Respiratory syncytial virus (RSV) is a very well-studied virus that can cause common cold-like symptoms in older children and adults and severe, debilitating airway inflammation in younger infants. It causes a significant number of outbreaks at childcare centers around the world and is a leading cause of hospitalizations of younger infants and missed workdays for parents. Almost all people will have been infected with RSV by their second year of life.
“Unfortunately, antibiotics will not work for treating RSV or any other virus,” HSHS Medical Group Pediatrician Kathryn Wade, MD, said. “Although researchers are working to develop RSV vaccines, there are none available yet. A drug called palivizumab, or Synagis, prevents severe RSV illness in certain infants and children who are at high risk, but most children do not fall into this category.” Premature infants, young children with congenital heart or chronic lung disease and young children with weakened immune systems due to a medical condition or treatment are at higher risk for severe RSV.
Across the country, RSV infections generally occur during fall, winter and spring. The timing and severity of RSV circulation in a given community can vary from year to year. RSV can spread very easily, resulting in large outbreaks in certain areas. People can get infected if droplets from a cough or sneeze get in their eyes, noses or mouths. RSV can also spread through direct contact with the virus, like kissing the face of a child who is currently ill with RSV.
In toddlers and school-age children, symptoms of RSV typically begin four to six days after being infected and most often include a profuse, clear runny nose along with cough, fever and decreased appetite. Young infants with RSV can similarly have runny nose, cough, fever and decreased appetite, but they may also have fussiness and decreased activity. RSV in all children generally progresses gradually, but young infants are at the highest risk for symptoms such as more severe cough, increased breathing rate and low oxygen levels. Young infants with RSV more often develop ear infections and pneumonia and require hospitalization or ICU admission. Medical providers are on high alert during RSV season, especially with young infants, to observe the sometimes-subtle signs at the beginning of RSV illness in order to best care for these patients.
“People infected with RSV are usually contagious for three to eight days,” Guy Venuti, MD, a pediatrician with HSHS Medical Group, said. “However, some infants and people with weakened immune systems can continue to spread the virus even after they stop showing symptoms—for as long as four weeks. Children are often exposed to and infected with RSV outside the home, such as in school or childcare centers and can then transmit the virus to other members of the family. RSV can survive for many hours on hard surfaces such as tables and crib rails. It typically lives on soft surfaces such as tissues and hands for shorter amounts of time.”
What can you do to keep your child and the rest of the family healthy? There are many simple ways to prevent infection:
• Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands.
• Wash your hands often with soap and water for 20 seconds.
• Avoid close contact, such as kissing, shaking hands and sharing cups or eating utensils with others.
• Avoid touching children’s faces with unwashed hands.
• Limit the time your children spend in childcare centers or other potentially contagious settings, especially during fall, winter and spring (RSV season).
• Keep items that are frequently contacted (such as doorknobs, tabletops, etc.) clean and disinfected.
In order to prevent more severe disease in those children at risk, people with cold-like symptoms should limit their interactions with premature infants, children younger than two years of age with chronic lung or heart conditions and children with weakened immune systems. If this is not possible, they should carefully follow the prevention steps mentioned above and wash their hands before interacting with such children.
If your child does have RSV, here are some simple interventions that may help ease their discomfort:
• Saline nasal rinses and gentle bulb suctioning
• Push fluids and ensure consistent urine output
• Motrin or Tylenol for fever or pain
• Elevate the head of bed to allow for easier breathing
• Vaporizer or humidifier
When in doubt or if your child is getting worse, give your primary care doctor’s office a call!