Here's what you need to know about a surge in RSV in Greater Akron and nationwide

A surge in a different respiratory virus from coronavirus is causing illnesses in infants and children this fall both locally and nationally.

Cases of respiratory syncytial virus, known as RSV, are overloading children’s hospitals, emergency rooms and pediatricians' offices.

Typically, RSV is seen later in the season. But this year, it has arrived earlier and cases seem to be more severe, said Dr. Michael Forbes, chief academic officer at Akron Children’s Hospital.

For the week ending Oct. 15, 40% of patients at Akron Children’s Hospital locations and pediatric with symptoms tested positive for RSV and 35% were rhinovirus (the common cold).

More:RSV in infants and kids is threatening to overwhelm hospitals. What parents should know.

Usually this time of year, RSV cases only account for 5 to 10% of cases, Forbes said.

“We usually don’t see it before Thanksgiving and it is January or February when we start to see it peak. It is usually gone by April,” said Forbes.

Similarly, RSV cases statewide and nationally are on the rise. Children's hospitals around the state are experiencing unusual levels of RSV hospitalizations, and hospitals in at least 26 states have reported unprecedented rises. Last week, Ohio's Director of Health Dr. Bruce Vanderhoff sounded the alarm on the recent development during a COVID-19 update in Columbus.

More:Surge in respiratory virus jams up Cincinnati Children's ERs, urgent cares

Forbes said colleagues in Australia, which is in the southern hemisphere and experiences seasons opposite the U.S., were reporting an earlier and more severe RSV season. Similarly, Australia is reporting an earlier and more severe flu season, so Forbes said he would expect that to happen as well.

Why is RSV dangerous and who is most susceptible?

Severe cases of RSV can really damage a lung, said Forbes.

“Many viruses will kill a lung cell. What RSV does is when it kills a lung cell, it creates a big giant blob of cells that don’t do anything that the lung would normally do, so those areas of the lung become non-functional,” Forbes said.

The most vulnerable and susceptible of children are newborns and especially premature babies, as well as children with heart disease who are on medications and those with chronic lung disease, Forbes said.

“For those kids, if they get (RSV), it can change life forever or they can die,” he said.

There is also evidence that kids who are sick enough to be hospitalized with RSV have a much higher likelihood of having an asthma-like diagnosis as well by the time they are 18, he said.

Additionally, immunocompromised patients of any age and senior citizens can be more at risk for RSV, he said.

More:What every parent should know about respiratory syncytial virus

There is no treatment for RSV because it is a virus, but RSV causes problems for those most susceptible and sometimes long-term effects.

Forbes, who works in the intensive care unit, said the hospital’s ICU and regular floors are about half to two-thirds full of RSV patients. National numbers are about 73%, he said.

Forbes said doctors are seeing older patients affected by RSV beyond newborns, such as 18 year olds and 3-year-olds.

Why is this happening?

RSV actually was mostly non-existent during COVID-19 because of the public health measures being taken, such as hand washing, masking and social distancing, said Forbes. Last summer, there was a spike in RSV cases locally, which was very unusual, but then RSV cases were low during the winter season, he said.

Immunity against RSV after infection is relatively short-lived and patients can get RSV twice in a season, Forbes said. Because there was little to no RSV in the last two years, the RSV cases this year with reduced public health measures as COVID precautions waned is causing a spike in cases, he said.

A severe RSV season this year could mean a better season next year with some of those collective immunities and cases, he said.

How can I distinguish between RSV, a cold flu and COVID-19?

RSV, the common cold, flu and COVID-19 all are part of a family of viruses that are indistinguishable without testing, said Forbes.

The symptoms for RSV are the same as the common cold, flu and COVID-19, including a runny nose, sneezing, coughing and a fever.

Patients who come in with these symptoms are tested for RSV, flu and COVID, he said.

“The bottom line is if you have any cold symptoms, isolate, wash your hands and wear a mask. Frankly, if anyone at my house has a cold, we all wear masks,” he said.

More:RSV, flu and the common cold: Kids sick with winter viruses are filling up hospitals

What is the treatment and when should I seek medical care?

“When we begin to worry is when they’re breathing really hard, their nostrils are flaring while they’re breathing, they’re breathing so fast they can’t eat, they look as if they’re losing energy. All of those signs are when you need to see a doctor,” said Forbes.

Additionally, if a child is losing his or her appetite, you should contact your doctor, he said.

There is no real antiviral specifically for RSV, though there is an antiviral used when doctors think it is needed in the ICU. But the bottom line is prevention, he said.

Are flu and COVID cases up now too?

Pediatricians and the hospital are seeing flu cases and COVID cases among symptomatic patients are hovering around 5%, said Forbes. Last week, no patients tested positive before surgery for asymptomatic cases of COVID-19, but that rate has been hovering around 1% to 2%, he said.

Do immunizations help prevent these respiratory illnesses?

There is no immunization for RSV, but Forbes said all children 6 months and older are encouraged to get their flu and COVID shots.

“If you’re six months or above, you’ve got to get your shots. We’re seeing what we’re seeing because there’s not a lot of background immunity and if we’re not getting vaccinated and boosters do work, we’re seeing data that supports that,” said Forbes. “You should certainly get them if you’re at risk, but even if you’re not that high risk, you need to get vaccinated.”

What other prevention measures do you suggest as we get into winter respiratory illness season?

“The good news is we know how to control this: In addition to the usual winter virus prevention steps (distance, handwashing, masks, stay home with symptoms, vaccinate if available), talk to your provider to see if your infant is in a high-risk category for severe RSV. There may be additional prevention measures available for your baby,” such as medications for high-risk babies, Forbes said.

“If you have a new baby, you’ve got to protect that baby this winter because they can get the flu and they can get RSV and they can get COVID,” said Forbes. “We call it bubble immunity. Everyone around that baby needs to be flu-vaccinated, COVID-vaccinated and practice safe behavior.”

Are cases of RSV among adults rising locally?

So far, RSV cases among adults and especially the elderly have been about the same as last year at Cleveland Clinic Akron General and Western Reserve Hospital. But there has been a slight uptick at Summa Health.

"We've seen some cases in the adult population but not above what would be expected for this time of year,” said Dr. Donald Dumford, medical director of infection control for Cleveland Clinic Akron General. “In most adults, RSV is relatively mild, but our elderly and immunocompromised patients are at risk for severe disease."

Likewise, Western Reserve Hospital spokesman Mark Bosko said there hasn't been a spike in RSV cases among adults.

At Summa, spokesman Mike Bernstein said the health system is seeking an uptick in RSV in adults in the community.

"We have had approximately 125 positive outpatient cases in the last four weeks (5% positivity rate)," he said. "We have not had any inpatient admissions. Please keep in mind that these numbers are what we were seeing this time of year pre-pandemic, so we are not surprised to see these numbers with the relaxation of masks."

Beacon Journal staff reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ To see her most recent stories and columns, go to www.tinyurl.com/bettylinfisher

This article originally appeared on Akron Beacon Journal: Surge in respiratory illness RSV is hitting kids in Greater Akron