Manitoba program aimed at protecting vulnerable babies, toddlers from RSV starts early as cases rise
'We have a lot of children … who are presenting with a lot more symptoms requiring hospital care': doctor
As Manitoba sees a surge of RSV cases, a program aimed at protecting babies and toddlers at risk of getting the sickest if infected has started early this cold and flu season.
The province's RSV prophylaxis program provides antibody treatments throughout RSV, or respiratory syncytial virus, season to young children identified to be at highest risk, said Dr. Aaron Chiu, the program's medical director and a neonatologist at Winnipeg Children's Hospital.
"When we run into a cold virus we create antibodies to fight it next time around, or even fight that current infection," he said.
"What this product does is that antibody that we normally make, we just give it to the babies so that they have some natural protection against it."
RSV is a virus that affects small airways of the lungs. Symptoms can include coughing, runny nose, fever and loss of appetite, and it can also affect breathing. In severe cases, it can lead to hospitalization.
Over the four-month period ending Oct. 31, the Children's Hospital in Winnipeg has seen a higher number of kids with RSV than normal for this time of year, a Shared Health spokesperson said Monday. That includes 48 cases in October, with 14 needing to be hospitalized.
Respiratory illnesses and influenza are believed to be driving a significant rise in patient volumes at the Children's Hospital emergency department over the past 10 days, Shared Health said.
The fact the virus is already circulating is why the RSV program started a couple of weeks early this year, said Chiu.
"We usually start seeing … [RSV cases] toward the tail end of November, beginning of December, and we started hearing from our colleagues across the country that they're seeing RSV cases more regularly," said Chiu.
"We figure it's important to get the patients protected."
Treatment for high-risk kids
Chiu said the treatment reduces the risk of a severe RSV-related hospitalization for those at highest risk from the illness, including premature babies and young children with underlying heart and lung conditions.
About 1,000 young children are referred to the program each year in Manitoba, and roughly 300 babies and toddlers meet the criteria for the treatment, he said.
While the majority of kids are two years old or younger, kids up to the age of four receiving bone marrow transplants also fit the criteria for the program.
The program in Manitoba launched in 2004 and was initially run by Canadian Blood Services, according to Shared Health.
While the majority of doses are administered through hospitals and clinics in Winnipeg, 30 per cent are provided outside Winnipeg by rural family physicians and public health nurses, said Chiu.
"The goal is to find a place that they can get the doses closest to home," he said.
The monoclonal antibody treatment is typically given every four weeks during RSV season, said Chiu.
Initial studies showed that in premature babies — those most vulnerable to RSV — the treatments probably halved the number of hospitalizations due to RSV, said Chiu. However, he said due to improvements in medical care for premature infants, it's hard to know exactly what that number would look like now.
Chiu said while some are more vulnerable to RSV, it can make anyone sick.
Many don't have antibodies because they didn't get infected while pandemic restrictions were in place, he said.
"We have a lot of children who are a bit older, who shouldn't be that sick from RSV, who are presenting with a lot more symptoms requiring hospital care, emergency care," he said.
Kids testing positive for multiple viruses
Shared Health said so far this month, a daily average of 180.5 patients have visited the children's emergency department, which is up nearly 24 per cent from October.
The provincial health organization also says the ratio of high-acuity patients in the Children's Hospital ER has increased, "interrupting normal patient flow in the department as children are sicker and require escalated levels of care for longer periods of time."
Staff are also seeing children testing positive for multiple respiratory viruses at the same time, the statement said.
While many common cold and flu symptoms can be looked after at home with rest and fluids, any children who have trouble breathing, can't take in fluids or have extreme fatigue should go to the nearest emergency room, the Shared Health spokesperson said.
With the viruses currently circulating, Chiu said it's important to wash your hands, not let people with cold symptoms kiss your child, and make sure you're up to date with your flu shot and vaccinations.
While there's currently no mask mandate, he said wearing one in large groups of people might be a good idea.
"What we learned from the COVID measures was that public health measures work," he said.
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