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Why RSV began stronger than usual this fall at Dallas-based Children's Health

A little boy is sick, and a combo antigen test (covid-19, flu a b, RSV) is needed for proper diagnosis.
A little boy is sick, and a combo antigen test (covid-19, flu a b, RSV) is needed for proper diagnosis.

RSV usually begins to show up in kids in the fall, but positive tests for the virus spiked last month at Dallas-based Children’s Health: A 55% increase from one week to the next and an 80% increase over much of October.

KERA’s Sam Baker talked with Dr. Preeti Sharma, a pediatric pulmonologist with Children’s Health and UT Southwestern Medical Center about the spike in cases.

Last year was a little unusual, particularly pertaining to the timing of RSV cases. We had a lot of cases early on and the season tended to extend a little longer than expected. So, this year we're in the right seasonal pattern and the numbers are high and increasing. I mean, it remains to be seen sort of the remainder of the season and how that plays out.

What's behind this initial spike?

The seasonality, but also being around people.

More kids are back in school. They've gotten through the first initial colds of the school year and now settling into spreading RSV among classmates.

You know, at one point in recent years, didn't COVID protocols masking good hand sanitation manage to limit RSV cases?

And I think that's why we saw such an early and dramatic spike last year because that was really the first year where we didn't have a lot of COVID mitigation protocols in place. We had a year of a lot of virtual school and virtual work.

And then when we got back into the workplace and into schools, they were still at the beginning of that school year, a lot of specific protocols. And then last year and this year we have very little and I think that is contributing to it.

At the same time, don't we also now have a monoclonal antibody shot for infants, not to mention a vaccine for older adults? Are those not having the desired impact?

So they are so recently released that I'm not sure that we're going to see the impact in this season in particular.

We generally offer monoclonal antibodies and historically there's been an injectable vaccine for high-risk infants that's given monthly during RSV season.

And as you pointed out, we now have a one-time dose that can be given to all babies born in the RSV season. And that's really very new and just kind of rolling out. So we don't have a lot of data about how that's going to change the landscape of RSV.

We do have recently approved vaccinations to be given to expectant mothers in their third trimester to also provide some passive immunity for infants born during RSV season. And as you said, we have vaccination for those adults over the age of 60 who are also at high risk for severe RSV-related disease.

As those become more widespread, we'll have a better understanding of how that impacts RSV cases, hospitalizations, etc.

Are people coming in at all for the shots or vaccines?

In our pediatric population, there has been a lot of interest surrounding obtaining either the monthly vaccination or the monthly monoclonal antibody injection for high-risk infants. And a lot of discussion about utilizing the one-time dose of antibodies. There have been limited allocations of the one-time dosing to many states. And so it's a little bit challenging to access.

What can people do in the meantime to try to rein in the RSV infections?

Of the common things that we think about:

  • Stay home if you're sick, try not to be around other people.
  • If you have symptoms, lots of handwashing covering your cough.

These are things that we talk about as adults that are potentially easier to do, but very hard in young children. And so probably the most compelling thing that can reduce the spread in children is if they seem to have signs of an illness, limit their interactions with others as best as you can.


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Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.