Pediatricians at Baystate Children’s Hospital are beginning to see an increase in cases of the highly contagious respiratory syncytial virus, better known as simply RSV.
While RSV results in mild, cold-like symptoms for most – a runny nose, nasal congestion, cough and fever – it can lead to serious illness, especially for infants and older adults.
“The winter months of December, January, and February are when we see the most children hospitalized with RSV. The number of hospitalized infants and young children was relatively high last year, and will likely be similar again this season,” said Dr. Mike Klatte of the Pediatric Infectious Disease Division at Baystate Children’s Hospital.
Don't sound the alarm
“Parents, however, should not be overly alarmed,” added Dr. Klatte, who noted that only a small percentage of youngsters develop severe disease and require hospitalization.
The Centers for Disease Control and Prevention (CDC) report that each year approximately 57,000 children under 5 years of age are hospitalized with the infection. Most infants are infected before age 1, and virtually all children have had an RSV infection by 2 years of age. RSV can also affect older children, teenagers and adults, especially those with compromised immune systems. Those adults 65 and older are especially susceptible with 14,000 dying each year from the respiratory virus.
RSV is also the most common cause of bronchiolitis and viral pneumonia in children under one year of age. “Unfortunately, there is no vaccine to prevent the illness and there is no antibiotic to help cure it. Like a cold, RSV must run its course,” said Dr. Klatte.
Is it a cold or RSV?
Low-grade fevers (such as to 101°F - 102°F) are common with RSV infections, and may come and go for a few days. If a child is having high fevers without relief for multiple days, or increased difficulty with breathing (such as wheezing, grunting, or ongoing flaring of the nostrils) is observed along with a child’s runny nose and cough, then a visit to the doctor is warranted.
“It’s all about symptom management….making sure your child is hydrated, his or her fever is under control, and that they’re not having any trouble breathing,” said Dr. Klatte.
The severity of the symptoms can vary depending on the age of the child, and whether he or she has any chronic medical problems, such as asthma or premature birth. Bacterial infections such as ear infections and pneumonia may develop in children with RSV infection.
Because RSV can cause serious illness in some youngsters and it is so widespread, some doctors consider it to be “the most important childhood infection of the respiratory system.” Those hospitalized often have severe breathing problems or are seriously dehydrated and need IV fluids, noted Dr. Klatte. In most cases, hospitalization only lasts a few days and complete recovery usually occurs in about 1-2 weeks.
Who is at risk?
Children under the age of 1 year are most frequently affected by the serious symptoms of RSV. It can spread directly from person to person – when an infected person coughs or sneezes sending virus-containing droplets into the air where they can infect a person who inhales them, as well as by hand-to-nose, hand-to-mouth, and hand-to-eye contact. The virus can be spread indirectly when someone touches any object infected with the virus, such as toys, countertops, doorknobs, or pens, and can live on environmental surfaces for several hours.
Infants and young children most at risk for severe RSV infection include:
• those with a history of prematurity
• infants less than six weeks of age
• those with congenital heart disease and chronic lung conditions
• and those who suffer from immunodeficiencies such as HIV, AIDS, cancer and transplant patients.
The American Academy of Pediatrics recommends the following important steps to prevent exposure to RSV and other viruses, especially in the first few months of your child’s life:
• make sure everyone washes their hands before touching your baby
• keep your baby away from anyone who has a cold, fever or runny nose
• keep your baby away from crowded areas (shopping malls, movie theaters, restaurants)
• keep your baby away from tobacco smoke
• and, for high risk infants, participation in child care should be restricted during RSV season whenever possible.
“The good news is that most infants and children overcome RSV infections without any long-term complications,” said Dr. Klatte, as RSV infections can often be relatively asymptomatic and go unnoticed.