Respiratory Syncytial Virus (RSV)
RSV is the most common cause of bronchiolitis (inflammation of the lower airways) and pneumonia in babies. It is an illness that often occurs in yearly outbreaks in communities and in newborn intensive care units (NICUs). In the United States, RSV is more common in winter and spring months.
RSV is spread from respiratory secretions through close contact with infected persons or contact with contaminated surfaces or objects. Infection can occur when infectious material contacts mucous membranes of the eyes, mouth, or nose, and possibly through the inhalation of droplets generated by a sneeze or cough. The incubation period (time from exposure to symptoms) is about four days.
RSV does not usually occur until a baby is 4 to 6 weeks old. However, because premature babies are born before receiving all of the mother's immunities, they are more susceptible. Babies can also be reinfected with the virus. RSV is slightly more common in boys than girls. Babies with chronic lung disease (a condition that may develop following respiratory disease as premature infants) are also at increased risk of developing RSV.
Infection with the virus can lead to severe respiratory illness and pneumonia, and may become life threatening. RSV in infancy may be related to development of asthma later in childhood.
The following are the most common symptoms of RSV. However, each baby may experience symptoms differently. Symptoms may include:
- runny nose
- poor feeding
- retractions (pulling in) of the chest wall
- rapid breathing
The symptoms of RSV may resemble other conditions or medical problems. Always consult your baby's physician for a diagnosis.
Diagnosis is sometimes difficult because the symptoms of RSV can resemble other infections. Illness in other family members, other babies in the hospital nursery, or the time of year may provide clues. In addition to a complete medical history and physical examination of your child, a test of the baby's respiratory secretions may show the presence of a virus.
Specific treatment for RSV will be determined by your baby's physician based on:
- your baby's age, overall health, and medical history
- the extent of the condition
- your baby's tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference
There are no medications used to treat the virus itself. Care of a baby with RSV involves treating the effects of the virus on the respiratory system. Because a virus causes the illness, antibiotics are not useful. Treatment may include:
- supplemental oxygen
- intravenous fluids (to prevent dehydration)
- tube feedings (if the baby has difficulty sucking)
- bronchodilator medications (to open the airways)
- antiviral medications (for very sick or high-risk babies)
Two medications are recommended for babies at high risk for RSV to protect them against the serious complications of the illness. One of the following medications is usually given monthly during the RSV "season" from late fall through spring:
- respiratory syncytialvirus immune globulin intravenous (RSV-IGIV)
- palivizumab - an antibody against RSV
These medications are not vaccines and do not prevent the virus. But they do lessen the severity of the illness and may help shorten the hospital stay.
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