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Megan Gruesser, MD is a pediatrician at Community Physician Network.
As influenza activity slows, the door opens for other viruses like RSV.
Respiratory Syncytial Virus is a virus that causes upper respiratory infections (a.k.a, the common cold) in older children and adults. However, in children under two years of age RSV can cause lower respiratory infections like bronchiolitis and pneumonia.
RSV attacks the lower air tubes in the lungs, causing inflammation and filling them with mucus. Because infants and young children have smaller lungs they have less reserve space for the mucus than an older child or adult. Therefore, RSV causes more serious symptoms in that population.
RSV tends to be a seasonal virus, causing infection from fall to early spring. It is transmitted through contact with nasal or mouth secretions from an infected person. This could be done airborne via coughing and sneezing, or by touching contaminated surfaces.
Symptoms begin approximately four to seven days after exposure and end after one to two weeks. Typical symptoms include sneezing, runny or stuffy nose, mild cough and a possible fever. Symptoms tend to peak on day three with a worsening cough.
Unfortunately, very young infants with RSV may not present with classic symptoms. Sometimes their only symptom is apnea, which is forgetting to breathe, and this can have devastating outcomes if not recognized in time.
Because RSV causes infection and inflammation to the lower air tubes of the lungs, this can result in difficulty breathing. Signs of this include rapid breathing, retractions (rib muscles sucking in and out with each breath), and/or nasal flaring (when the nostrils widen and narrow with each breath). Some children with RSV can develop wheezing or grunting. Rarely, children can develop color changes due to their oxygen levels dropping.
Not every child with RSV needs to be seen by their doctor or taken to the emergency room. As with most cold viruses, RSV is treated with supportive care.
Use a nasal suction bulb or aspirator to help clear secretions from the nares of infants and children who are too young to blow their nose. You can also use nasal saline drops to help loosen any thick secretions to make removal easier.
You can use a humidifier or vaporizer in the child’s room to help loosen congestion. You can also have the child sleep with the head of bed elevated. Push plenty of fluids and monitor for signs of dehydration. Acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®) can be given for fever or discomfort.
The American Academy of Pediatrics (AAP) advises against the use of over the counter cough and cold medicines in children under six years old. Please speak with your doctor prior to giving any other medicine other than acetaminophen or ibuprofen to discuss safety, dosing, and efficacy.
If you feel your child is having fast or difficulty breathing, seek medical attention. In cases where a child is found to have significant breathing issues, treatment may include breathing treatments, supplemental oxygen and possible hospital admission for ongoing care.
Unfortunately there is no vaccine for RSV. There is a special medicine called Synagis that can be given to high-risk infants to help protect them from RSV, but this is only given to babies born at 28 weeks gestation or less, babies born with chronic lung disease, or babies born with a hemodynamically significant congenital heart lesion.
With RSV being a common winter bug, it can be hard to avoid, but there are some simple things that you can do to protect yourself and your children.
