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RSV: Manage the symptoms and keep your family safe from respiratory syncytial virus

December 09, 2022
dad checking the temperature of a child sick with RSV

There is a surge of respiratory viruses, particularly respiratory syncytial virus (RSV), at Baystate Children’s Hospital and hospitals across the country.

Make sure you know about the highly-contagious disease and its symptoms so your family can be protected.

Dr. John O’Reilly, Chief of General Pediatrics at Baystate Children’s Hospital shares some helpful tips and gives insight into the virus.

Almost everyone will get RSV eventually

RSV is the most common cause of bronchiolitis and viral pneumonia in children under one year of age.

The Centers for Disease Control and Prevention (CDC) reports that each year about 58,000 children under 5 years of age are hospitalized with the infection. And it says most infants have been infected by RSV by the time they reach the age of 1, and almost every child will get RSV by the time they reach the age of 2.

But it’s not just kids that are affected. RSV can also infect older children, teenagers, and adults.

Most people will have minor symptoms

Not everyone who gets RSV gets a serious case and needs to be hospitalized.

“Most children will have only minor symptoms and only a small percentage of youngsters develop severe disease and require hospitalization. Those hospitalized often have severe breathing problems or are seriously dehydrated and need IV fluids. In most cases, hospitalization only lasts a few days and complete recovery usually occurs in about 1-2 weeks,” said Dr. O’Reilly.

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.

Children under the age of 1 year are most frequently affected by the serious symptoms of RSV.

Know the symptoms of RSV

It can be hard to tell whether you have COVID, the common cold, the flu, or RSV. You may only know for sure if you’re tested by a doctor.

Children infected with RSV usually show symptoms – which don’t appear all at once - within 4-6 days after being infected.

Symptoms include:

  • Runny nose
  • Decrease in appetite
  • Coughing
  • Sneezing
  • Fever
  • Wheezing

RSV symptoms in very young infants less than 6 months may include:

  • Irritability
  • Decreased appetite
  • Decreased activity

Low-grade fevers (such as to 101°F - 102°F) are common with RSV infections. The fevers may come and go for a few days.

But RSV infections can often be relatively asymptomatic and even go unnoticed.

WHEN TO SEE THE DOCTOR

“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 call to your pediatrician is warranted,” Dr. O’Reilly said.

Those who have a high risk for severe illness caused by RSV include:

  • Premature babies
  • Adults 65 years and older, 177,000 of whom are hospitalized and 14,000 of them die each year in the U.S.
  • People with chronic lung disease or certain heart problems
  • People with weakened immune systems, such as from HIV infection, organ transplants, or specific medical treatments like chemotherapy

Is there a vaccine for RSV?

There is no vaccine yet to prevent RSV infection, but scientists are working hard to develop one.

There is a medicine that can help protect some babies at high risk for severe RSV disease. Healthcare providers usually give this medicine (called palivizumab) to premature infants and young children with certain heart and lung conditions as a series of monthly shots during RSV season.

If you are concerned about your child’s risk for severe RSV infection, talk to your child’s healthcare provider.

MANAGING THE SYMPTOMS

There is no specific treatment for RSV.

“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. O’Reilly.

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.

Children under the age of 1 year are most frequently affected by the serious symptoms of RSV.

How is RSV spread?

RSV is contagious to people of all ages from babies and toddlers to adults.

RSV spreads directly from person to person when an infected person coughs or sneezes sending virus-containing droplets into the air. The droplets 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 also be spread indirectly when someone touches any object infected with the virus, such as toys, countertops, doorknobs, or pens. The virus can live on environmental surfaces for several hours.

Why are there so many RSV cases now?

The COVID 19 pandemic has had a big impact on our normal pediatric respiratory illness cycles, noted Dr. O’Reilly.

“Early in the pandemic masking and social distancing helped to limit the spread of respiratory viruses such as RSV. Because there were so few cases of RSV in the first two years of the pandemic, most infants and toddlers did not get the natural immunity that their body would have produced if they had natural illness. That left a larger number of children more vulnerable to getting RSV illness, which is what we are seeing now in the community,” he said.

PREVENTING THE SPREAD

RSV normally peaks in late December to mid-February.

Dr. O’Reilly and the CDC recommend the following steps to help prevent the spread of RSV:

  • 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.
  • Keep your hands off your face; germs can spread by touching your eyes, nose and mouth.
  • Avoid close contact with sick people, as well as kissing, shaking hands, and sharing cups and eating utensils with others.
  • Clean and disinfect surfaces.
  • Stay home when you are sick.

Some parents, as part of a new trend to further protect their babies, are going as far as to place signs on their car seat and stroller asking someone to not touch their new infant.

Available on many online stores including Etsy and Amazon, a typical sign might read: “Stop! I know I’m cute as can be but please do not touch little me. Thank you!” or “Wash Hands & No Kissing Please – Your Germs Are Too Big for Me.

“The good news is that most infants and children overcome RSV infections without any long-term complications,” said Dr. O’Reilly.