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Can someone who’s had RSV get the virus again?

Doctor says reinfections are not only possible, but may be more prevalent

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Matthew Lowe, who was hospitalized with RSV, plays with his brother Scotty at home in Salt Lake City.

Matthew Lowe, 5, who was hospitalized with RSV, plays with his brother Scotty at home in Salt Lake City on Friday, Dec. 9, 2022.

Kristin Murphy, Deseret News

Just after Halloween, Michelle Lowe’s 5-year-old son, Matthew, ended up in the hospital with RSV. Now, not only does she have to worry about the rest of her family coming down with the virus, there’s a possibility Matthew could get it again, too.

Lowe said she wasn’t prepared for her son’s bout with respiratory syncytial virus, which kept him at Intermountain Primary Children’s Hospital for four days and on oxygen at home for more than another week.

“I had read about it and I thought, ‘Oh, we have to start being careful,’” said the Salt Lake City mother of five children ranging in age from 6 months to 14 years old. “It kind of caught me off guard that he was the one who got it, and got it so bad.”

Lowe said she thought of RSV as “a baby disease,” but was told by doctors her 5-year-old, who’s now in kindergarten, probably hadn’t been exposed to the virus before since he wore masks at preschool last year to protect against COVID-19.

So far, Lowe said no one else in the family has gotten RSV, although her second grader had “a little bit of a cold” while Matthew was home recovering. She said she tries to get her children to wash their hands after school before playing with their baby brother.

The family chose to book a church gym for their Thanksgiving dinner with relatives so the 20 or so people gathered had plenty of room to spread out, enough that they were able to play a little basketball.

“The baby’s the one I worry about,” Lowe said, although she’s also concerned about Matthew, who’s fully recovered, getting hit by the virus again. When she started asking about the chances of reinfection, though, the responses she received varied.

“I said, ‘Is this an immune thing? Do we have to worry the rest of the season?’ and they said, ‘Well, he kind of does have a little bit of immunity behind him,’” Lowe said, adding, “A doctor did say, ‘I think you can feel calm at least for a little while, but you’re not out of the woods.’”

It was her sister-in-law, a nurse at Primary Children’s Hospital, who was the most blunt.

“She said, ‘Oh, no, of course he can get it,’” Lowe said her sister-law explained. “Their whole family got it and they were so sick. But she said, ‘Oh, no, he can get it again. That’s not a thing.’”

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Michelle Lowe plays with her son Scotty at home in Salt Lake City on Friday, Dec. 9, 2022. Her other son Matthew Lowe, 5, was hospitalized with RSV in November.

Kristin Murphy, Deseret News

Will Utah see more RSV reinfections?

Getting reinfected with RSV, even during the same season, has always been possible. But with cases already crowding doctor’s offices and filling hospital beds, Utahns may see more reinfections in the coming months.

“RSV is a super-common respiratory virus that’s been in the news a lot lately,” said Dr. Per Gesteland, a pediatric hospitalist with University of Utah Health and Primary Children’s Hospital. RSV is hitting Utah “with pretty significant force, affecting lots of people and causing a pretty dramatic surge.”

That’s likely because many people, especially young children, weren’t exposed to RSV during the COVID-19 pandemic, when precautions like social distancing, mask-wearing and frequent hand-washing helped keep many infectious diseases contained.

Normally, most children have had RSV by the time they’re 2 years old, Gesteland said. For many, RSV feels like a common cold, but he said they may end up in the hospital if the virus spreads to their lower respiratory tract and causes bronchiolitis, inflaming and narrowing their airways.

Studies have shown up to 25% of children can get reinfected with RSV, the doctor said, possibly that same season. Anyone can get the virus, including adults, although the most severe illness is usually in the very young as well as those who are older or have chronic medical conditions.

Reinfections are seldom as bad as the first, Gesteland said.

“The way we understand RSV, is that the more you get exposed to it, you build up some immunity and those subsequent infections are typically milder,” he said. “What we’re seeing now is just a bunch of kids that are having their first encounter with RSV and that’s why we’re seeing some of those older groups of kids coming in.”

But does RSV’s return mean there will be more reinfections?

“I think we might, actually,” Gesteland said, adding, “Because it’s happening kind of early, I can imagine that there are people who are going to see RSV again in the more typical winter months or in the spring, it might have a comeback.”

The next round of the virus might not be as bad as this one, though.

“Hopefully, it will be that if it’s their second go-round, it’s going to be milder and they’re not going to need the same level of attention that they did for their first infection,” he said. It may be a different story for those with compromised immune systems, impaired lungs or heart disease.

When will the RSV season end?

“The real trick is, how quickly is RSV going to go away,” Gesteland said, noting cases usually don’t peak until February or March. It’s too soon to say if the current surge, which has led to some surgeries being postponed at Primary Children’s, is headed down anytime soon.

“We’ll just have to see what happens with this one,” he said, since cases started climbing well before the Thanksgiving kickoff to the holiday season “and it’s still going to be going very strong as kids get out of school and everybody gets together for their holiday gatherings. That might really extend the duration of this.”

The Utah Department of Health and Human Services does not track RSV cases because it’s not a reportable illness in this state, spokeswoman Charla Haley said. But emergency room visits for RSV are monitored and show a steady increase over the past two months to a seven-day average of more than 100 cases as of Nov. 30.

Due to a steady stream of patients with RSV and other respiratory illnesses, Primary Children’s Hospital said “patient volumes continue to exceed typical winter surge levels, and the hospital has been at or near capacity for several consecutive weeks.”  

About 50 scheduled nonemergency procedures and surgeries that require inpatient stays were delayed, about 10% of all operations performed there, according to the hospital. A similar number were postponed last week, but the hospital said, “Patients who urgently need surgeries and procedures will continue to receive them.”

What Utahns need to do to slow the spread of RSV

To slow the spread of RSV, the state health and human services department is advising parents and those who care for young children to take extra precautions such as:

  • Avoiding close contact with sick people.
  • Covering coughs and sneezes.
  • Wearing masks “if appropriate.”
  • Washing hands (including the child’s) often with soap and water for at least 20 seconds.
  • Cleaning and disinfecting surfaces.
  • Avoiding touching faces with unwashed hands.
  • Limiting the time spent in child care centers or other potentially contagious settings when RSV activity is high.
  • Staying home when sick.
  • Calling a health care provider if a child has trouble breathing, isn’t drinking enough fluids, or has worsening symptoms.

While there’s no vaccine yet for RSV, staying up-to-date on flu and COVID-19 shots can help, too, since both of those viruses are also sweeping through the state in what’s being called a “tripledemic.” Gesteland warned that the viruses “can stack on top of each other,” creating multiple infections at the same time.

The doctor said people may also want to be even more cautious if they have babies to minimize their exposure. “Constrain your social life a little bit so you maybe skip a birthday party, keep them away from the church nursery” and even avoid some holiday gatherings, he said.

“The hard part for me is you can predict it, you can tell the story in advance of what happens when these things are circulating around then you have your family get together with the newborn kid, the grandparents. You can just imagine how that plays out when somebody brings in RSV,” Gesteland said.

Spreading what may feel like a mild cold to those who are vulnerable to severe illness from RSV, he said, is “not the kind of gifts we want to give.”