Doctors warn respiratory virus cases could increase as pandemic precautions are reduced – .

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Doctors warn respiratory virus cases could increase as pandemic precautions are reduced – .


TORONTO – As social distancing and travel restrictions loosen amid falling COVID-19 infection rates, doctors warn of a potential off-season resurgence of respiratory syncytial virus (RSV), which has tendency to affect infants and the elderly.

RSV is one of the leading causes of lower respiratory tract infections such as pneumonia and bronchitis, which in a typical year result in an estimated 2.7 million deaths worldwide, according to a published commentary. Monday in the Journal of the Canadian Medical Association. It is very common and contagious and presents as bronchiolitis in young children under two years of age.

“We wanted to alert primarily the medical community, the need to be prepared… and also for families, especially for parents of high-risk babies,” said Dr. Pascal Lavoie of the BC Children’s Hospital Research Institute and the University of British Columbia, one of the commentary’s four co-authors, in an interview.

According to Lavoie and his colleagues, RSV cases have declined sharply during the pandemic, as social distancing measures have all but halted its spread. In Canada, for example, only 239 tests for RSV were positive between August 29, 2020 and May 8, 2021, compared to 18,660 positive tests during the same period a year earlier.

However, the easing of COVID restrictions has increased the number of cases in Australia and the United States, and Canada should expect the same, doctors said.

“We argue that Canada should anticipate a similar resurgence of seasonal respiratory viruses in the summer of 2021,” the authors wrote.

While the majority of RSV cases have no symptoms or just mild illness, children born prematurely or with chronic lung or congenital heart disease are at higher risk.

“Most babies are fine with this virus, but there are a few who are at very high risk …. The advice we would give them in the winter would be to stay away from other people who have it.” common cold. So I think they need to be a little more careful in the summer because nobody is used to seeing the RSV come in the middle of summer, ”Lavoie said.

There is currently no vaccine for RSV, but adults under 65 tend to be protected against serious illnesses due to the immunity built up from seasonal exposure to the virus, while pregnant women transmit generally short-term immunity to infants.

But according to the comment, the lack of cases over the past year meant that most pregnant women and very young infants were unable to develop immunity. This in turn puts young children potentially at risk for more serious illness this year.

“The off-season resurgence of seasonal respiratory viruses now poses a potential threat to vulnerable infants,” the authors wrote.

Additionally, higher risk children such as those with chronic lung disease or congenital heart disease are usually treated with monthly antibody therapy, which significantly reduces the risk of hospitalization. However, many antibody programs have been suspended or suspended over the past year in part due to the lack of RSV cases and to reduce unnecessary doctor visits during the pandemic.

With generally few to no cases in the summer, Lavoie noted, many antibody treatments are also seasonal.

“We have to make sure we’re ready – so stockpile doses and have nurses and everything in place in case the cases increase again,” Lavoie said.

In order to avoid a potential increase in cases, the authors also suggest that Canadians continue to emphasize hand washing and basic hygiene measures, as well as other potentially protective measures such as breast-feeding, which transmits antibodies to children, preventing second-hand smoke. , contact with those who are sick and stay home if they are sick themselves.

They also recommend continuing RSV testing if necessary, as well as planning by pediatric intensive care units to manage a potential increase in RSV cases. They also suggest giving preventative treatment to infants most at risk during the summer if cases start to return to normal levels.

There are already a few cases in eastern Canada, Lavoie said, so immunity will build gradually, especially in infants, but doctors want to alleviate some of the increase in cases. Lavoie says they have data they hope to get peer reviewed and published that shows a “significant loss of RSV immunity in the population.” This is “not serious” in adults, but something to watch out for in infants, especially those with complex health issues, he explained.

“This letter was not meant to be alarmist,” Lavoie said. “But I’m a neonatologist, so I see babies who are quite vulnerable and I want to make sure that there is awareness and that those who are really at high risk are protected. ”

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