Children’s hospitals in Canada are seeing an increase in cases of a common respiratory virus that, in rare cases, can lead to severe illness in infants.
Respiratory syncytial virus (RSV) causes infections of the lungs and respiratory tract. It can result in severe infection in some people, including babies under two and older adults with pre-existing conditions.
Cases of RSV dropped dramatically early in the pandemic, but spiked last fall and are now surging in many parts of the country, says Dr. Earl Rubin, director of the infectious diseases division at the Montreal Children’s Hospital.
Rubin says that surge is part of the reason his hospital is struggling with long wait times and a shortage of beds.
“We are overwhelmed,” he said. “We are experiencing in the pediatric hospitals what the adult hospitals were experiencing during the peak of COVID.”
Here’s a look at what’s behind the increase in RSV cases.
What is RSV?
The virus generally leads to cold-like symptoms such as runny nose, cough and fever. It’s the most common cause of lower respiratory tract illness in young children worldwide, and typically leads to outbreaks in Canada from late fall to early spring.
While many infections are simple colds, children less than two years of age are at risk of severe disease such as bronchiolitis — a blockage of small airways in the lungs — or pneumonia and may be hospitalized.
“Almost all babies are infected by two years of age. It’s very common … but some babies can get very sick with it,” said Dr. Anna Banerji, an infectious disease specialist and associate professor at the University of Toronto’s faculty of medicine.
In its most recent update, the Public Health Agency of Canada reported a rise in RSV cases in many parts of the country, though Banerji says testing isn’t widespread enough to get a complete picture. Hospitals in the United States have also reported an increase in cases.
Quebec’s Ministry of Health reported a higher positivity rate than the national average. CHEO, an Ottawa children’s hospital, said in a statement RSV cases were part of the reason it “just had its busiest September ever.”
Why are cases rising now?
Both Banerji and Rubin say there were fewer RSV cases when public health measures were in place because of COVID-19, but there was a spike last autumn and again this year as young children were exposed to more people.
Many of those children don’t have strong immunity because they weren’t exposed previously and, similarly, their birth mothers might not have been exposed and passed immunity on either, Banerji said.
At his Montreal hospital, Rubin says he’s also seeing some slightly older children, between age one and two, that are sicker than usual.
“They have no immunity, and if they have any predisposing conditions, whether it’s asthma or allergies, that will predispose [them to RSV],” he said.
How does it spread?
RSV is predominantly spread by aspirated droplets, says Rubin. He recommends hand washing and, for older children, ensuring they sneeze into their elbow and cover their mouth when they cough.
It can also spread through contact. “If you touch a contaminated surface and then rub your eye, pick your nose, you can infect yourself,” he said.
People infected are usually contagious for three to eight days. Babies and people with weakened immune systems, however, can spread RSV for longer.
Who is most at risk and what can be done?
Those with pre-existing conditions, particularly those born prematurely, can be vulnerable to the most serious infections.
Studiesconducted by Banerji also suggest that Inuit infants in Canada’s north are particularly at risk.
“They have much higher rates of admission than almost any other population in the world,” she said.
During RSV season, injections of an antibody-based medicine are sometimes prescribed to protect premature infants and other very vulnerable babies.
Banerji launched a petition — now with more than 200,000 signatures — calling on the Nunavut government to expand the use of that medicine to make it available to all babies in the territory.
More generally, doctors may also prescribe oral steroids or an inhaler to make breathing easier. In serious cases, patients in the hospital may get oxygen, a breathing tube or a ventilator.
“If a child needs to be admitted to the hospital, it’s because their oxygen levels are low or they’re having a really hard time breathing on their own and may need to be ventilated or they’re not feeding well,” Banerji said.
At home, she said, parents can do their best to manage symptoms with fever medications, and ensure their baby is adequately hydrated.
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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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