Unprecedented numbers of children are being hospitalized in Colorado with respiratory syncytial virus, or RSV. 5280 spoke with Children’s Hospital Colorado’s associate chief medical officer Dr. Kevin Carney about the severity and seriousness of the illness and its pressures on local medical facilities—and what we can expect going into the holiday season.

Editor’s note: The following conversation has been edited for length and clarity.

5280: Respiratory syncytial virus, or RSV, isn’t a novel bug—so why is it making headlines in 2022?
Dr. Kevin Carney: RSV has been around for a while. Most young kids will get it at some point, but this year is unlike anything I’ve seen in my 12 years at Children’s. This year’s respiratory season actually started in August with enterovirus D68; that virus dissipated but then we got hit with RSV far earlier than expected. It’s been roughly eight or nine weeks of seeing lots of kids who need help getting enough oxygen.

Why do experts think this season has seen an early onset and more severe disease?
I’m not an epidemiologist, but I believe my colleagues in that field will be studying this in the coming months. They’ll be looking at how the COVID-19 pandemic may have changed virus seasons. It’s possible that the way we responded to the pandemic changed the way viruses spread and kept them at bay—until now. Experts will also be looking at what people are calling the immunity gap, which is an unproven theory that suggests that our immune systems—especially young kids born in the past couple of years—aren’t prepared to fight common illnesses after two years of caution and isolation.

I think most people know what the flu looks like and we’ve all have heard about COVID-19 ad nauseam, but what are the symptoms of RSV?
In adults and some kids, RSV just feels like a cold. But in very young children and immunocompromised adults, it can lead to hospital admission because it causes bronchiolitis, which is inflammation and congestion in the lungs. At first, bronchiolitis looks like a cold, but then it causes a harsh cough and difficulty breathing. There can be wheezing. For infants, it can be hard for them to feed because of the nasal congestion and that can lead to dehydration.

So, what do parents need to know?
I have three kids; they’ve all had bronchiolitis. I was often up at night with that blue nasal bulb trying to remove mucous, so I know how distressing it can be. Parents need to pay attention to how hard their child is working to breathe; how low on energy the child might seem; and how hydrated the child is. If a kid is fatigued and wheezing and isn’t going through diapers normally or isn’t producing tears when they cry or if their mouth isn’t moist, it’s time to call the pediatrician or take them to the emergency room.

What might happen at the ER?
Doctors will check a child’s oxygen level and assess whether they’re getting too tired to breathe on their own. In that case, a child might need to be admitted into the hospital or ICU to get respiratory support, like a nasal canula or breathing tube. Right now, though, all four of our Colorado campuses are having to expand in-patient beds just to keep up with demand. We’re bringing in emergency staff and hitting capacity on all units on most days.

What’s it like for your staff after more than two years of fighting COVID-19 and now a surge in RSV?
It’s fair to say the teams are tired and stressed. The health care system is in a different place now; we’ve lost a lot of people since early 2020 so we’re having to come up with solutions to keep helping those who need us. Despite their exhaustion and despite it being cliché to say it, the people we have here want to help kids. They want to be part of the place that takes care of the sickest kids. This is why we’re here.

Next week is one of the biggest travel times of the year—should we all reconsider our plans to be with family and friends if we have small kids?
The holiday season is going to offer a lot of opportunity to catch something. Flu and COVID are out there, too, and both are on the rise right now. I know everyone wants to see family, but we should use caution and realize that what might be a mild illness for you could be scary for someone else. If you are going to travel, use the same precautions we all learned to use during the pandemic. Minimize time spent in small, enclosed spaces unmasked. Wash your hands a lot. Don’t touch your eyes and mouth. If you aren’t feeling well, wear a mask. Also, it’s not too late to get your flu shot or a COVID vaccine or booster. Remember: The goal is not to prevent all infections; it’s to prevent severe infections.

Is there a vaccine for RSV?
Not yet, but one is being worked on and studied as we speak. It’s on the horizon, so that’s exciting.

For more information on RSV and other viruses, visit childrenscolorado.org.