“Why do I get sick more often in winter?”
As an emergency room doctor in a ski town, this question definitely makes my top 10 frequently asked questions. First, cold and dry air creates the ideal conditions for viruses to replicate, and second, we tend to spend more time inside around other people in less-ventilated places like bars, restaurants and movie theaters. The convergence of these circumstances is why we see the uptick of RSV and Influenza—and now COVID, in the winter months. Here in the Roaring Fork Valley, we have a great influx of people who pass through airports all over the globe to get here, visitors and locals alike, with the shared goal of enjoying world-class winter sports in a world-class setting.
As the community’s hospital, our goal is to help you make informed decisions on how to avoid illnesses and injuries so you can revel in the unique way our valley is transformed in winter.
Let’s start with RSV.
RSV is a respiratory virus that circulates in the late fall and winter. It is most dangerous for young children (<2 years old), especially those who were born prematurely or have underlying lung or heart disease. It can present with an asthma-like illness and causes hypoxia (low oxygen) which is treated with oxygen supplementation. For those at the highest risk (premature, lung or heart disease) there is a preventative medicine, injectable, given monthly during the season. Adults generally have a mild cold or flu-like illness when infected with RSV, and can be treated for their symptoms with Tylenol and ibuprofen as needed. Adults over 65 with chronic disease are at higher risk of severe illness or death. Adults are not approved for any preventative treatments. Illness can last 7-14 days. Preventative measures are the same as for all respiratory viruses: hand washing, not sharing utensils or drinks, wearing masks, etc.
Aspen Valley Hospital’s capacity to admit children has not yet been strained by the rise in RSV. We have admitted a few patients for oxygen therapy and transferred a few to a higher level of care in lower altitude when unable to improve oxygen levels here at high altitude. The biggest concern the providers at AVH have concerning RSV admissions is that our referral centers at lower altitude (Denver; Children’s Hospital and Rocky Mountain Hospital for Children) have been running at close to full capacity for over a month, so there is always the possibility that transfer might be delayed due to lack of available bed space.
Now let’s talk about Influenza.
Influenza is a respiratory virus that we generally see every winter, however, during COVID years, when people were wearing masks and keeping their distance from each other, we saw very little Influenza. But it is back this year! I have seen more Influenza in the ER in the past month than either RSV or COVID. Influenza is transmitted the same way as RSV and can be prevented similarly. Vaccines are available for everyone over 6 months of age to prevent severe illness and death from infection.
What about COVID?
We are still seeing COVID at AVH and it is increasing in the community. We have not yet seen severe COVID related to the new variants. We have had admitted patients, but no recent transfers due to severe illness. There are bivalent boosters available to help prevent severe illness and death.
Continue reading for tips on how to lessen the transmission of RSV in children and infants.
Tips to Lessen the Transmission of RSV to Your Infant and Other Children
Teach your children to wash their hands often and for at least 20 seconds before touching the newborn. Have them sing the Happy Birthday song to the baby while washing their hands vigorously with soap and warm water. If you are tired of Happy Birthday, you can download our infection prevention flyer with a template to write your own handwashing song.
Sneeze in the Sleeve
Teach your children to sneeze in their sleeve to prevent the virus from becoming airborne and spreading to others.
Raise the Humidity
Have cool mist humidifiers in your infant and children’s rooms (the American Academy of Pediatrics recommends room sharing for a year—not bed sharing—to help in the prevention of SIDS); a humidifier in your room will be helpful at this time as well. A moist airway harbors less bacteria and viruses than a dry airway. Keep the humidifier clean to avoid mold growth.
Lubricate and Clear Nasal Passages
Have saline solution and a nasal aspirator or bulb syringe handy and know how to use them so you can suction your child’s nose as needed. Babies are primarily nose breathers for 6 months, so suctioning if they sound stuffy will ease their breathing.
Breastfeeding your infant and children is now recommended for 2 years by the American Academy of Pediatrics and the World Health Organization. Breastmilk contains antibodies that can fight infection. Those antibodies are present in high amounts in colostrum. However, antibodies are in breastmilk the entire time a mother continues to nurse. Breastmilk is also made up of other proteins, fats, sugars and even white blood cells that work to fight infection in many different ways. There are also factors in breastmilk that directly stimulate and support the baby’s immune system. Try to use fresh breastmilk as much as possible. If you are pumping, keep in mind that breastmilk can be kept at room temperature for 5 hrs. Freezing and heating breastmilk kills some of the protective live cells; please note that if you need to freeze and reheat your milk, that still provides many benefits to your baby. If you need help with breastfeeding, please contact Lactation Services at AVH at 970.544.1130.
Hydration with oral fluids is extremely important, especially at altitude, to help keep secretions thinner so they are easier to clear.
Please keep your school-age children who have a cold (or other viruses) away from their younger siblings, especially babies, until their symptoms clear up.
Currently, there’s no vaccine to prevent RSV. But there are vaccines that prevent respiratory viruses in children that can cause similar symptoms to RSV. It is strongly recommended that all children 6 months and older get the yearly flu vaccine and a COVID-19 vaccine.