What to Know About RSV and the Tripledemic

Like the rest of the country, we at East Portland Pediatric Clinic are seeing a sharp increase in cases of respiratory illnesses this season, especially in influenza (the flu), RSV (respiratory syncytial virus), and COVID-19.

This potential tripledemic is due to a variety of reasons, including the disruption of typical seasonal shifts in viruses as well as the dropping of indoor masking requirements. Along with basic hygiene like handwashing, how can you protect yourself and your family from the tripledemic this season? Read on to learn more.

RSV or the flu?
While not as well known as the flu or COVID-19, respiratory syncytial virus (RSV) is a common virus that circulates every year. Almost all children get RSV at least once before they turn two years old. For most healthy children, RSV causes mild, cold-like symptoms that resolve within a week or two. But some kids get very sick with RSV and can develop bronchiolitis or pneumonia. AAP’s article on RSV has a helpful video that demonstrates the signs of breathing problems we want parents to look for.

Like RSV, the flu is circulating at much higher rates this year. The best way to protect you and your family against it is to get vaccinated each year. The flu vaccine is recommended for everyone 6 months of age and older and are especially important for pregnant people. For our patients 2 years and older, we offer the option of flu vaccine as a shot or a nasal spray. This AAP article explains the difference.

COVID-19 cases are on the rise again, and are expected to peak in December. Your best protection is getting your COVID vaccine and staying up-to-date on boosters. COVID vaccines are recommended for everyone 6 months and older. Just like the flu vaccine, if you are pregnant, getting your COVID vaccine is safe and the best way to protect your baby.

To learn more about the tripledemic, check out this Portland Monthly article. Want to find out more about the differences between the flu, COVID-19, and RSV? AAP offers this breakdown.

Need to schedule a flu or COVID-19 vaccination for you or your child? Please contact us for an appointment with our pediatricians in Portland.

How can you prevent the spread of respiratory illnesses?

• Handwashing. This is one of the best ways to prevent yourself and your family from getting sick.
• Mask in crowded, indoor settings. Masking is also highly recommended if you or your child is sick or interacting with someone at medium or high risk. Dr. Matthieu’s children, like many other students, continue to mask at school.
• Stay home when sick. Like handwashing, keeping your kids (and yourself) home while sick is essential to preventing the spread of all infectious diseases. For a more comprehensive list of symptoms visit AAP’s page on when to keep your sick child at home. We also have a list of acetaminophen and ibuprofen dosages on our website.
• Avoid the emergency room unless absolutely necessary. Pediatric offices, emergency departments, and hospitals across the country have been dealing with very large numbers of patients, and in many states, including Oregon, there’s a shortage of pediatric hospital beds.
• Get plenty of sleep. Rest is truly one of the best medicines.

Expect longer wait times
Due to the increase in respiratory illnesses this season we’re even busier than usual with phone calls and appointments. Please be assured we’re working hard to meet your needs. At times we do have to prioritize urgent situations, which may make your wait time longer. If you have a non-urgent question, feel free to skip the hold music and use the portal. Thank you so much for your patience and understanding.

FAQs – Answered by Our Portland Pediatricians

Are there tests for flu and RSV?
Yes, we do have tests for influenza and RSV. Testing is done with a nasopharyngeal swab; the one that goes all the way to the back of the nose. Testing for RSV is rarely needed since RSV is treated like any other respiratory illness, with rest, hydration, and managing congestion with nasal saline and suction. Influenza testing can be helpful if done in the first 48 hours of illness, as this is when an anti-viral medication can be started that may shorten the length of the illness by 1-2 days and may help prevent complications like pneumonia or needing to be in the hospital.

Why did the governor issue a pediatric public health state of emergency?
This week, Governor Kate Brown issued a public health state of emergency in order to assist hospitals and public health agencies in the state manage the surge of respiratory illnesses in children. Our pediatric hospital and emergency rooms are already running at or beyond full capacity, including pediatric intensive care unit beds, and respiratory illnesses will be increasing for some time. This crisis is not limited to Oregon, and the AAP has called for the federal government to issue a nationwide state of emergency.

Is it true there is an antibiotic shortage?
Unfortunately, yes. There is currently a multi-country shortage of amoxicillin, the first-line antibiotic used in many pediatric infections. Antibiotics are not helpful against viruses, so the vast majority of children with COVID, flu, or RSV will not need amoxicillin. But viral illnesses can sometimes lead to bacterial infections, such as ear infections or pneumonia. The more children with viral illnesses, the more this small percentage of bacterial complications grows. As doctors prescribe other antibiotics, this is having a domino effect on the availability of other antibiotics as well.

Should my child mask at school?
We have good evidence over the last two years of how well ventilation and masking work at preventing respiratory infections. Masking at school will not only help prevent illnesses in your child, it can help slow the spread of these viruses to others. KN95 and KN94 masks offer the best protection as well as a better fit (the shape of the KN95s make them more comfortable than other masks. Masking and staying updated on vaccines are your best bet to avoid missed school days and to save the holidays!