RSV Strikes Again

Now that we are done with all the holidays and the kids are back in school and daycare, our schedules are a little less crazy (maybe!). However, this winter has brought lots of Flu, strep throat, and the “crud.” In addition, one of the most prominent players this year so far is Respiratory Syncytial Virus or RSV. RSV is a virus that can cause some serious respiratory symptoms in kids of all ages, but especially in infants.

RSV usually starts off as a simple cold—runny nose, a little cough, and stuffiness. However, over the course of a few days, it can progress to wheezing, and rapid shallow breathing (80-90 times per minute). I know that there are several daycares and schools that have sent notes home regarding RSV, so I want you to be armed with information. Let’s talk about what is happening in the lungs so we can understand the treatment.

Bronchiolitis is the general term for the infection that RSV causes. RSV isn’t the only cause, it’s just the most common and can be the most dangerous. In bronchiolitis, the lower airways become very inflamed and produce a lot of mucus. This obstructs the airways, causing the respiratory symptoms. While there is no fool-proof way to prevent bronchiolitis, washing hands frequently and avoiding sick exposures can help. However, there are some risk factors. Anyone that is in daycare, even mother’s day out for a few half-days a week, anyone exposed to cigarette smoke, and younger siblings of school age children are at risk. The time from exposure to full-blown symptoms can be a few days, but the illness itself can last from 7-21 days depending on the severity! The virus is highly contagious and is spread through the air.

The reason RSV is such a big deal is that is has been responsible for serious respiratory illnesses, hospitalizations, and even death in younger and/or premature infants. Now, not all cases end up being this serious, but sometimes it can be, so be on alert. The hard part about RSV in young infants and premature babies is that the rapid, shallow breathing can lead to fatigue and poor air exchange. When a child gets fatigued, they also tend to eat and drink less and in an infant can lead to dehydration.

The treatment of RSV is tricky. Since it is a virus, antibiotics don’t help get rid of the primary infection. However, you can develop secondary bacterial infections after the initial infection. The best treatments are supportive care. Humidifiers and saline drops can be useful, and sometimes, if the respiratory symptoms are severe enough, a nebulizer or breathing machine can help. The diagnosis of RSV is made at you doctor’s office and treatment options can be discussed. The most important thing is to keep a child hydrated. Oftentimes a child with RSV will take less volume of formula or breast milk at any sitting because of the increased work of breathing and fatigue. But a child will feed more often so that their intake will still be OK over a 24 period.

Be on alert, RSV is here this year. Don’t hesitate to discuss this with you physician, especially if you have a young infant with respiratory symptoms.

Robert L. Rux, M.D.

Robert L. Rux, M.D. is a Board Certified Pediatrician at Magnolia Springs Pediatrics. Originally from Mobile, he attended medical school at The University of Alabama School of Medicine (UAB) and completed residency at The Children’s Hospital of Alabama (UAB). He is married to Jaime and has three children, Adler, Walker and Mary McAtee.