Don't blow off exposures to RSV and other viruses

COEUR d'ALENE — 'Tis the season for coughs, sniffles and sneezes. 

Staying healthy enough to stave off a winter virus is an admirable goal, but when it comes to RSV, young children and older adults are especially at risk. 

Dr. Hinah Parker, medical director of pediatrics at Kootenai Health, said they have been seeing a higher volume of kids with RSV, or respiratory syncytial virus, in the last two weeks for inpatient care and outpatient clinics have noted a rise in cases over the last month.

“It’s a lot of RSV, but it’s also a lot of other viral cases. We are getting a decent amount of kiddos needing respiratory support and getting a little more sick than we would have thought they would get. In outpatient care, they’ve also seen an uptick in COVID-19, too, and flu,” Parker said.

Severe cases of RSV are the leading cause of hospitalization in infants, according to the American Lung Association.

“There’s a bell curve for viral infections. You’ve got your very young who tend to get more ill and then you’ve got the other peak being folks in their 70s on up,” Parker said.

Some kids get RSV and have a fever for a couple of days and they’ll have two to three weeks of just persistent cough. In an ideal world, kids would be able to stay home for the duration of a cough, but with working families, that often isn’t possible. 

Because a lot of viral transmission happens via contact, Parker said that to reduce exposure during the most infectious times, anyone with a fever needs to stay home. If they go without a fever for 24 hours, kids are generally clear to go back to school. 

“It’s hard, I know, to have to take off work and figure out child care, but that’s how you get day cares that also stay open. Outside of kids getting ill, you also have day cares that now have teachers that are out, and now they can’t staff their classes and are closing down for a day or two, and that’s no good for anyone. If they spread it to the teachers, then there goes child care,” Parker said.

Handwashing is the best offensive tactic when it comes to staving off winter illnesses. RSV gives the lungs what Parker refers to as “a good knockaround.”

Kids that get any viral infection, RSV included, are now at a higher risk for superimposed bacterial pneumonia and bacterial infections because their immune system has been temporarily weakened.

“There’s a larger component of making sure that handwashing is a huge part of your day and have a routine in the winter that everyone washes their hands before they do anything else in the house,” Parker said.

Don’t blow off exposure 

When people have a virus, they may be asymptomatic or folks in the same family may exhibit very different symptoms.

“Everyone can present differently. Even within the same family, someone will get a cough, someone will have nothing, and someone can have diarrhea. What we forget, too, is the classic GI (gastrointestinal) stuff," Parker said.

Limiting exposure for infants is key to keeping them safe and healthy during flu and cold season. If there’s someone who may be sick in your life, Parker says have them wait to visit or mask around your baby as a protective measure.

“I tell parents to just be cautious, especially if you have those very young babies less than 3 months old who are at the highest risk. Maybe don’t let people come and love up on their face. Reduce the exposures as much as you can at least for the first few months," Parker said.

One thing Parker experiences a lot of pushback on is a perpetuating myth that active exposure to illness is more beneficial than vaccine immunity. 

“I hear a lot from families that ‘This is good for their immune system.’ That’s not wrong, but sometimes that logic can be weaponized into the idea that ‘My kids can go to school when they’re sick, because it’s good for them and their immune system,’ and that’s definitely not true,” Parker said. 

She counsels against things like chicken pox parties or deliberately exposing kids to viruses by direct contact or sharing contaminated foods.

It is good for young children to be exposed to various pathogens, Parker said, but not all at once.

“It helps build their long-term immunity and they get memory immunity so the next time they’re exposed, they get less and less ill,” she said.

Ideally, kids would be exposed to normal viruses through something like a microdose and just wind up with a stuffy nose and quickly bounce back.

“It’s enough so that they don’t have symptoms, but their body can build some immunity. I think what people don’t understand is that sure, you get that immunity, but there’s no data that exists that says that immunity is better than the vaccine. It’s not better immunity because it’s an active infection,” Parker said.

Catching any virus can impact the nervous system in the short- or long-term, which is why most medical experts say vaccines are critical in helping build up immunity in the first place.

“All of the viruses can do nervous system stuff, which can be scary later on,” Parker said. “No one's fear-mongering, this is what we’ve literally told families for years and years even prior to COVID-19. This is just stuff that can happen when you get viral infections.”