INDIANAPOLIS — Children’s hospitals across the country are reporting rising cases of a common respiratory illness, and pediatricians here in Indiana are saying they too are seeing a spike.

RSV, respiratory syncytial virus, affects about 2 million children under 5 years old annually nationwide. The illness can be a common cause of mild cold-like symptoms such as runny nose, cough and fever. But it can also cause severe breathing problems for babies.

The U.S. Centers for Disease Control and Prevention estimates that 1% to 2% of infants younger than six months who get infected with RSV require hospitalization. In an average year, around 250 children die from the disease.

“The problem comes in young babies or those who are at high risk with heart or lung disease and it can cause wheezing, difficulty breathing, fast breathing, or changes in color and can be very severe,” said Dr. Christopher Belcher, a pediatric doctor with Peyton Manning Children’s Hospital at Ascension St. Vincent. “Typically it’s yearly starting sometime later in the fall with a peak in January or February and then slowing down over the next few months but COVID has changed all of that.”

On average, RSV sends about 60,000 young children to the hospital each year in the U.S. In 2022, however, the virus has hit early and according to the CDC, doctors have found more cases in each week of October than any week in the prior two years.

Right now, Riley Children’s Health reports a 25% increase in patient volume compared to last year.

“The typical season for RSV starts in September or October and goes until March or April and the peak is typically in January or February so we’re way shifted earlier for this and we don’t know when it will slow down,” said Dr. Belcher. “The cases are tremendously more than this time of the year compared to last year so we’ve really had an experience that after COVID the seasons are way off. So, this would not have been unexpected in the past for a peak in February but the problem is that it’s October and we don’t know how high it will get this winter.”

Some studies have shown that the seasonality of RSV has shifted, mainly due to the COVID-19 pandemic. One theory behind the surge in RSV cases is that the illness is spreading among a highly vulnerable population of babies and children who were sheltered from common bugs during the pandemic lockdowns and use of social distancing measures.

Immune systems might not be as prepared to fight the virus after more than two years of masking, which offered protection, according to Dr. Elizabeth Mack of the Medical University of South Carolina in a statement sent to the Associated Press.

The virus is not just a threat to the health of children, in recent years doctors have seen RSV can also cause severe disease in high-risk adults and people older than 65. RSV causes 177,000 hospitalizations and 14,000 deaths yearly in adults over 65 as well.


Currently there are a few RSV vaccines under development, but for now the best protection is preventative measures.

“It’s mostly spread by touch so people touching their secretions and spreading them on. So good hand washing, hand sanitizer, masks do help a little bit with it to keep from spreading droplets and to keep to yourself,” said Dr. Belcher.

“If it feels like a cold, it doesn’t matter what it is we don’t want you spreading it to people so you don’t need to get tested but stay home, wash your hands, wear your mask if you’re out and about, cough into your shoulder to contain your secretions.”

Health experts say it is a matter of managing symptoms and letting the virus run its course. Doctors may 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.

During RSV season, an injection of an antibody-based medicine is sometimes prescribed to protect premature infants and other very vulnerable babies.

“If you have someone who is susceptible like a baby with heart disease, lung disease, or premature, you kind of want to keep them in small spaces and not take them in a large group setting where someone else may have it and spread it to them,” Dr. Belcher added.

The surge in cases may mean a need for hospitals to take further steps to protect patients.

“Pediatric hospitals in the winter season when are RSV strikes will have visitor restrictions because we worry about sicker or older children coming in with it thinking they just have a cold and spreading it to those who are very susceptible to it,” said Dr. Belcher. “Unlike some viruses like influenza we do have drugs to treat it but when it comes to RSV we just want to prevent it from happening.”

Threat of a Tripledemic

One reason for the urge to take precautions and awareness of rising RSV cases, the threat of a “tripledemic”.

RSV, flu and COVID-19 are hitting hospitals across the country, and as winter approaches, health experts fear the three illnesses could put them under more stress.

Along with taking preventative measures such as hand washing, cleaning surfaces and covering coughs and sneezes, doctors are urging everyone to get updated on their vaccines.

Currently, flu activity is low in Indiana, but health officials have warned of a more severe flu season this year.

The CDC added the COVID-19 vaccine to the schedule of recommended immunizations for children and plans to add them to a program that provides care for low-income or uninsured children.

If someone is sick with symptoms that look like a cold, it may be best to avoid close contact until they feel better. And if you feel sick, stay home or wear a mask to help protect others.

The Associated Press contributed to this article.