U.S. facing threat of a "tripledemic" this winter

KSNF/KODE — Just when we thought the worst of the COVID-19 pandemic was over, experts are warning that a “tripledemic” is heading our way this winter. This trio of viral threats includes respiratory syncytial virus (RSV), influenza (flu), and COVID. Many children’s hospitals across the country are already experiencing a surge, fueled by a spike in respiratory viruses, leaving them with no free beds.

“COVID cases are expected to rise during the winter. This will be occurring at the same time we expect to see influenza rates increase while we are already seeing an early start to RSV season. With all three viruses on the rise, we are worried about an increase in the rates of viral infection that may lead to an increase in hospitalizations.” said Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital.

Symptoms To Look Out For

With COVID-19, symptoms include:  

  • Fever or chills
  • Respiratory symptoms (cough, sore throat, runny nose)
  • Loss of taste and smell
  • Fatigue
  • Sore throat
  • Muscle or body aches
  • Headache

Influenza (flu) is typically defined by a really rapid onset. You might be feeling fine one minute, then all of a sudden, you feel like you were hit by a freight train. You can expect:

  • Fever or chills
  • Respiratory symptoms (cough, sore throat, runny nose)
  • Muscle aches and pains
  • Headaches

Children tend to have more stomach symptoms with influenzas, such as stomachaches, vomiting, and diarrhea — compared to RSV and COVID.

RSV results in runny noses and frequent sneezing, but it’s generally a milder infection compared to flu and COVID. Other RSV symptoms include:

  • Coughing
  • Fever
  • Wheezing
  • Decrease in appetite

In order to confirm which virus is causing infection, a nasal swab test would need to be ordered by your primary care physician.

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What is RSV?

RSV is a common upper respiratory infection that circulates in the community every year. Some people may even get it twice a year.

Children are generally infected in the first 3 years of life, and reinfection is common. It’s primarily spread via respiratory droplets when a person coughs or sneezes.

But the following groups are at higher risk for getting more severe RSV, resulting in hospitalization:

  • Young children
  • Children born prematurely or born with other congenital health conditions
  • The elderly

If your child is having trouble breathing, their lips are turning blue, or their ribs are sticking out when they are breathing, then you should take them to the nearest emergency department.  

An estimated 58,000 children under 5 years old are hospitalized from RSV every year, according to the Centers for Disease Control and Prevention (CDC).

Treatment Options For RSV

Children can get supportive care. They may receive oxygen to help them breathe. Some children work so hard on their breathing that they may fall behind on their fluids and get dehydrated.  

For children most vulnerable to severe infection, there is a monoclonal antibody preventative injection, palivizumab, that is given once per month during the RSV season to prevent infection. But there’s only a small number of children who qualify.

There is no vaccine available for RSV. However, RSV vaccines are in development and might be available in the next few years.

Why Did We Not See A Tripledemic Last Winter?

According to the CDC, last year we still had more masking in place and social distancing, so we didn’t have the increased risk of transmission in the same way. RSV rates increased this summer, which is early, but they didn’t reach a very high rate. 

We did see a large increase of influenza this year in the southern hemisphere during their winter, which is our summer here in the U.S. In Australia, influenza rates were greater than anytime seen in the last 10 years. They were three times greater than normal. This is usually predictive of what we’re going to see here in the U.S., the CDC claims.

You’ll find more information on COVID, influenza, and RSV, HERE.

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