Thanksgiving is the traditional start of the holiday season. It's also the traditional start of the cold and flu season. As family and friends gather, they not only bring food and good cheer, they can also bring coughs and sneezes.
This year, one of the illnesses, RSV or respiratory syncytial virus, has become a serious threat for young children and a concern for local healthcare workers.
I spoke with Dr. Allen Radner, an infectious diseases specialist and chief medical officer at Salinas Valley Memorial Healthcare System and Dr. Suzanne Rosen, a family physician at Salinas Valley Medical Clinic. They talked about the nature of RSV, how parents can protect their children and why such a common virus is a big threat this year.
This interview has been edited for length and clarity.
Dr. Suzanne Rosen (SR): This is not a new virus and I think it's important for parents to understand that. We see it every year. In fact, most people over the age of two have had RSV before, but the difference this year is that in 2020 and 2021 we were staying home and we had masks on and we were isolating and children weren't going to school.
Dr. Allen Radner (AR): So we're looking at double the population of children that are at risk of getting respiratory syncytial virus. And a number of the more serious cases that we've seen here are four and five year olds, children that historically had already had a mild illness before the age of two. In some parts of the country, they're seeing up to 300% increases in the numbers of RSV cases that they've historically seen.
Doug McKnight (DM): Are you seeing an increase in children coming into your clinic?
SR: We sure are. We're seeing a lot of sick kids. Anyone who's spending any time around kids right now knows that there's a lot of kids that are sick.
AR: We're running about 2 to 3 times our average census on our pediatric wards. What has us very concerned is that very sick children are almost always cared for at academic medical centers like Lucile Packard or UCSF and unfortunately, they're running out of beds.
DM: Are most of the children able to be treated and go home?
SR: Yes, for most children, RSV is a mild disease. They'll have cold-like symptoms. Some children will have fever. Some children will have wheezing, congestion, stuffy noses and sore throats. About 1-2% of small children can get severe disease, and that's about that number that ends up getting admitted to hospitals.
DM: What should parents look for before deciding to take their child to a doctor of emergency?
SR: I think the first thing is don't panic.
What I tell my patients to look for is children that look like they're working hard at breathing. What parents will notice is they'll see a heaving of the chest and sometimes the abdominal muscles as well, a lot of heaving of the chest coming in and out.
The other thing we ask parents to look for is something we call retractions. Retractions is where you can see the skin sucking inward with each breath. The places we ask parents to look are above the collarbones and above the breastbone. You can see the skin suck in with every breath.
Another place to look for, especially in babies, is nasal flaring. You can see the nostrils flare with a breath. So those are the signs that they may want to call their doctor or even bring their child into the emergency room to be evaluated.
DM: What's your advice for people during this holiday period?
SR: Certainly hand-washing, covering a cough, wiping down surfaces, and ventilation are important. If you can be outdoors or open windows or have Thanksgiving dinner out on the patio, that can make a big difference. If you have a child who has a history of severe asthma or is immunocompromised or you have a newborn, you may want to reconsider going to a large family gathering. I would also ask anyone who's having any cold symptoms to please stay home.
AR: We're very concerned. We've discussed over and over again that we're concerned that if we're going to see a surge, it's going to be after Thanksgiving.
This interview was conducted with Dr. Allen Radner, Chief Medical Officer at Salinas Valley Memorial Healthcare System and Dr. Suzanne Rosen, a family physician at Salinas Valley Medical Clinic.
