RSV cases spiked in late February

After falling for a couple of weeks, the number of lab-confirmed RSV cases is back on the rise.

The latest weekly report, from Feb. 22 to Feb. 28, shows that there were 296 cases of lab-confirmed RSV — respiratory syncytial virus — in Maricopa County. There were 123 cases the previous week. Since the RSV season began in October, there have been 1,504 cases of lab-confirmed RSV in the county.

A graph on the Arizona Department of Health Services’ Web site shows that the latest numbers are above the four-year average for RSV cases for this stage in the illness’ season.

According to one doctor, that’s probably less than 5 percent of all cases around the Valley, since often it’s only the very sick who go to the doctor and have a lab test performed.

RSV is the most common viral infection that involves the lungs, said Dr. Karen Lewis of the Arizona Department of Health Services. It often falls, then spikes back up before the season runs out.

In most children and adults, RSV appears as a very bad cold, with a runny nose, cough and fever. But for young children — usually those less than 1 year of age — the mucus buildup can be so great that more attention is needed.

“The virus can cause an infection of the lungs leading to labored breathing,” said Dr. Nate Brooks of San Tan Urgent Care in Queen Creek.

“It can progress to respiratory distress,” Brooks said, noting that young infants and toddlers can have accelerated breathing and increased heart rates. “These little ones feel just miserable.”

“This can be scary for parents,” he said.

Brooks said he has sent a few kids to the hospital suffering from RSV who were having difficulty breathing, but that’s uncommon. Most of the time, the disease is diagnosed by primary care physicians, and parents are instructed on supportive care measures and close follow-up.

Jeff Kirkpatrick, director of Catholic Healthcare West’s Gilbert Urgent Care, said he has seen more cases than last year, but with fewer of the really sick kids.

“We’re seeing several children daily with bronchiolitis, the deep airway infection,” he wrote in an e-mail to the Tribune. “It’s deeper in the lungs than bronchitis (upper bronchial tubes), but not as deep as pneumonia (the deepest lung tissue air sacs). The younger the patient, the worse the illness tends to be. Older kids or adults with RSV often just have a bad cold, with runny nose and mild cough.”

RSV is not the only virus that can cause bronchiolitis, but it does seem to last longer, he wrote. The cough can take two to three weeks to clear up, Kirkpatrick said.

Antibiotics are not an answer for the virus unless a bacterial infection pops up. If the virus triggers bronchial spasms with harsh coughing, albuterol breathing treatments may be prescribed.

Dr. Sonia Reidy, at Phoenix Children’s Hospital’s East Valley Urgent Care Center in Mesa, said RSV season typically starts in November, with cases still coming up in March and April.

Besides the breathing issues, children sometimes suffer from dehydration. Intravenous fluids may be necessary, she said.

“Most children that have RSV bronchiolitis will get better on their own in one to two weeks,” she wrote in an e-mail.

“Premature infants, very young infants and children with chronic medical conditions are at higher risk for severe illness. Some children may need hospitalization for closer observation or for medical interventions that cannot be provided at home,” Reidy said. “If a parent has any concerns about the symptoms their child has, it is always best to have them seen by a doctor.”