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Hospitals warn parents of young children over RSV virus following surge in patients under five years old

The i 26/08/2021 Paul Gallagher

Hospitals are dealing with a surge in patients under the age of five who are being admitted with a virus which is the main cause of bronchiolitis in younger children.

Doctors are asking parents to be watch out for the signs and symptoms of Respiratory Syncytial Virus (RSV), as cases increase across the country following the easing of Covid-19 restrictions and more mixing by families.

RSV is a common virus causing colds and coughs but can be more severe in some children.

Parents are being encouraged to look out for symptoms of severe respiratory infection in at-risk children, including a high temperature of 37.8°C or above, a dry and persistent cough, difficulty feeding, and rapid or noisy breathing.

Doctors say it is important to note that while some of the symptoms may appear similar, RSV is not related to Covid-19.

The number of under-fives in hospital with RSV has jumped from fewer than five per 100,000 at the start of summer to well over 30 per 100,000 now and rising, according to latest official figures.

Cases are much higher than usual for this time of year and doctors fear the situation will worsen as winter approaches.

Alasdair Munro, a paediatric registrar in Southampton, said: “These are the kinds of numbers we would normally see in winter for RSV – this is what happens when you disrupt an entire infection/immunity ecosystem. We’ll see what happens come winter.”

Most cases of bronchiolitis are mild and can be managed at home, but about 3 per cent of cases will need hospital care. RSV can be more severe in premature babies, those under two months old, and children with certain underlying conditions, such as those born with a heart condition.

Worldwide, RSV is the second largest cause of death in children under one year of age, second only to malaria.

chart, line chart: RSV cases have surged in recent weeks following the end of lockdown restrictions (Source: PHE Flu & Covid-19 Weekly Surveillance Report) © Provided by The i RSV cases have surged in recent weeks following the end of lockdown restrictions (Source: PHE Flu & Covid-19 Weekly Surveillance Report)

Health professionals at Doncaster and Bassetlaw Teaching Hospitals NHS trust issued a warning this month over RSV as cases increased in the area.

Nadine Cooper, a paediatric respiratory nurse specialist, said: “While respiratory infections are common in children, last winter saw much fewer infections in younger people due to Covid-19 restrictions.

“This means that many will not have developed immunity and may be at higher risk of severe illness. We may also see more cases than in a typical season. For the majority of children, these illnesses will not be serious and they will soon recover following rest and plenty of fluids.”

Public Health England added a warning over RSV to its Flu & Covid-19 Weekly Surveillance Report earlier this month after cases rose for the eighth consecutive week. The highest positivity was seen in the under-fives at 29.9 per cent.

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Dr Yvonne Doyle, Medical Director at PHE, said: “This winter, we expect levels of common seasonal illnesses such as cold and flu to increase as people mix more and given that fewer people will have built up natural immunity during the pandemic.

“Children under two are at a particular risk of severe infections from common seasonal illnesses. If a child under two is suffering from a cold, keep a close eye on their symptoms and make sure to contact your doctor if they get a high temperature, become breathless or have difficulty feeding.

“It’s important that we carry on with good hygiene habits that we’ve become used to during the pandemic, in order to protect ourselves and those around us. This means washing your hands regularly, using a tissue to catch coughs or sneezes and washing your hands afterwards, and staying away from others if you feel unwell.”

A report by the Academy of Medical Science, published last month, warned that a combination of Covid-19, influenza, and the RSV could push an already depleted health service to breaking point unless action was taken immediately.

The report stated that flu and RSV hospital admissions and deaths could be twice that seen in a “normal” year, and could coincide with an increase in Covid-19 infections.

Models suggest that between 15,000 and 60,000 could die from flu this winter, although the report acknowledges that there are still high levels of uncertainty around the effects flu and other respiratory illnesses could have.

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