Respiratory Syncytial Virus (RSV): What is it and what to do about it?

Recently, I have been seeing quite a few kids with RSV infection. Respiratory syncytial virus (RSV) is a major cause of respiratory illness in young children. According to the American Academy of Pediatrics, about 125,000 children are hospitalized with RSV each year in the United States, and about 500 of these children die. In adults, RSV may only produce symptoms of a common cold, such as a stuffy or runny nose, sore throat, mild headache and cough. However, in premature babies and kids with diseases that affect the lungs, heart, or immune system, RSV infections can lead to other more serious illnesses.

Child with RSV

RSV is highly contagious and can be spread through droplets containing the virus when someone coughs or sneezes. It also can live on surfaces (such as countertops or doorknobs) and on hands and clothing, so it can be easily spread when a person touches something contaminated. RSV can spread rapidly through schools and childcare centers, which is another important reason to kid your children home from school when they are sick. Babies often get it when older kids carry the virus home from school. Almost all kids are infected with RSV at least once by the time they are 2 years old.

RSV infections have an incubation period of 2-6 days. This means that after your child is infected, it may take up to 6 more days before they fall sick. Then, it usually starts out with cold symptoms (such as a runny nose, a minor cough, and a low fever). In fact, for many babies and young children, the virus is no more troublesome than a cold. For a few, though, mild cold symptoms develop into a more serious cough, labored breathing, and sometimes wheezing. Your baby may also be irritable, restless, and have a poor appetite.

RSV2

Doctors typically diagnose RSV by taking a medical history and doing a physical exam. RSV can be identified within an hour by using a cotton swab to collect nasal secretions for lab testing.

When to Call the Doctor

Call me if your child has any of these symptoms:

  • high fever with ill appearance
  • trouble breathing
  • worsening cough or cough that produces yellow, green, or grey mucus
  • signs of dehydration
  • thick nasal discharge

In infants, besides the symptoms listed above, call me if your baby is unusually irritable or inactive, or refuses to breastfeed or bottle-feed.

Seek immediate medical help at the hospital if your child is having difficulty breathing or is breathing very rapidly, is lethargic, or if his or her lips or fingernails appear blue.

Treating RSV

Most cases of RSV are mild and require no specific treatment from doctors. Antibiotics aren’t used because RSV is a virus, and antibiotics are only effective against bacteria. Medication may sometimes be given to help open airways. Usually clinical improves in five to seven days. If your baby has a more serious infection, it may take longer, and the cough can linger for weeks. In an infant, however, an RSV infection can be more serious and may require hospitalization so that the baby can be watched closely. He or she may require fluids, oxygen supplement and possibly treatment for breathing problems.

Is there a vaccine to prevent RSV?

There is currently no vaccine to protect against RSV.

Then what can I do to prevent RSV?

Because touching infected people or surfaces easily spreads RSV, frequent hand washing is key. Try to wash your hands after having any contact with someone who has cold symptoms. Teach everyone in your family to cover their mouth and nose with their forearm when coughing and sneezing.  Stay home from work or school when you are sick. Frequently disinfect doorknobs, phones, toilet handles, plastic toys, and other places that are often touched. And keep your school-age child with a cold away from younger siblings — particularly infants — until the symptoms pass.

What can I do to help make my baby more comfortable at home?

As with the common cold, there’s no cure for RSV, but you can take steps to keep your baby comfortable:

  1. Offer your baby plenty of fluids to keep him well hydrated. If he’s breastfeeding, nurse him as often as he’ll eat.
  2. Slightly elevate the head of his bed or crib by inserting a towel between the mattress and the crib springs. (Don’t put a pillow in his crib with him.) Or let him nap in his car seat. Raising his head and chest will make it easier for him to breathe through a stuffy nose.
  3. Put a few drops of saline solution into his nose to loosen any mucus, then use a bulb syringe to suction it out.
  4. Keep your baby away from cigarette smoke, fresh paint, burning wood, and any other irritating fumes, which can make breathing even more difficult. Exposure to tobacco smoke will make your child more likely to have a serious bout of RSV or another respiratory virus.

 

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