China - Expert: Number of children currently admitted to hospital with respiratory syncytial virus exceeds COVID-19 and seasonal flu, half are wheezing. - May 16, 2023

[sharon sanders]

"I have a fever again" "This time I have a bad cough"...The number of cases of this kind has increased significantly recently

17:35, May 16, 2023


　　"Fever again" "This time it's a severe cough" "It's like pulling a bellows, and it's a bit like asthma"...
　　Recently, many parents have been "scared" by a virus, which is respiratory syncytial virus (RSV).
　　On social media, many parents shared the process of their children's recent infection with RSV, lamenting that the virus is menacing, even more terrifying than the new crown and influenza A.
　　The reporter learned that cases of RSV infection in children are very common recently. Cao Qing, director of the Department of Infectious Diseases at the National Children's Medical Center and Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University School of Medicine, said in an interview with reporters that the proportion of children infected with RSV currently admitted has exceeded that of the new crown and influenza, and half of them have wheezing symptoms.

　　However, relevant experts said that RSV is a self-limiting disease, and generally symptomatic treatment is sufficient, so there is no need to panic.
　　

What is respiratory

syncytial virus?

　　RSV (respiratory syncytial virus) is an RNA virus of the family Pneumoviridae and the genus Orthopneumovirus. People of all ages can be infected, and the high-risk groups of infection are mainly concentrated in children, the elderly and immunocompromised groups.
　　After infection, the incubation period is usually 2-8 days. The clinical manifestations are mainly respiratory tract infection symptoms. Most of the early infections are limited to the upper respiratory tract, and the clinical manifestations are nasal congestion, runny nose, cough and hoarseness.
　　Most of the symptoms of RSV-infected patients will disappear within 1-2 weeks, and a small part can develop lower respiratory tract infection, mainly manifested as bronchiolitis or pneumonia, which is more common in infants under 2 years old. Clinical symptoms include cough, wheezing, severe Shortness of breath and feeding difficulties occur in a small number of further aggravated cases, and severe cases may develop into respiratory failure.
　　In terms of transmission routes, both symptomatic infected persons and asymptomatic latent infected persons can transmit the virus, usually through the following routes:
　　Contact transmission, such as nasopharyngeal or ocular mucosa contact with virus-containing secretions or pollutants;
　　Close contact with patients coughing or sneezing, etc.
　　

How to

prevent and treat respiratory syncytial virus?

　　Regarding the treatment of RSV infection, Wang Xinyu, deputy director of the Department of Infectious Diseases, Huashan Hospital Affiliated to Fudan University, said, "At present, there is no antiviral drug approved for clinical use in RSV, and the main purpose of treatment is to relieve symptoms. Children infected with RSV can cause severe Management of bronchitis, as in children with bronchiolitis caused by other pathogens, is primarily supportive care with fluid and respiratory support as needed. "
　　He further suggested that in adults and older children glucocorticoids and bronchodilators may have some effect on RSV-induced bronchial hyperresponsiveness. Treatment options for RSV infection in immunocompromised patients are also individual; for these populations, interventions that may help reduce the progression and mortality of upper and lower respiratory tract infections include ribavirin, intravenous immunoglobulins, Monotherapy or combination therapy of protein, palizolumab and/or glucocorticoids, etc.
　　Current preventive measures for RSV are still limited. Recently, the US FDA approved the world's first RVS vaccine developed by GlaxoSmithKline (GSK) for a single vaccination in adults aged 60 and over, but how long the protective effect can last is still uncertain.
　　GSK's RSV vaccine is a protein subunit vaccine. Professor Xu Jianqing, a researcher at the Institute of Biomedical Sciences of Fudan University and director of the Shanghai Institute of Reproducible Infectious Diseases, told reporters that the protective efficacy of such vaccines against other diseases currently observed should be at least More than 10 years.
　　"The pox virus has been observed for more than 30 years, and it still has protection; the hepatitis B vaccine has been observed for 10 years, and it still has protection." He told reporters, "It is generally believed that the protection of protein subunit vaccines may not be less than 10 years, but there is still a lack of systematic data."
　　

Why Outbreaks of RSV Infection in Unusual

Seasons ?

　　RSV infection is widely prevalent in the world. Affected by factors such as geographical location, temperature and humidity, in my country, RSV infection occurs in winter and spring (about November to February of the following year). In the past, the number of patients with RSV infection The number of children has gradually increased, but this year, since April, RSV infections have increased day by day, and some infected patients have been sick for a long time.
　　The reason for this abnormal phenomenon may be related to self-protection during the epidemic. Through measures such as wearing masks, home isolation, and frequent hand washing and disinfection, the transmission route of RSV was cut off, and the infection rate of RSV was reduced. Children's immunity to the virus is also generally reduced. With the effective control of the domestic epidemic situation and the change of prevention and control policies, the scope of public activities has expanded and people have gathered, resulting in an increase in RSV infection and an out-of-season epidemic.
　　

What are the similarities and differences between RSV virus, new

crown and influenza virus?

　　These three viruses are highly contagious viruses that can be transmitted through the air. They all cause symptoms such as fever, cough, and nasal congestion. Although they have many similar symptoms, there are some differences.


　

What

symptoms should parents send to the doctor in time?

　　Children with RSV infection mainly present with cough, wheezing, and fever . Shortness of breath, groaning, sunken chest when breathing, or poor energy, irritability, feeding difficulties or dehydration,parents need to send their children to see a doctor in time.


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[sharon sanders]

Respiratory syncytial virus infections in children on the rise

16:08, May 17, 2023




　Recently, many parents shared their children's experience of respiratory syncytial virus infection on the Internet.
　　What are the typical symptoms of RSV? Compared with the new crown and flu, how important is it? Which children need special attention?
　　On May 16, the reporter interviewed Qin Qiang, Chief Physician of the First Respiratory Department of Beijing Children's Hospital, and interpreted the issues that parents are more concerned about. Beijing News reporter Dai Xuan
　　There are multiple reasons for the increase in viral infection cases in children
　　Beijing News: Recently, has there been any significant change in the number of children with respiratory syncytial virus?
　　Qin Qiang: Not only the respiratory outpatient clinic, but also the general internal medicine outpatient clinic recently saw an increase in children with fever, cough, and signs of viral infection. There are many types of respiratory infection viruses, including respiratory syncytial virus.
　　According to the monitoring of the virus laboratory, the incidence of respiratory syncytial virus infection has recently increased compared with usual, and at the same time, infections such as metapneumovirus and parainfluenza virus have also increased. Influenza cases are still found recently, and there are also new coronavirus infections. of cases.
　　Beijing News: Why is this happening?
　　Qin Qiang: Let's take respiratory syncytial virus infection as an example to analyze. The first is the characteristics of the virus itself. It is an RNA virus, similar to the new coronavirus, with a small molecular weight and rapid mutation. There are many genotypes found at present. After the human body is infected with this virus, the immunity will not last for a long time. In a few months or so. Even if the child was infected in the previous year, there is a possibility of re-infection in the second year.
　　In northern China, the high incidence season of respiratory syncytial virus is in winter and spring, and generally there will be a significant decline after mid-May, and sporadic cases will appear in other seasons. It's mid-May, maybe a little later than usual, but not significantly off.
　　From the perspective of the characteristics of crowd activities, everyone has fully returned to normal life now, with frequent exchanges and intensive exchanges, and it seems that they don't pay much attention to virus infection, which is a promoting factor for the spread of respiratory viruses.
　　Beijing News: Will there be a similar situation with many virus infections this year?
　　Qin Qiang: Common and seasonal viruses in previous years may have similar situations. However, as long as the virus does not undergo special mutations, it is still a common infection, and the public need not be particularly worried.
　　Some high-risk children with milder symptoms than the new crown flu need to be vigilant
　　Beijing News: Recently, parents are particularly concerned about respiratory syncytial virus. What are its typical symptoms? How long is the disease?
　　Qin Qiang: The symptoms of respiratory syncytial virus infection are not specific. Most infected people will have cough, runny nose, fever, etc., which are typical symptoms of respiratory tract infection. Therefore, many people don't care much about it, and they will live a normal life after infection.
　　What needs to be paid attention to is that young babies and children with previous allergies have more secretions in the respiratory tract after infection than other viral infections, and are prone to coughing up sputum and wheezing.
　　Its entire course of disease is generally 7-10 days, more routine.
　　Beijing News: Compared with respiratory syncytial virus, new crown and influenza virus, which infection has more serious symptoms?
　　Qin Qiang: Generally speaking, the clinical manifestations of respiratory syncytial virus infection are milder than those of influenza and new coronavirus. For older children, if the immune system is fine, there is no need to worry, just treat the symptoms.
　　Beijing News: Which children belong to the high-risk group?
　　Qin Qiang: For children under 2 years old, respiratory syncytial virus infection may cause relatively severe symptoms; if the child has special conditions, such as premature birth, birth weight below 2300 grams, congenital heart disease and other underlying diseases, parents should ask Pay attention to. Severe infection not only invades the respiratory system, but may also affect the heart and nervous system.
　　Beijing News: Do I need to do differential diagnosis such as nucleic acid testing?


　　Qin Qiang: It is of little significance to conduct a separate test for this virus. There is no so-called specific drug for it. Even if it is identified, it is only a routine treatment. Unless severe illness occurs, doctors may screen and identify multiple viruses.
　　Beijing News: Do parents need to prepare medicines? What should you pay attention to in your child?
　　Qin Qiang: There is no need to prepare medicines for this purpose. If the child has symptoms, just take some common antiviral drugs; children with a history of allergies and wheezing can prepare some nebulized drugs; Whether there is blue or purple, whether the breathing rate is normal, whether the amount of urination has decreased, and whether the spirit has been affected. If you have any problems, you should go to the hospital in time.
　　Another thing I want to remind everyone is that although life is returning to normal now, various virus infections still exist, and the virus is easy to take advantage of the slack. Therefore, it is necessary to maintain some good personal protection habits. Wear a mask in public places, wash your hands frequently, and ventilate frequently. These measures are not difficult, and can reduce the risk of infection and make the peak of infection less concentrated. (Source: Beijing News)

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