It's Gone Viral - RSV

Winter is here. And with Winter has come a slew of cold and flu cases in the last few months. One virus we look at is Respiratory Syncytial Virus, otherwise known as RSV. Mostly a danger to children under 2, RSV has been a common concern among physicians and parents. So it’s important to understand the illness and how to treat and prevent it. Anyone can catch RSV, but infants have been found to be at the most risk for severe cases. Babies who were born premature, have asthma, or born with heart problems tend to have the highest risk of hospitalization. The virus transmits between people just like the flu and common cold. Direct contact with saliva, nasal secretions or surfaces occupied by RSV can lead to its spread. Unfortunately, previous infection with RSV does not prevent future infections. Infants are particularly prone to developing bronchitis or pneumonia from RSV infections.

So, what are the signs parents should look out for? RSV infections typically cause fever, cough, stuffy nose, and decreased appetite. Severe infections are marked by fast breathing, pauses in breathing (also known as apnea), and wheezing. It is common for babies to get dehydrated from poor feeding as well. If your baby shows any of the signs above, please see their doctor as soon as possible. Your baby’s doctor can test for RSV and make sure your baby is getting enough oxygen. They will also be able to make sure your child is getting enough hydration. Occasionally, babies require IV hydration when they don’t feed enough. It is also important to know when to skip an office visit and call 911 instead. Reasons to call 911 include the baby stops breathing, turns blue or gray, starts grunting, or looks like their breathing is tiring them out. Costal retractions are when the sides under the ribs of the baby begin to sink in with every breath. This indicates that the baby is having a lot of trouble breathing and needs to go to the ER immediately.

For milder cases not requiring hospitalization, there are few treatments that can help a baby get over this illness. One thing to keep in mind is that RSV is a viral illness; antibiotics will not help treat the symptoms or the illness. Some things that will help include humidifiers, bulb suctions to help with the stuffy nose, and Tylenol if they have a fever. Never give Ibuprofen (Advil) to a baby under 6 months because it can hurt their kidneys. If over 6 months, alternate Ibuprofen and Acetaminophen (Tylenol) to keep the fever down. Otherwise, the main thing to do is to wait the illness out. Most cases self-resolve in 1-2 weeks. During this time, parents should make sure to keep feeding their child as much as they can and monitor how many wet diapers they are making. The easiest way to monitor for dehydration is to make sure babies are making the normal number of wet diapers.

In the end, the best thing to do is prevent the illness in the first place. The main way to prevent RSV infection is hand hygiene. Frequent hand washing by children and adults is the best way to prevent the spread of viral diseases. Teaching children how to properly wash hands for 20 seconds with warm water and soap is the best way to help. We have had a bad RSV season this year. Staying knowledgeable about the illness and doing your best to prevent its spread will help keep our children safe.

Dr. Patel is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community