Reassuring Details About Respiratory Syncytial Virus

An RSV infection in a child isn't always as serious as parents fear

Child blowing nose
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Finding out your child has a respiratory syncytial virus (RSV) infection can be scary. If you're like most parents, you've probably heard nightmarish stories about this illness—tales of babies struggling to breathe and running sky-high temperatures. But in reality, such severe symptoms don't tell the whole story of the typical problems RSV causes. That's a good thing because, by the age of 2, most children will have been exposed to RSV.

Not All RSV Symptoms Are the Same

RSV "season" typically runs from November or December through March or April. Typically kids are exposed to RSV either by direct contact with respiratory secretions (droplets spewed into the air when an infected person coughs or sneezes, for example) or by touching toys or other objects a sick child has touched.

Symptoms tend to kick in three to five days after someone is exposed to RSV. More often than not, a child who's infected with RSV comes down with a simple cold or develops very mild symptoms—a clear runny nose, say, or an occasional cough—that can easily be treated at home. Other possible symptoms include a low-grade fever, sore throat, headache, and irritability. Most of the time a doctor will diagnose RSV infection based purely on these symptoms, although it is possible to detect the virus in nasal secretions.

Babies and children under 2 years of age are most at risk for the more severe (and notorious) symptoms caused by RSV, such as a very high fever, sleep apnea, and bronchiolitis—an infection of the tiny airways that lead to the lungs called bronchioles.

When they become inflamed, they swell and get plugged with mucus, making it hard for a child to breathe. It's when a child is really struggling to breathe that she may need to be in the hospital for treatment for RSV. Infants who develop bronchiolitis may be at increased risk for asthma and other respiratory problems later in life.

Treating and Preventing RSV Infection

If your child comes down with an RSV infection, her symptoms may linger for as long as three weeks. How your pediatrician chooses to treat her will depend largely on her age and how severe her symptoms are. Most likely, if she's over the age of 2 and her symptoms are mild, she'll likely need nothing more than an over-the-counter medicine for pain and fever (such as ibuprofen) and maybe something for her cough if it's really bothering her or keeping her up at night until the infection clears on its own. A cool mist humidifier can help relieve a stuffy nose.

A doctor will likely treat a baby or toddler who develops serious symptoms more aggressively. For instance, some will go after wheezing aggressively with nebulizers or steroids, just as they would for a child with asthma. A very young child who has to be hospitalized because of difficulty breathing will likely be treated with intravenous fluids and oxygen. Sometimes a little one will need to be on a ventilator for awhile to help her breathe.

There are no drugs for treating RSV. If a child's symptoms are serious enough to be life-threatening, her doctor may give her an antiviral medication called ribavirin, but this approach is controversial.

Because RSV is a virus, antibiotics won't be helpful, but if a child develops a secondary bacterial infection, such as an ear infection, she may need an antibiotic to clear it up.

The best way to protect a child from infection with RSV is the same strategy you'd use to prevent an other viral illness: frequent handwashing by all family members. Older siblings who go to day care or are in school are especially likely to bring RSV home, so make a trip to the bathroom sink for a thorough scrub-down before touching or playing with a baby brother or sister an important house rule. It's also a good idea to not allow kids to share bottles or pacifiers.

There is a vaccine for RSV, but it must be given as a shot once a month and typically is prescribed only for children who are at high risk of infection, especially premature babies.

Sources:

American Academy of Pediatrics. "AAP Updates: Recommendations for Use of Palivizumab Against RSV ." July 28, 2014.

Tiffany L Turner, Benjamin T Kopp, Grace Paul, Lindsay C Landgrave, Don Hayes, Jr, and Rohan Thompson. "Respiratory Syncytial Virus: Current and Emerging Treatment Options."  Clinicoecon Outcomes Res. 2014; 6: 217–225.

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