RSV, respiratory syncytial virus, is a common cause of lung and upper respiratory tract infections occurring in winter. Anyone can get RSV. Most kids have had it by the age of two years. Symptoms range from a mild cold to bronchiolitis (inflammation of the small airways in the lung) and pneumonia. Serious RSV infections primarily afflict children younger than five years old and people over 65, as extremes of age weaken the immune system. Children under the age of two are at the highest risk for severe illness from RSV. One in 56 otherwise healthy babies are hospitalized with RSV their first year of life.
Typical symptoms of RSV in a child under two include a runny nose, decreased appetite, and coughing or wheezing. If the symptoms become severe, last more than seven days, or the child has any trouble breathing, a medical professional must be contacted. Be aware that babies under six months old don’t have the usual symptoms of a bad cold. They may only be irritable or show a decrease in appetite and activity. They can have pauses in their breathing pattern of up to ten seconds. These symptoms all warrant calling the pediatrician.
RSV is diagnosed by nasal swab, the results available in about an hour. Most kids can be treated at home with Tylenol (acetaminophen) for fever or pain, and fluids to prevent dehydration. Antibiotics are not a treatment for viral infections like RSV. Hospitalization may be required if the child isn’t eating or drinking properly, or is having trouble breathing. A hospital stay generally lasts only a few days and involves supportive care: oxygen and IV fluids. Mechanical ventilation is used only rarely.
Adults over 65 can get seriously ill with RSV, especially with underlying heart disease or lung problems like emphysema or asthma. Up to 10,000 adults die per year from RSV in the US. RSV symptoms present like a cold: runny nose, cough, sore throat, fever. If the symptoms become severe or last more than five days, a medical consultation is needed to rule out RSV or other viral infections with a rapid test. Treatments at home include rest, fluids, and acetaminophen. Patients with problems breathing or keeping up with fluids are hospitalized for IV hydration, oxygen, and observation.
The CDC notes that RSV infections this year began far earlier than expected, with 60% more cases thus far than 2021. Hospital pediatric units have been stretched to capacity. The high number of RSV cases is primarily due to a change in our good habits of preventing germ spread. During the 2020 and 2021 Covid-19 pandemic, we practiced social distancing, coughed and sneezed into tissues or sleeves, and wiped down common surfaces like doorknobs. That significantly minimized all types of exposure to viral infections, including RSV. Now we shake hands again and attend large family gatherings. We forget to wash our hands. RSV has become an epidemic, and some scientists fear a “tripledemic”—high numbers of people sick with RSV, flu, and Covid-19, all at the same time!
The best way to avoid sickness with RSV is by prevention. RSV is spread by infected people indiscriminately sneezing, coughing, and touching shared surfaces. The following precautions will protect children and elders from getting sick: Sneeze or cough into a tissue or your elbow. Wash hands frequently with warm water and soap for 20 seconds (the equivalent of singing “Happy Birthday to You” twice). Avoid close contact with others, and no more shaking hands. Clean frequently-touched surfaces like cell phones and bathroom counters. Don’t touch your mouth and nose. Update your child’s vaccinations and your own too, to prevent disease and keep your immune system strong.
Go to www.CDC.gov for more details about RSV and other common viral infections. A helpful website for parents sponsored by the American Academy of Pediatrics is www.healthychildren.org.