What the GN is doing about RSV

As a follow-up to your commentary on RSV (Feb. 28), I would like to explain some of the challenges we have in Nunavut in coping with this virus.

This is a common virus and the underlying cause of most bronchiolitis and pneumonia in children under two years of age. Most children are infected by age two, and for many, the symptoms are no more than a mild cold. However, for reasons we don’t yet understand, Inuit babies develop severe respiratory disease at 10 times the rate of non-Inuit children.

In general, it is known that breast feeding can give babies up to 90 per cent protection against many common infections. It is also known that overcrowding and exposure to environmental tobacco smoke are associated with higher rates of respiratory infections in children. Certainly hand washing, not coughing or sneezing near a baby and avoiding bringing young babies out to crowded events decrease the chances of the infant catching this virus.

All health centers in Nunavut have pamphlets (in four languages) explaining what RSV is and what can be done to reduce the risk of a baby catching this infection. Health centres also have treatment protocols for bronchiolitis in place and work very hard to ensure the best care for these infants. But there is no specific “cure” for bronchiolitis. Treatment is supportive only — ensuring the infant has enough oxygen and fluids while their own immune system fights the disease.

A vaccine would be the most effective preventative method. One is currently being developed but unfortunately it will be many years before it is commercially available.

In the meantime, a vaccine-like product (Synagis) is given to premature babies and those with heart-lung defects (it is not recommended for other children) to protect them during the RSV season.

The department of health and social services is funding Dr. Anna Banerji’s research on lung health in Baffin children in order that we might have a better understanding of the factors associated with transmission of this virus in Nunavut, as well as investigating other potential infectious causes.

Also, Dr. Thomas Kovesi from the Children’s Hospital of Eastern Ontario is conducting research on the relationship between indoor air quality and respiratory infection in infants in Nunavut. These studies should facilitate the development of specific preventive measures.

RSV remains a huge challenge for all involved in health care in Nunavut, and most of all for the tiny infants who suffer severe respiratory distress.

Dr. Geraldine Osborne
Chief Medical Officer of Health
Government of Nunavut