The First Case of RSV in Puerto Rico

Op-Ed: RSV is packing hospitals with sick kids, but it can be contained

The story in the headline is too short to convey the urgency. It all goes back to Hurricane Maria, which I’ll come back to in its proper place. But first, some background. RSV was first reported in Puerto Rico in late October.

The case began one morning, during a routine clinic visit in a public hospital in San Juan. A 10-year-old boy complained of a headache and cough. His parents told doctors he had been feeling poorly for several days. He had been vomiting the previous week, and they thought it might be something more serious. They asked doctors to take him to the emergency room.

It was a busy day for emergency rooms in Puerto Rico, as patients streamed in for treatment. Many of them were suffering from high temperatures, so this one turned into a medical disaster. On the way, the parents noticed their son had a black eye, a cut lip, and a blackening around his mouth. His respiratory muscles were being affected, his brain was affected, and his kidneys were on point. He needed immediate emergency care.

That’s when the parents decided to contact their local hospital with their concerns. Hospital staff were not prepared for the scale of the case, and doctors arrived with only an hour’s notice. They told doctors not to come and admitted their patient to a different emergency room.

That night, doctors at the second emergency room found out that their patients had been exposed to a novel infection. They had little time to diagnose the cases, but fortunately, the second doctor was a pediatrician trained in pediatric infectious diseases. As a result, he was able to identify five cases of RSV, five patients who had been exposed to the infection that had developed into the classic cold-like symptoms that accompany RSV.

From the start, Dr. Alfredo Barcelo knew it was serious. In a press conference with his colleague, Dr. Jorge Valcarce, he called what had been happening a “fiasco.” He was very angry. This was his department’s first case of RSV, and it was not the first time physicians in Puerto Rico have encountered a patient that had the same infection.

RSV is caused by an adenovirus that is shed in the air or exhaled by

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