A surge in Covid, flu and respiratory syncytial virus (RSV) could lead to the NHS being overwhelmed this winter, a report by leading medics has warned.
The Academy of Medical Sciences report, by 29 experts and commissioned by the UK Government, said hospitalisations and deaths from both flu and RSV could double those seen in a normal year.
It warned as many as 40,000 children could end up in hospital with the latter virus.
Cases of RSV are expected to increase exponentially in winter because people’s immunity to the virus - which is common in children and the elderly - is likely to have fallen due to Covid lockdown restrictions over the past year.
So, what is RSV, what are the symptoms and how can you spot it in children?
Here’s what you need to know.
What is RSV?
RSV, an enveloped RNA virus, is from the same family as mumps and measles.
It’s a very common virus that normally circulates in winter in the UK, and it can lead to a lung infection called bronchiolitis.
It’s one of the viruses that causes coughs and colds in the colder months and occurs regularly each year.
RSV is transmitted by tiny droplets of liquid from the coughs or sneezes of someone who is infected with the virus. It’s also able to survive on surfaces or objects from around four to seven hours.
The incubation period of RSV - the period between infection and the appearance of symptoms - is relatively short at about three to five days.
What are the symptoms of RSV?
An RSV infection causes symptoms similar to a cold.
According to the government, these usually include: runny nose, sneezing, nasal congestion, cough and sometimes fever.
Most people experience a mild respiratory illness, but for a small number of at-risk people, the virus could cause pneumonia.
The authors of the report say RSV, flu and Covid often produce similar symptoms.
The medics call for those with any symptoms of the three viruses to isolate and stay at home to protect others.
How can you spot it in children?
RSV is very common in children and almost all children are infected with it by their second birthday.
The virus is the leading cause of bronchiolitis in babies and infants, which can make breathing harder and cause difficulty breathing.
It can also cause ear infections and croup - a barking cough caused by inflammation of the upper airways.
About 20,000 children under five are admitted to hospital each year with RSV.
More than three in five children usually catch it by their first birthday, but public health officials believe that lockdowns and school closures mean many have not been infected and are therefore not yet immune.
Further advice on RSV can be found on the NHS website here.
What is bronchiolitis?
Bronchiolitis is caused by RSV, which leads to the smallest airways in the lungs, called the bronchioles, to become infected and inflamed.
This inflammation reduces the amount of air entering the lungs which can impact breathing.
It’s a common infection which can affect young children under 2 years old, and especially babies between three and six months of age.
According to the NHS, around one in three children will develop bronchiolitis during their first year.
Most cases are mild and clear up within two to three weeks without any need for treatment.
However, some children do develop severe symptoms and require hospital treatment.
The early symptoms of bronchiolitis are also similar to a cold, like a runny nose or cough.
More symptoms then usually develop over a few days, including: a fever, a dry and persistent cough, difficulty feeding, and rapid or noisy breathing or wheezing.
If you’re worried that your child has a serious case of bronchiolitis, see your GP or call NHS 111.
Around 2 to 3% of babies who develop bronchiolitis before their first birthday need to be admitted to hospital after developing more serious symptoms.
How do you treat it?
There’s no medication to kill RSV, but infection usually clears up within 2 weeks without any need for treatment.
Most children can be looked after at home in the same way that you would treat a cold.
The NHS website includes advice on treating bronchiolitis in children, including making sure they are sufficiently hydrated.
You can also reduce your child’s risk of catching it by washing your and their hands regularly, washing and wiping toys and surfaces and keeping infected children at home until their symptoms have improved.
You should also keep newborn babies away from people with colds or flu.
Some children who are at high risk of developing severe bronchiolitis may be able to have antibody injections each month, which can help to limit the seriousness of infection.