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Colorado is responding to sharp increases in Respiratory Syncytial Virus (RSV) hospitalizations and outbreaks, supporting the coordination of hospitals as they plan for the possibility of more cases, and is sharing information about how to reduce the spread of virus across the state. The concern is that a “trifecta” of viruses — COVID-19, RSV, and a more severe strain of the flu — are creating an early and heightened risk of illness this winter, especially for children and those over 65.

Beginning this past Wednesday, the Colorado Department of Public Health and Environment (CDPHE) is sending text and email reminders to approximately 517,000 Coloradans 65 years and older whose records in the Colorado Immunization Information System show they may be due for their annual flu vaccine. State health officials are working to increase flu vaccine uptake statewide as this flu season could be more severe than we have seen in years.

COVID Testing. Image courtesy of Johns Hopkins Bloomberg School of Public Health

Health care providers, including primary care and especially pediatric providers, can play an active role in helping families determine the best ways to help children with RSV, including home care management and when a child should be seen in the clinic, urgent care, or emergency room. Cases are occurring earlier than usual in the respiratory illness season. CDPHE is supporting the coordination of hospitals as they plan for the possibility of more cases.

RSV is a common respiratory virus that spreads by inhaling or having contact with virus-containing droplets (typically through the mouth, nose, or eyes) produced by a person with RSV infection when talking, coughing, and sneezing. While most people who get RSV will only have cold symptoms, it may be more severe in infants and young children, as well as older adults. Symptoms can include a runny or stuffy nose, sneezing, or coughing, and can also include fever, decreased appetite, and difficulty breathing or wheezing. RSV causes respiratory tract illness in people of all ages, but infants, young children, and older adults are at greater risk of severe illness from RSV. This virus is typically more common in the late fall, winter, and early spring.

Currently, 95 percent of RSV hospitalizations are among children. Additionally, CDPHE has seen a sharp increase in reported RSV outbreaks occurring in childcare and school settings, with 42 confirmed outbreaks reported since Oct. 1, 2022. Among these outbreaks, more than half have had at least one person involved in the outbreak seek care at a hospital.

CDPHE is in frequent communication with K-12 schools, preschool programs, and childcare facilities to provide information about RSV, including strategies to reduce transmission. Since the beginning of October, CDPHE has shared resources, such as the updated 2022-23 Guidance for Prevention & Control of Non-COVID-19 Respiratory Illnesses in Schools and Child Care Settings, How Sick is Too Sick tool, and Infectious Disease in School and Child Care Settings.

CDPHE staff is also available for consultations with schools, childcare providers, and our local public health partners to discuss resources and mitigation strategies for RSV and other infectious diseases. In addition, CDPHE today sent a Health Alert Network message to healthcare providers. The Health Alert Network message was aimed to raise awareness among these providers about the rise in RSV to ensure awareness about the increase of RSV in Colorado and what symptoms may be associated with an RSV infection.

Childcare centers and schools can also play an active role in preventing the spread through increased handwashing, disinfecting surfaces and areas, and strict adherence to and implementing their illness policies.

Hospitals report an increase in RSV cases is putting a strain on the state’s pediatric hospital system. The state is coordinating across all hospitals to protect hospital capacity. Since Oct. 1, 2022, there have been 292 RSV-associated hospitalizations in the five-county Denver metropolitan area (Adams, Arapahoe, Denver, Douglas, and Jefferson counties) and 42 outbreaks statewide. That’s more than double the number from the same timeframe in 2021.

“The increase in RSV-related hospitalizations in Colorado in recent weeks is considered concerning. While there are now vaccines for flu and CVOID-19, there is still no vaccine for RSV.

“Children with RSV can develop wheezing, poor feeding, and dehydration, which can lead to hospitalization. Connecting with your primary care or pediatric provider if your child is not getting better may help to keep your child out of the hospital,” said Pediatrician and CDPHE Chief Medical Officer Dr. Eric France.

“CDPHE has issued a Health Action Network message to all health care providers and CDPHE is supporting the coordination of hospitals as they plan for the possibility of more cases,” said Dr. France. “We have learned a lot about how to respond effectively and coordinate as a state, but we need everyone to do their part. Practicing good hand hygiene and staying home when you are sick can help slow transmission of RSV and most viruses.”

Coloradans can help reduce the transmission of RSV in several ways:

  • Stay home when you are sick, including not visiting or interacting with people who may be at higher risk, including older adults, young children, and infants.
  • Frequently wash your hands with soap and water or an alcohol-based hand sanitizer with at least 60 percent alcohol.
  • Encourage children to cover their nose and mouth with a tissue or upper arm sleeve when they cough or sneeze, throw away the tissue after they use it, and clean hands as instructed above.
  • Clean potentially contaminated surfaces, like doorknobs, tables, handrails, etc.
  • Avoid sharing cups, eating utensils, and touching your face with unwashed hands.
  • If your child is demonstrating early signs of respiratory distress, consider taking them to their primary care doctor for evaluation.

Coloradans can find more information about RSV rates in Colorado on CDPHE’s website.