Biggest Scare of the Winter: Respiratory Syncytial Virus (RSV)

Hearing the diagnosis of RSV for a sick child—your own or one your baby has been exposed to—can strike fear in a parent’s heart. But knowing the facts and being vigilant in prevention can bring a little peace.

Difference between RSV and the Common Cold:

Dr. Becky Alfred, an Overland Park pediatric urgent care physician, says, “Respiratory Syncytial Virus, or RSV, is a virus that infects the lungs and airways. It is the most common cause of bronchiolitis (an inflammation of the smaller airways) and pneumonia in children under 1 year of age.”

The Centers for Disease Control and Prevention (CDC) reports the majority of children will have RSV by the time they are 2.

“RSV is spread by saliva and respiratory secretions, both in the air and on surfaces,” says Dr. Alfred. “In our area, infections usually occur from November through April.”

RSV symptoms are similar to the common cold: runny nose, sneezing, cough and fever. For some infants, “RSV infection can be more severe with rapid breathing, wheezing, harsh coughing, poor feeding or dehydration,” reports Dr. Alfred. “At times (these children) require hospitalization for supplemental oxygen, suctioning of secretions from airways or intravenous fluids.”

Children at the greatest risk of severe disease and complications are infants under 6 months of age, premature infants, children with chronic heart or lung disease and children with weakened immune systems.

Can I Keep My Baby from Catching RSV? “Researchers are currently developing a safe and effective RSV vaccine,” Dr. Alfred says. “Until then, prevention of infection is the goal.” Proper handwashing (20 seconds with warm soapy water) is key to preventing any virus. “Remind siblings, family members, visitors and caregivers do the same. Also, don’t forget to wash your baby’s hands and face before he or she will be eating or sleeping,” Dr. Alfred says.

The doctor also offers other practical steps to aid in disease prevention. First, keep your baby away from anyone with cold symptoms. Regularly clean toys, surfaces and doorknobs with disinfecting agents. Also avoid taking your baby to crowded areas, especially during the first two months of life.

“Do not smoke or allow anyone to smoke around your baby,” Dr. Alfred advises. “Breastfeed your baby if you are able - this may decrease risk of infection.”

Diagnosing RSV:

Confirming a case of RSV requires a 15-minute test. Kathy Ballenger, nurse practitioner at Pediatric Care North in Kansas City, MO, says, “In our practice, we diagnose RSV by inserting a swab into the child’s nose and then testing the mucus for the virus.”

Karen Davis, a Prairie Village mom of two, said when she was pregnant with her second child, her older child contracted RSV. “I took her in to see the doctor multiple times because she kept having this horrible cough during the night and would run a temperature periodically.”

The doctor said that because the child had a virus, antibiotics would be ineffective and advised Karen to treat the symptoms with over-the-counter cold remedies.”

“It was frustrating because nothing seemed to help the cough. I don't know if the pediatrician didn't want to worry me while I was at the end of my pregnancy, but she didn't actually use the term RSV until after (my son) was born,” said Karen.

Fortunately, her daughter did not need hospitalization.

Treatment:

Because RSV is a virus, it can’t be cured by antibiotics. There are no antiviral medications that work either. Symptoms should resolve in 1-3 weeks, which may feel like an eternity, but many children can be treated at home. “There are differing opinions on whether or not nebulized (breathing) treatments and steroids are of any benefit for the symptoms of RSV,” says Dr. Alfred.

She recommends encouraging oral fluids to hydrate, giving pain-relieving and fever-reducing medications as needed, using a cool mist vaporizer to humidify the room air and bulb suctioning nasal secretions to make breathing, eating and sleeping easier.

Stacey Hatton is a pediatric RN and freelance writer from Overland Park.