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Unusual wave of RSV reported in the south

The Centers for Disease Control and Prevention (CDC) recently issued a health advisory to notify clinicians and caregivers about increased interseasonal respiratory syncytial virus (RSV) activity across parts of the Southern United States.

Due to this increased activity, the CDC is encouraging broader testing for RSV among patients presenting with acute respiratory illness who test negative for SARS-CoV-2, the virus that causes COVID-19.

RSV can be associated with severe disease in young children and older adults.

RSV is primarily spread via respiratory droplets when a person coughs or sneezes, and through direct contact with a contaminated surface. It is the most common cause of bronchiolitis and pneumonia in children under one year of age in the U.S. Infants, young children, and older adults with chronic medical conditions are at risk of severe disease from RSV infection.

The CDC says, each year in the U.S., RSV leads to on average approximately 58,000 hospitalizations with 100-500 deaths among children younger than 5 years old and 177,000 hospitalizations with 14,000 deaths among adults aged 65 years or older.

RSV infections occur primarily during the fall and winter cold and flu season. In April 2020, the CDC stated that RSV activity decreased rapidly, likely due to the adoption of public health measures to reduce the spread of COVID-19.

Compared with previous years, RSV activity remained relatively low from May 2020 to March 2021. However, since late March, the CDC has observed an increase in RSV detections in Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, and Texas.

The CDC notes, since this elevated interseasonal activity is a deviation in the typical circulation patterns for RSV, at this time it is not possible to anticipate the likely spread, peak, or duration of activity with any certainty.

Due to reduced circulation of RSV during the winter months of 2020–2021, older infants and toddlers might now be at increased risk of severe RSV-associated illness since they have likely not had typical levels of exposure to RSV during the past 15 months.

In infants younger than six months, RSV infection may result in symptoms of irritability, poor feeding, lethargy, and/or apnea with or without fever. In older infants and young children, rhinorrhea and decreased appetite may appear one to three days before cough, often followed by sneezing, fever, and sometimes wheezing. Symptoms in adults are typically consistent with upper respiratory tract infections, including rhinorrhea, pharyngitis, cough, headache, fatigue, and fever.

There is no specific treatment for RSV infection other than symptom management.

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