Do you have a post-holiday cold? What you need to know about RSV and all the other respiratory viruses circulating

A health-care worker treats a patient in the emergency department at Toronto’s Hospital for Sick Children on Wednesday, Nov. 30, 2022. THE CANADIAN PRESS/Chris Young

Are you feeling a bit under the weather coming out of the holiday season?

You might just be battling the common cold but it could also be one of a myriad of other respiratory infections that are circulating at this time of year, including Respiratory Syncytial Virus.

RSV, as it is more commonly known, is a infection that in most people, typically presents itself like a common cold with most children under the age of two getting it at some point.

Anyone who contracts the virus typically presents symptoms like a fever, coughing, sneezing and a runny nose.

"The issue is that there are some adults who are much more likely to develop severe disease, and those are individuals who are older and individuals who have underlying conditions, and, in particular, older individuals that also have underlying conditions are at an elevated risk of developing severe disease," Shelly Bolotin, director for the Centre for Vaccine Preventable Diseases at the University of Toronto, told CTV News Toronto in an interview.

Here's what you need to know this winter season.

How bad is COVID-19 and RSV this season so far?

"There's been in Ontario a rise of laboratory confirmed infection in the last month or so," Bolotin said, adding cases can peak anywhere between November and April.

According to Public Health Ontario's data for the week of Dec. 8 to 14, there is a roughly 10 per cent positivity rate with 171 people in the hospital due to RSV. Meanwhile, COVID-19 is more prevalent at this time, with a 13 per cent positivity rate throughout the week and 724 hospitalizations. Influenza is far less prevalent in the province currently, representing a 4.3 per cent positivity rate this week and 68 hospitalizations.

Locally, Toronto Public Health's Integrated Respiratory Disease Dashboard (IRDD) reveals the per cent positivity rate for RSV has risen steadily since the summer. That said, the wastewater activity – while increasing since then – remains below the historical average for this time

TPH reports that it has seen a total of 111 influenza cases during the second full week of December, representing a 6.1 per cent positivity rate, with COVID-19 representing a 9.5 per cent positivity rate.

Anna Banerji, an infectious disease specialist at the University of Toronto, explained that like the flu, RSV is also cyclical.

"There is an RSV season which occurs in the fall, just like influenza tends to be cyclic. There's multiple reasons, but also because kids are indoors, people are indoors more, and so these viruses tend to spread more," Banerji said.

What does RSV look like in kids?

"It can be very serious in infants, especially young infants and the younger they are, the more at risk they are for severe respiratory infections," Banerji told CTV News Toronto in an interview.

When it infects kids under the age of six months old, or even under the age of three months, Banerji said they can develop something called bronchiolitis, which is a lung infection.

"It causes inflammation and mucus plugging," Banerji said, which can impact how a baby breathes.

Banerji adds babies can have "laboured breathing" – when they are breathing fast and using the neck or abdominal muscles to breathe – when they contract RSV. If it gets worse and the infant struggles to breath, Banerji says it can cause the infant to turn blue as they're losing oxygen.

"If it gets worse than that, then babies can go into what we call respiratory failure. If there's no intervention, then an infant can die," Banerji said.

If an infant is struggling to breathe, looks discoloured or feels cold, or they're not eating or urinating, Banerji urges parents to bring their child to a healthcare provider.

"The other thing is, any baby less than two months of age with a fever needs to be seen by a healthcare provider," Banerji adds.

How to protect yourself

"We are very, very fortunate that the RSV landscape has really shifted in the last couple of years because we have a couple of new vaccines that are very, very safe and effective in protecting older individuals from RSV," Bolotin said, saying Arexvy and Abrysvo are Health Canada approved for older adults.

Several Ontarians are eligible for these particular vaccines including infants and those who are at least 60 years old and a resident at a long-term care home, an individual experiencing homelessness or First Nations, Inuit or Metis individuals. For a full list of who is eligible to receive these vaccines, Ontarians can refer to the province's online guidance.

For those who do not meet the criteria, Bolotin says Ontarians can purchase the vaccine privately.

"If you have health insurance through your employment, for example, often health insurance covers part of the cost of the vaccine," Bolotin said.

Toronto Public Health said pregnant individuals, who are between 32 and 36 weeks gestation, delivering near the 2024-2025 season can go to their prenatal care provider to receive a vaccine to protect their newborn

Additionally, TPH says infants and high-risk children no older than 24 months old can receive a monoclonal antibody treatment for immediate protection against the virus.

With COVID-19 vaccines, anyone aged six months or older are eligible for immunizations and can head to participating pharmacies to receive their doses. Appointments can also be made through Ontario's COVID-19 vaccine portal, through public health units' using their own booking system, participating primary care providers or Indigenous-led vaccine clinics.

"Vaccination is an effective way to protect residents, preventing severe illness, hospitalization and death, especially for high-risk individuals," the public health unit said in a statement.

On top of staying up to date with immunizations, TPH says Torontonians can reduce the spread of respiratory infections by staying home when they feel sick, washing their hands properly and masking when in a crowded space.