Mask-wearing urged around babies as respiratory virus cases surge to new record

No paediatric ICU beds free at weekend due to record numbers of RSV cases in small children

The number of RSV cases recorded so far this year – 3,861 – is already 1,000 higher than last year’s peak. Photograph: Alan Betson
The number of RSV cases recorded so far this year – 3,861 – is already 1,000 higher than last year’s peak. Photograph: Alan Betson

The HSE has urged people to wear masks when around small babies due to the risks posed by a record surge in respiratory illness affecting children.

A record 731 respiratory syncytial virus (RSV) cases were notified in the week to November 20th, the highest weekly figure since RSV was made a notifiable disease a decade ago.

Some 40 per cent of these patients – 290 in total – had to be hospitalised, according to the HSE’s Health Protection Surveillance Centre. The vast majority of cases – 74 per cent – involved children aged under five.

The number of RSV cases recorded so far this year – 3,861 – is already 1,000 higher than last year’s peak.

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There were no paediatric ICU beds available at the weekend, the HSE said. None of the 30 paediatric beds were occupied by a patient with Covid. There were no free general beds in Temple Street Children’s Hospital, four free beds in the children’s unit at Tallaght Univeristy Hospital and six at Crumlin children’s hospital.

RSV notifications
RSV notifications. Graphic: Paul Scott

The best way to protect family members from RSV and other winter viruses is to stay at home if unwell, and to practise good respiratory etiquette and hygiene, according to Dr Abigail Collins, national clinical lead for child health with the HSE.

She urged parents to keep children home from school or childcare where they are unwell with cold symptoms.

RSV also affects older people, with four RSV outbreaks reported last week in nursing homes. Another two outbreaks occurred in family homes and one in a hospital. In contrast, no flu outbreaks were reported to the Health Protection Surveillance Centre last week.

Dr Collins said the post-Covid pandemic surge in respiratory illness was expected because children have had more contact with each other, thereby increasing the risk of spreading winter respiratory viruses.

“In addition, because children had limited contact with one another last year their exposure to all respiratory viruses and resultant immune response was diminished and therefore more children will have lower immunity to these viruses this year,” Dr Collins said.

Most cases are mild and clear up within two to three weeks without treatment, she said. Antibiotics are not needed and will not help to treat a viral infection.

“Parents of young babies do need to take extra care and be clear about shielding babies from situation where they may come into contact with a virus.

“This may mean putting friends and family off from visiting for a while if someone is unwell, not encouraging people to touch your baby’s face, and asking people to wear a mask around your baby can also help.”

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She also advised parents to clean their, and their children’s, hands regularly and have their children nasally vaccinated against flu.

In the US, which is also experiencing a big RSV surge, children’s hospitals have told the Biden administration that unprecedented levels of RSV combined with increasing flu cases are pushing some hospitals to breaking point.

Together with the American Academy of Paediatrics, the children’s hospitals have asked the federal government to declare an emergency to provide hospitals with added flexibility to meet the surge.

RSV, or bronchiolitis, is a common chest infection in babies and young children. The virus spreads when someone coughs or sneezes and it affects babies and young children under two years old, especially babies under six months old.

Severe cases in infants may mean they need oxygen support because their airways are smaller and inflammation makes it difficult for them to breathe. They may also need intravenous fluids for several days because they are dehydrated or not feeding well.

Cases of winter flu are also rising, with 192 laboratory-confirmed cases and 64 patients in hospital, including two in intensive care.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.