As I was pondering what to write about this week it became clear to me after a weekend on call that the most timely issue would be a discussion of RSV. It seemed like most kids I was seeing in the office and an unfortunate few in the hospital have been infected with RSV.
What is this horrid disease we call RSV?
(Yes, it’s another fun medical acronym.) RSV stands for respiratory syncytial virus. Maybe you’ve received a note home from school or daycare announcing its presence in the classroom of your child. The fact is it’s ubiquitous this time of year and I would be shocked to hear of a place caring for children without RSV in the mix.
RSV is a virus that infects pretty much everyone by the time they are two years of age. It comes around every year starting in the winter and lasting through early spring. By the time you reach adulthood you’ve probably been sick with it several times in your life. Most often RSV causes a runny nose, cough, irritability, and a decrease in appetite, i.e. the “common cold”.
RSV is known for being a serious illness in the pediatric world because a very small percentage of those infected with the virus (usually infants) need to be admitted to the hospital to help them through the infection. Small infants can have a hard time dealing with all the secretions that come with RSV, clogging up their nose and airways so that it is hard to breathe and eat. There is not a cure or really any disease-killing drugs available so we have to rely on supporting a person through the illness. In the hospital setting, this usually consists of giving a person IV fluids, oxygen, and intensive suctioning of the nasal and respiratory passages. For most of us battling RSV in our own homes with children it means lots of tissues, restless sleep, and whining.
Whether or not the cold symptoms in your home this season are caused by RSV or one of the other thousands of viruses floating around out there is probably irrelevant. The important things to watch for in children when they are ill with the common cold are significant trouble breathing, dehydration, and persistent fever. Any of these signs in your child would be a good reason to take a trip to your local pediatrician. Things that you can do to help a small child with cold symptoms include nasal saline and suctioning with a bulb syringe, pushing fluids, running a humidifier at night, and elevating the head of the bed.
It is probably worth mentioning that there is some association between being infected with RSV and wheezing with future colds (a common form of asthma). Usually this comes up when a concerned parent (often one who has been surfing the web about medical diseases -JUST SAY NO!!) wants to know what they should do about future asthma. Truthfully, the association is unclear as to cause and effect. It’s the age-old question of what came first – the chicken or the egg? Kids with more severe cases of RSV do more frequently go on to develop asthma as they get older. However, it could easily be argued that these children’s genetic tendency toward asthma was the cause for the severe RSV infection as an infant.
Also of note is the fact that there is a vaccine available against RSV. However, it is only available to children who are highly vulnerable to severe infection. Most often those who qualify for the vaccine are quite premature, born before 32 weeks of gestation. While I’m talking about vaccines I can’t help myself from mentioning that it’s still not too late to get your flu shot this year. Influenza hasn’t hit our area hard yet so there’s still time!!