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Early jump in RSV hospitalizations concerns Minnesota experts

Severe cases of respiratory syncytial virus are already near typical peak levels. It could spell trouble for the cold and flu season ahead.

MINNEAPOLIS — Prior to the COVID-19 pandemic, it was hard to escape respiratory syncytial (RSV) virus during winter months in Minnesota.

Since the pandemic started, it's hard to know when you might catch it.

RSV is a common respiratory virus that usually causes mild, cold-like symptoms. But as the Centers for Disease Control and Prevention (CDC) notes, and many parents know, it can sometimes be severe in infants and young kids.

That is exactly what's happening right now in Minnesota.

To find out what's happening with RSV in Minnesota right now, KARE11 reporter Kent Erdahl Spoke to Dr. Beth Thielen, a physician-scientist with the University of Minnesota Medical School who specializes in pediatric and adult infectious disease.

Dr. Thielen: "For me, the thing that was most striking was that we had over 100 hospitalized children with RSV in the month of September. As a comparison, we had around 50 in July and August."

Erdahl: "Is it a little early for this to happen?" 

Dr. Thielen: "Yeah, typically in Minnesota, we see most of our RSV happening December through March. That is the typical peak season, at least prior to the pandemic.

Dr. Thielen says the steady rise in RSV hospitalizations in the last two weeks already rivals what local ERs were used to seeing during peak winter months prior to the pandemic, and that's just counting hospitalizations.

Dr. Thielen: "It's just the tip of the iceberg. More of the tests that we're doing out in the community are coming back positive, which is telling us that there is probably more RSV out there."

Erdahl: "Any reason to believe that this is bad news for the rest of the season, either for RSV or for the flu?" 

Dr. Thielen: "Yeah, we know we have a population that hasn't seen much influenza or RSV for a couple of years and we do know that there's a substantial protection that happens by repeated exposures, so I think people are going to be a little more vulnerable than they might be during a typical season."

Erdahl: "And when you say people, do you mean young kids, or do you mean all people?"

Dr. Thielen: "It's important to make a distinction that RSV causes the most severe disease in young children, but it really does affect the whole population. Parents may be familiar with their child going to daycare, coming back with a runny nose and then they get a cold a few days later. Often times that maybe be due to RSV, it's just that adults have seen the virus multiple times before and they have a better immune response that are able to keep in contained. We do know that RSV causes a substantial amount of severe disease that is underdiagnosed in older adults, and so we definitely see severe disease happening in the very young and the very old."

Similar concern extends to the upcoming flu season, which has yet to show up in Minnesota, but Dr. Thielen says the flu season in Australia just concluded and it was the worst in five years.

"And then that is sort of compounded with the fact that I think our health system has really taken a hit over the last few years and our healthcare worker numbers are still down from where they were at the beginning of the pandemic, and so our ability to sort of surge respond to outbreaks, I think is diminished."

In response, she says both M Health Fairview and Children's Minnesota are moving up their usual efforts to manage RSV.

"We have several things that we can do, for the most vulnerable children, and that includes pre-term infants," Thielen said. "It's an antibody treatment that can help prevent an RSV infection, and so we're taking steps in Minnesota to help roll that out earlier. To time it better with the onset of the RSV season."

But they can't do it alone, and Dr. Thielen says now is the time that we can all do our part.

"Get your flu shot, get your Covid boosters," she said.  "Anything people can do to mitigate the risks for some of the other viruses, for which we have treatment, is going to be really important for dampening the overall impact of our viral respiratory season this fall and into the winter."

Though there is not a vaccine for RSV, Dr. Thielen says, with the right medical care, even severe cases can usually be managed with hospital care like IV's and oxygen.

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