By Guest Blogger Dr. Sameena Evers
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!!
Thanks for this post. It is very helpful and nice to hear everything in layman’s terms!
What an excellent article! As a pediatrician, I hear lots of questions about RSV. You answered them perfectly here.
You make it sound like RSV is a walk in the park…I cant attest that it is not. My 5 month old son had it and we had to give him nebulizer treatments every 3-4 hours. Granted he wasnt admitted to the hospital but some days I wish he was so I could have had professional help around the clock. RSV can be easy to deal with but there are many cases that are not.Since having RSV – we have also had 3 ear infections and Croup in 2months. My non medical opinion is that RSV took such a huge toll on our son that he still hasnt fully gotten over all of the effects thus making his body an easy target for these things.
My twins got RSV when they were 9 months old. We treated their symptoms with a nebulizer which made a world of difference. I’m so glad we had the nebulizer b/c for the next year or so, every time they got a cold, they had a tough time breathing, especially at night. I was SOOOO glad to have the nebulizer to help them through. I always saw immediate results with their breathing. Now at age 3, they don’t necessarily need the neb when they get a cold. I can see where asthma and RSV may be related down the road. I’m hoping we won’t get asthma. We’ll just deal with it if we get it.
I think it’s important to note that parents should be particularly on top of symptoms when their newborn is exposed to older siblings. My 2 week-old (with older 2 year and 4 year-old sibs at the time) contracted RSV, got pneumonia, and ended up in the PICU for 2 weeks on a ventilator. His blood pressure also plummeted, necessitating two meds to maintain it for 9 days. He came very close to death (but is doing fabulously well at age 3 with no respiratory issues whatsoever thus far!) He seemed to get sick in a day- we took him in with a yellow runny nose, and he was ventilated within an hour. My advice- when in doubt, take the baby in! And be on top of cold symptoms in newborns! By the way, he got sick at the end of March, which is supposedly the tail end of RSV season.