Rise in RSV cases anticipated as COVID-19 measures relax
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As COVID-19 preventive measures begin to relax, authors of a commentary in the Canadian Medical Association Journal anticipate a resurgence in childhood respiratory syncytial virus in Canada.
“In response to the apparent disappearance of respiratory syncytial virus during the pandemic, several Canadian respiratory syncytial virus programs paused, shortened and even suspended the seasonal administration of monoclonal antibody, to avoid unnecessary medical visits,” Pascal M. Lavoie, PhD, from the division of neonatology in the department of pediatrics at the University of British Columbia Children’s Hospital Research Institute in Vancouver, Canada, and colleagues wrote. “However, an interseason resurgence of respiratory syncytial virus cases has recently been reported in the Southern Hemisphere in the setting of decreased SARS-CoV-2 circulation and relaxed physical distancing measures.”
During the COVID-19 pandemic, in Canada, there were only 239 positive cases of respiratory syncytial virus (RSV) from Aug. 29, 2020, to May 8, 2021, compared with 18,860 cases from Aug. 25, 2019, to May 2, 2020.
The authors described a resurgence in RSV cases in Australia and the U.S., which highlights the importance of population immunity to regulate epidemics after exposure peaks, they wrote. In addition, in Australia, the median age of children with RSV increased to 18.4 months compared with 7.3 to 12.5 months from 2012 to 2019.
The authors also noted that pregnant women were less likely to be exposed to RSV during the pandemic, and therefore less likely to boost their RSV antibodies to normal levels, which may cause infants to be less protected than usual.
The authors recommended the following preventive measures:
- continue hand-washing and basic hygiene measures along with other protective measures, including breastfeeding when possible and avoiding secondhand smoke exposure;
- continue testing when required to confirm RSV cases;
- pediatric ICU planning to manage RSV increases; and
- administer preventive treatment to high-risk infants during summer if RSV cases increase to normal fall season levels.
“It is crucial that we continue to monitor respiratory illnesses to inform RSV prevention programs and help protect vulnerable patients,” the authors wrote. “This may involve administering RSV monoclonal antibody therapy in high-risk children off-season, which is a major departure from standard practice.”