“RSV is a common winter illness in children. Why did it see a summer surge in Australia this year? - The Conversation AU” plus 2 more
“RSV is a common winter illness in children. Why did it see a summer surge in Australia this year? - The Conversation AU” plus 2 more |
- RSV is a common winter illness in children. Why did it see a summer surge in Australia this year? - The Conversation AU
- Can you really diagnose RSV based on how the cough sounds? - Contemporary Pediatrics
- Is Chronic Bronchitis Contagious? What You Need to Know - Verywell Health
| Posted: 09 Mar 2021 11:06 AM PST Winter typically brings a surge in respiratory viral infections, when we see many children running around with runny noses and phlegmy coughs. But the 2020 Australian winter was very different. Public health measures in place to control the spread of COVID-19 saw a major shift in the typical seasonal pattern of other respiratory viruses. This has perhaps been most notable with respiratory syncytial virus (RSV), a very common cause of hospitalisation in young children over winter months in many parts of the world, including Australia. But following an abnormal winter that saw a significant drop in rates of RSV — we found there were 98% fewer winter cases in Western Australian children — paediatric hospitals around Australia have seen unexpectedly large numbers of children presenting with RSV over summer. So, what is RSV, and why are these changing trends important? A winter lurgyRSV typically circulates during winter in temperate climates, much like influenza. It's the major cause of lung infections in children, commonly causing bronchiolitis. Symptoms of RSV include a runny nose, cough, reduced feeding and fever. Complications include wheezing and difficulty breathing, which can develop into pneumonia. Severe cases occasionally lead to death, predominantly in very young infants. Almost all children have had an RSV infection by age two, but infants in their first year of life are more likely to experience severe infections requiring hospitalisation, because their airways are smaller. Babies have also not built up immunity to RSV from previous years (we call this being RSV-naïve). RSV is spread through respiratory secretions, when an infected person sneezes or coughs. In this way it's similar to COVID-19. But in contrast to the coronavirus, children are more vulnerable to RSV infection than adults. As a result, RSV is readily spread among children, especially at daycare, kindergarten and school. Read more: Is it really the flu? The other viruses making you ill in winter How is RSV treated?Most children will recover without needing specialist care in hospital, and children with mild infection can be treated with rest at home. However, many children, particularly young infants, those born prematurely, and children with underlying health issues, are admitted to paediatric wards with severe RSV every year. Treatment for RSV is focused on helping children with their breathing (for example, giving them oxygen) and feeding (for example, administering fluids through a drip). There's no licensed vaccine for RSV, but the World Health Organization considers this a priority, and a number of vaccines are currently in development.  What happened to RSV in 2020?The stay-at-home orders across Australia from late March 2020, and the implementation of quarantine for international arrivals, coincided with the start of the usual RSV and influenza season in Australia. With these measures in place, RSV and influenza cases dropped dramatically and remained very low throughout winter. In Western Australia, despite a relaxation of COVID-related restrictions, including schools reopening from May 2020, there was still a dramatic reduction in RSV cases through winter. This suggests border closures were important in reducing transmission from arriving overseas travellers. RSV cases remained low until late spring, when a large surge was observed in New South Wales and WA. The speed and magnitude of this increase was greater than the usual winter peak of RSV. More recently, other states including Victoria and Queensland have seen a similar unseasonal rise in RSV cases. Read more: Why do kids tend to have milder COVID? This new study gives us a clue It's likely reductions in COVID-19 restrictions have opened the door for increased RSV spread. Reduced immunity to RSV may also have contributed through both an increase in number of RSV-naïve children and possibly waning RSV immunity in older children related to the delayed season. Studies seeking to understand exactly why we've seen a rise in RSV cases are ongoing. Why might the Australian surge be important elsewhere?Australia's experience may carry important lessons for Northern Hemisphere countries, including the United States and the United Kingdom, which saw similar reductions in RSV cases during their winter. Relaxing of COVID restrictions, which is beginning in many Northern Hemisphere countries now, may provide an opportunity for rapid spread of RSV. Our experience should serve as a warning for paediatric hospitals in the Northern Hemisphere to ensure adequate staffing and available resources to meet the possible increased need.  Our RSV experience may also be applicable to influenza, which still remains at very low levels globally. Reduced immunity to influenza due to the skipped 2020 season may result in a very severe season when influenza returns. Seasonal influenza vaccines could be particularly important in 2021 to protect against a possible large resurgence. Let's hold on to our good COVID habitsThe COVID-19 pandemic has shown us the spread of respiratory viruses can be reduced by physical distancing and increased hygiene measures. While we are (hopefully) unlikely to see prolonged stay-at-home orders again in Australia, ongoing basic measures including hand washing, cough etiquette and keeping snotty children at home can all help reduce the spread of RSV and influenza moving forward. As we approach the 2021 Australian winter, by doing these simple things, as well as getting our flu vaccines, we can all help protect children, including those most vulnerable, from these important respiratory viruses. Read more: Kids are more vulnerable to the flu – here's what to look out for this winter |
| Can you really diagnose RSV based on how the cough sounds? - Contemporary Pediatrics Posted: 01 Mar 2021 12:00 AM PST  Senior staff and nurses, but not residents, can diagnose respiratory syncytial virus (RSV) infection based on cough sound as accurately as bedside tests. However, they can't outperform the gold-standard diagnostic test—multiplex ligation-dependent probe amplification (MLPA)—according to the results of 1 Netherlands study.1 During a 3-month period, parents of children aged younger than 1 year who were admitted to the pediatric ward because of airway complaints recorded their child's cough sounds with their smartphone. Investigators then linked these audio fragments to the viral agents found via MLPA analysis. They inserted 16 cough fragments representing 4 different viral pathogens (RSV, influenza, human metapneumovirus, and rhinovirus) into a questionnaire presented to 32 pediatric nurses, 16 residents, and 16 senior staff members. Respondents were asked to classify each cough (as wet, dry, or other), specify features of the so-called typical RSV cough, and indicate whether the cough was or was not caused by RSV. Participants showed no consistency in describing the coughs, making it impossible to specify features of a so-called typical RSV cough. Influenza was most easily distinguished from RSV, whereas RSV itself most often was identified as RSV. On average, senior staff correctly identified 3.8 of 5 of the RSV coughs, with 37.5% identifying all coughs correctly, demonstrating a mean sensitivity of 76.2%. Nurses did nearly as well, correctly identifying 3.7 of the 5 RSV coughs, with 34.4% achieving 100% accuracy, corresponding to a mean sensitivity of 73.1%. Residents, whose average work experience was 2.1 years, fared worse than senior staff and nurses in identifying the coughs (mean sensitivity, 51.3%), and investigators determined that they needed at least 3.5 years of working experience to reach the same level of detection as their more experienced colleagues. Compared with bedside tests, senior staff and nurses performed as well at detecting patients with RSV based on cough sound, but could not validly distinguish RSV from other pathogens. Investigators therefore concluded that diagnosis based on cough sounds could not replace MLPA analysis. Thoughts from Dr. Farber I got a different takeaway from this. Although it is rarely necessary to diagnose RSV infections specifically in outpatients, this study shows that experienced pediatricians can do this quite well without any testing, and without even auscultating the lungs for wheezing. If you also look at the child to see how ill he or she appears, which should enhance accuracy, these findings suggest that televisits for diagnosing bronchiolitis in infants are not far-fetched. Reference
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| Is Chronic Bronchitis Contagious? What You Need to Know - Verywell Health Posted: 11 Mar 2021 12:00 AM PST /GettyImages-1219140569-c275a23432774fc38d50e4e636dbf5cc.jpg) Chronic bronchitis is one of the two main types of chronic obstructive lung disease (COPD). The other is emphysema. Most people with COPD have symptoms of both conditions. In chronic bronchitis, swollen airways and excessive mucus production cause a chronic cough and difficulty breathing. Many people hear the persistent cough associated with chronic bronchitis and wonder if it is contagious. Over 16 million people have been diagnosed with COPD in the United States. Of these, over 3.8 million were diagnosed with emphysema, and nine million were diagnosed with chronic bronchitis. Chronic inflammation in the bronchi, airway obstruction, and chronic mucus production cause changes throughout the lungs. Many people who have chronic bronchitis eventually develop emphysema as well. twinsterphoto / Getty Images Acute vs. Chronic BronchitisBronchitis is an inflammation of the bronchi, branching tubes going into the lungs. These tubes carry air to and from the lungs. When the bronchial tubes become inflamed and swollen, less air can pass through them. Inflammation causes increased mucus production, which leads to an irritating cough when trying to clear the mucus. The inflammation may last a short period after an upper respiratory infection or may be chronic. Acute bronchitis usually develops after a cold or upper respiratory infection, and it improves within a few days without residual effects. Chronic bronchitis is more serious and develops slowly over time, sometimes months or even years. Because the symptoms of chronic bronchitis develop so slowly, many people do not notice how bad their symptoms have become. Acute bronchitis usually starts with a runny nose, sore throat, chills, and low-grade fever. As the infection moves from the nose and throat into the lungs, a dry cough usually develops. The bronchi become inflamed and mucus production is increased. At this point, you may notice a productive cough, wheezing, and chest tightness. In acute bronchitis, these symptoms are limited to no more than three weeks. Those with chronic bronchitis usually have a persistent cough and are frequently smokers. Smoking damages the cilia, tiny whip-like structures that beat dust and dirt out of the airway. Chronic bronchitis may develop after multiple episodes of acute bronchitis. Acute Bronchitis
Chronic Bronchitis
Chronic Bronchitis Generally Isn't ContagiousChronic bronchitis is an inflammation of the airways usually found in people with a long history of smoking, exposure to environmental chemicals, or genetic predisposition. Even though you may have a productive cough with chronic bronchitis, you are not contagious. The cough is secondary to mucus production and airway irritation, not a viral or bacterial infection. Increased mucus and inflammation can increase the risk of a secondary infection. If you have chronic bronchitis and have a sudden worsening of symptoms, fever, increased sputum production, or discoloration of the sputum, you may have developed a secondary infection. A secondary infection with a virus or bacteria is contagious, and it can be passed from person to person. Chronic bronchitis is not contagious unless there is a secondary infection. The chronic cough and mucus production characteristic of this disease may seem similar to pneumonia or other respiratory infection, but it is not the same. Preventing InfectionsVaccinesInfluenza A and B, parainfluenza, respiratory syncytial virus, and coronavirus are the most common viral causes of secondary lung infections. Getting an annual flu shot can help prevent secondary infections from influenza viruses, as can avoiding people who are ill. The viruses that cause influenza vary each year, so it is essential to get the influenza vaccine yearly. Schedule your influenza vaccine between October and December, so you are protected for the entire influenza season (in the Northern Hemisphere). Ensure all of your vaccines are up-to-date to minimize your risk of catching preventable respiratory infections. Verify whether you are a candidate for a pneumococcal vaccine. The pneumococcal vaccine is recommended for all adults 65 years and older and adults younger than age 65 with certain health conditions, including lung disease. Follow up with your healthcare providers regularly so any secondary infections can be detected early. Lifestyle ChangesPractice good hand hygiene, avoid crowded areas and ones with poor ventilation. To keep lung secretions thinner and easier to handle, drink lots of fluids and use a humidifier or vaporizer if it eases symptoms. If you are a smoker, seek help to quit. Avoid being around secondhand smoke and air pollution. There are medications for nicotine replacement that have helped many smokers quit. Counseling and support groups may also help. Take care of your overall health by getting as much exercise as you can tolerate. Eat healthy, well-balanced meals. Get plenty of rest and sleep. Stress causes changes in hormone levels in the body. These changes can make chronic conditions worse. If possible, decrease stress using deep breathing or relaxation exercises. A Word From VerywellChronic diseases can be hard to manage. It can be discouraging when you have a relapse and symptoms worsen, but there are many steps you can take to minimize the risk of worsening disease. Seek help if you are a smoker. There are many therapy options available to help you quit. Focus on your health by ensuring you get exercise, eat healthily, and get plenty of sleep. Advise family members and friends of your condition so they understand that your cough is not contagious, but you are at increased risk for secondary infections, which are contagious. Ask them to let you know if they may be ill so you can protect your health. Follow all of your healthcare provider's instructions on medications to minimize your symptoms and improve your overall health. Finally, do not hesitate to seek help if managing your symptoms is emotionally overwhelming. |
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