As RSV appears to wane, flu is on rise in ‘really unusual’ season | MUSC

Cases of RSV, respiratory syncytial virus, appear to be waning at MUSC Children’s Health after a very early spike. As you can see on the graph above, there were 407 positive test results for RSV in September. October has seen plenty of cases, 178 as of the 20th, but RSV appears to be on a downward trend.

Allison Eckard, M.D., serves as division chief for Pediatric Infectious Diseases. “I do think that we’ve peaked early with RSV, and that we’re coming down. But I think that we have to be cautious about what will happen during the winter. Will we see a second spike?”

 
Dr. Allison Eckard

Parents hope not. Some, like Cory and Sara Robertson of Mount Pleasant, South Carolina, have had the harrowing experience of seeing their babies hospitalized with RSV. While RSV causes cold-like symptoms for most people, children under 4 months old are susceptible to getting really sick because they’re transitioning from using their mother’s immune system to developing their own and have immature lungs that are more susceptible to infection-induced inflammation.

And this is no time for families to let their guards down, Eckard said. Another virus, influenza, is hot on RSV’s heels. Positive test results at MUSC Children’s Health rose from a total of 26 in September to 113 for October as of the 20th.

“It’s very unusual for us to have an influenza season that starts this early. We usually wouldn’t become a red state until December or January and sometimes even later than that – till February or March,” Eckard said. Red refers to the high flu level for the state noted on the Centers for Disease Control and Prevention’s national map below.

Map showing where flu is spiking across the United States. Most of the country is at a low or moderate level, but a few states, including South Carolina, are shaded in red to show that they have a high level of flu. 
A recent map created by the CDC shows flu activity across the country.

There are just a handful of states with high levels of flu right now, and it’s unclear why them – and why now. “The epidemiologists are going to have a field day with this,” Eckard said.

She and other experts say COVID may have thrown off regular seasonal patterns for some viruses, including RSV and the flu. Masking and isolating kept a lot of people from getting sick. When they stopped doing those things, the viruses returned. And since most people hadn’t had the viruses for a couple of years, they didn’t have recently acquired immunity to protect them.

Eckard said most people also haven’t had their flu shots yet. “So just about everybody’s unprotected, and I’m sure that that is contributing to the spread. People really need to go out and get the flu vaccine as soon as possible. And I always say for people who have children under 6 months of age, everybody in the family needs to be vaccinated to protect that baby. The flu vaccine isn’t approved for infants less than 6 months of age, but they are often among our sickest patients.”

Eckard said people who have already had the flu this year still need to get vaccinated. “With flu, there are typically multiple strains that circulate during the season, and we often have two peaks. For example, one with flu A and one with flu B. So even if you’ve had the flu this year, you still need to get the vaccine because it provides protection against multiple strains. It can be a debilitating illness. Getting the flu shot prevents you from being sick on the couch with a high fever and terrible body aches for a week or two.”

Flu and RSV aren’t the only viruses circulating right now. So far in October, children have been also admitted to the MUSC Shawn Jenkins Children’s Hospital with rhinovirus, enterovirus, adenovirus, COVID and other respiratory illnesses. Some of them have more than one infection. It all adds up to what Eckard called an unusual season for viruses. “It just got started really early this year.”