Durban – The National Institute for Communicable Diseases has noted an increase in respiratory illness cases among young children.
In a report on Wednesday, the NICD said in recent weeks there have been more cases in Respiratory Syncytial Virus (RSV) and clinicians are reminded to consier RSV in differential diagnosis for severe respiratory illness, more especially in younger children.
“It is noted that RSV detection has breached the low threshold among all ages. Among children, younger than 5, the RSV detection rate is currently as moderate levels. The RSV season usually precedes the flu season with the usual average onset at the end of February. This has been noted over the last decade. However, this year, we unusually did not see an RSV season which is likely to be related to control measures implemented for Covid-19, leading to a reduced RSV circulation,” the NICD said.
The Institute said during April, the detection rate of RSV briefly crossed the seasonal threshold, moving into moderate activity level from September 21 and rising about the peak of the 10-year mean, at least 20 weeks later than usual.
“The highest number of positive RSV detections in a week this year has been 25 whereas up to 65 positive detections per week were made during the season in previous years. Unusually, this year among patients of all ages, the seasonal threshold was only breached in week 39, reaching low transmission. It is unclear whether this increase will be sustained as the timing differs from that of the usual RSV season,” the NICD said.
The NICD said although this is not a classical timing for RSV season, clinicians are reminded to consider RSV in differential diagnosis for severe respiratory illness, especially in young children.
Respiratory syncytial virus detections and detection rate, all ages, pneumonia surveillance, South Africa, 01-January-2020-08 October 2020 Picture: NICD
Respiratory syncytial virus detections and detection rate among patients aged ≤5 years, pneumonia surveillance, South Africa, 01-January-2020-08 October 2020 Picture: NICD
“The majority of infants with RSV-associated bronchiolitis do not require hospitalisation, but certain children are at risk of severe disease or require oxygen. Infants aged younger than 6 months may develop severe disease such as hypoxia, severe respiratory distress, tachypnoea, nasal flaring or lower chest retractions, inability to feed or apnoea, requiring hospitalisation.”
The NICD said in very young infants, irritability, decreased activity, and breathing difficulties may be the only presenting symptoms.
“Risk factors for severe RSV-associated disease include prematurity, congenital heart disease, chronic lung disease of prematurity, neurological disease, infants younger than 6 months, immunodeficiency and lack of breast feeding.
“Environmental factors that are risk factors for severe RSV-associated disease include overcrowding, poverty, overcrowding and day care centre attendance,” the NICD said.