By Donald Gilpin

Runny noses, coughing, sneezing, fever — respiratory syncytial virus (RSV) cases are on the rise, with cold-like symptoms that are often mild but can cause severe illness in some people, including babies, older adults, and the immunocompromised.

RSV is the leading cause of childhood illness and hospitalization in infants, according to the Centers for Disease Control and Prevention (CDC), which also recently reported that more than half the counties in New Jersey have a “very high” percentage of emergency department visits for RSV. Emergency room visits for RSV in Mercer County were described as “moderate.”

Penn Medicine Princeton Medical Center Emergency Medicine Chair and Faculty Medical Director Colleen Marchetta, DO, FAAEM, reported, “Post-holiday, we have already seen a significant increase in patient visits to our Emergency Department for respiratory illnesses.”

She continued, “The growing concern about RSV arises from its increased incidence and the pressure it places on health care systems. RSV is a leading cause of hospitalization in infants and can cause severe disease in older adults and those with underlying health conditions. The simultaneous circulation of RSV with other respiratory viruses, such as influenza and COVID-19, exacerbates this burden.”

Marchetta described significant variations in RSV in recent seasons, which Princeton Deputy Administrator/Director of Health Jeff Grosser attributed, at least in part, to effects of the COVID-19 pandemic.

“After the pandemic years (2020-2022), when strict social distancing and masking measures reduced the spread of many respiratory viruses, there was a notable surge in RSV cases in late 2022 and early 2023,” Grosser wrote in an email. “This was attributed to a lack of natural exposure during the pandemic years, leading to a higher number of unexposed individuals once restrictions were lifted.”

In order to manage the surge in RSV cases, the Penn Medicine Princeton Medical Center Emergency Department has “increased bed capacity and ensured adequate staffing to accommodate the influx of patients,” “reintroduced face masks in clinical areas to curb the spread of infections,” and continues “to encourage vaccination against RSV, influenza, and COVID-19, especially among vulnerable populations,” according to Marchetta.

Grosser emphasized that it is not too late in the season to get vaccinated and that the CDC recommends either maternal RSV vaccination or infant immunization with RSV monoclonal antibodies for infants and young children and one of three available RSV vaccines for adults aged 60 to 74 who are at increased risk for severe RSV disease and all adults aged 75 and older.

Grosser pointed out that RSV season in New Jersey typically starts in early to mid-fall and can continue through early spring. Both Grosser and Marchetta noted that the continued presence of COVID-19, flu, and other respiratory ailments adds a layer of complexity to the situation.

They also emphasized the importance of good hygiene practices — regular hand washing, using hand sanitizers, avoiding close contact with sick individuals —and getting recommended vaccinations for influenza, COVID-19, and RSV.

Marchetta explained that most people recover from RSV within a week or two without requiring emergency care, but she urged, “Seek immediate medical attention if you or your child experiences difficulty breathing; bluish skin color, indicating insufficient oxygen; high fever; or dehydration.”

She added, “If you’re uncertain about the severity of symptoms or appropriate care, contact your primary care provider or utilize local health services for guidance. Reserving emergency room visits for severe cases helps reduce strain on healthcare facilities and ensures that critical resources are available for those in urgent need.”

Grosser emphasized the importance of maintaining a healthy lifestyle, “including proper nutrition, regular exercise, and sufficient sleep” to support your immune system. “In high-risk situations or when interacting with someone who is ill, consider wearing a mask to further reduce the transmission of respiratory viruses,” he added.