RSV Strikes Again

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Kids Health Watch is brought to you by our friends and Magnolia Springs Pediatrics

Now that the pandemic is over, we are seeing a lot of different infections coming back in full force! Of course, the flu is bad right now, but I want to educate you about an illness that can affect infants and those with underlying medical issues, especially lung problems. I’m talking about Respiratory Syncytial Virus or RSV. RSV is a virus that can cause serious respiratory symptoms in kids of all ages, but especially in infants. RSV usually starts off as a simple cold with a 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 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 respiratory symptoms. While there is no foolproof way to prevent bronchiolitis, washing hands frequently and avoiding sick exposures can help. However, there are some risk factors. Anyone 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 it has been responsible for severe respiratory illnesses, hospitalizations, and even death in younger and/or premature infants. Not all cases are this serious, but sometimes they can be, so be alert. The hard part about RSV in young infants and premature babies is that rapid, shallow breathing can lead to fatigue and poor air exchange. When a child gets fatigued, they also tend to eat and drink less, which can lead to dehydration.

The treatment of RSV is tricky. Since it is a virus, antibiotics don’t help eliminate 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 your doctor’s office, and treatment options can be discussed. The most important thing is to keep a child hydrated. Frequently 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 their intake will still be okay over 24 hours.

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

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).


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