HealthLinks Charleston Jan/Feb 2023

60 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com C H A R L E S T ON CO U N T Y M E D I C A L S OC I E T Y THOSE PESKY VIRUSES AND THEIR MUTATING FRIENDS By Theresa Stratford It’s probably safe to say that every parent is officially sick of the word “virus.” And quite literally, actually. Between the perils of COVID and now the influx of respiratory syncytial virus and numerous cases of the flu, our children are running a fever and coughing up phlegm like it’s their job. We are in the midst of what some are calling a “triple pandemic.” And, yes, parents are sick and tired of seeing their kids sick and tired. But what do we do about it? Well, brace yourself – it is going to be a hard winter. According to the Centers for Disease Control and Prevention, since the first week of October 2022, more than 32,000 children had tested positive for flu. There are more children in the hospital now than in the past 10 years. And then there is RSV, which is particularly dangerous in infants and those with lung disease or poor immune systems. The CDC reported that every year, there are 2.1 million outpatient visits among children younger than 5 with RSV. And although the COVID infection rate has decreased over time, it is and will continue to be a concern, especially, as Dr. Janice Key put it, “when people put their guard down.” As a professor of pediatrics at the Medical University of South Carolina, Dr. Key has noticed that many of the viruses that were not seen during the first years of COVID sort of “woke back up.” “Coronavirus has been around for decades,” she said. “But it mutated in 2019 and became the lethal virus that is COVID-19.” She noted that the issue with respiratory viruses such as COVID, RSV and the flu is that they have the power to mutate and change. She also mentioned their ability to travel around the globe through the air as well as spread from person to person. Vaccines help prevent infection in many but not all cases, according to Dr. Key: “The flu vaccine is created in the summertime from the variant that is found on the opposite side of the world in Asia. So we have to create it based on that strain and predict what will happen here the following winter. It’s a mix of mutations that we have to create every year, so every year there is a slightly different flu vaccine. Sometimes we are right on the money and then other times we aren’t.” The tendency to mutate is common among some viruses, requiring yearly updates in vaccinations to protect people. Most bacterial diseases don’t change as rapidly, so they do not need new versions of a vaccine. For example, the same vaccination for tetanus, a bacterial disease, has been used for years and only requires a booster every 10 years as our immunity gradually wears off. As a pediatrician, Dr. Key said she currently is most concerned about RSV: “It is the most dangerous because of the likelihood of it turning into pneumonia.” Dr. Janice Key