledge of Covid-19 mitigation strategies and their secondary effects on other respiratory viruses.
  • Awareness of current healthcare system capacity and hospital occupancy metrics.
NEXT STEPS
  • Research the latest developments in RSV vaccine trials and their expected release dates.
  • Examine the historical context of immunity gaps, particularly in relation to the H1N1 1918 flu pandemic.
  • Investigate the impact of Covid-19 on seasonal respiratory infections and healthcare capacity.
  • Learn about the symptoms and treatment options for RSV in children and elderly populations.
USEFUL FOR

This discussion is beneficial for healthcare professionals, public health officials, educators, and parents concerned about the rising RSV infections and their implications for children and vulnerable populations.

jim mcnamara
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TL;DR
Respiratory Syncytial Virus RSV is reported at rates 60% higher than last year because of an "immunity" gap. Something similar happened to the 1918 H1N1 influenza pandemic with greatly increased mortality
RSV background: https://www.cdc.gov/rsv/index.html
"immunity gap": https://www.cnn.com/2022/10/26/health/rsv-immunity-gap/index.html

RSV -respiratory syncytial virus - commonly occurs in small children, sometimes in older adults. It is a lower respiratory disease with some mortality.

The US is seeing a 60% increase in RSV for this year - and in the "wrong" months. In the past RSV was seen in winter months. A spike began this year in late August and is roaring along now (10/26/2022), very much an atypical occurrence.

The reason is probably an "immunity" gap caused by our response to Covid. Mask use, social distancing, and other increased hygiene behaviors to control Covid had a secondary effect - large reductions in RSV and flu infections. So, the immune systems of small children did not "see" RSV. Lots of children are now becoming sick since they were not exposed earlier and have not developed antibodies.

One of the reasons the H1N1 1918 flu pandemic was very severe, ~50 million deaths, was probably due to a generational immunity gap with disproportionate mortality in the 18-40 year old population. In addition to the "usual" mortality in small children and older adults.

See: https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html
 
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My wife (primary teacher) says it's going strong through the schools. One class in her school was almost entirely out for a few days due to RSV.
 
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U.S. hospitals overwhelmed by Covid, RSV and flu​

https://www.nbcnews.com/nightly-new...overwhelmed-by-covid-rsv-and-flu-156572229552

A number of healthcare folks we know have told us that RSV is affecting children and elderly. There is some flu around, and positive Covid cases have increased slightly. Locally, our county had no Covid-related deaths for 18 days from 8 Nov through 24 Nov. In the last 11 days, there were 7 deaths related to SARS-Cov-2 infections.

I don't know of any combined infections, but some friends have had kids with RSV.

CDC reports about 4500 since October 1 this year. Hospital beds are at 79% occupied (I haven't independently verified).

Some counties/regions have a high level of hospital occupancy.
https://www.covidcaremap.org/maps/us-healthcare-system-capacity/#3.5/38/-96
 

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