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Respiratory Syncytial Virus (RSV)

Respiratory syncytial virus (RSV) can resemble a common cold in adults. For children, though, Dr. MeKeisha Pickensespecially those younger than 2 years old, it can be more serious.

RSV is an infection of the lungs and airways. In the Northern Hemisphere, including the United States, RSV occurs most frequently between November and April. “RSV is a winter virus, and we’re at the peak of its season right now in January and February,” said Dr. MeKeisha Pickens, staff pediatrician at Children’s of Alabama Pediatrics West primary care practice.

RSV is the most common cause of bronchiolitis, which is an infection of the bronchioles, the smallest airways of the lungs. “RSV has a greater impact on infants and young children because their noses and small airways can become more easily blocked,” Pickens said.

Preventing RSV
RSV is highly contagious and can spread quickly through daycare centers and schools. It is transmitted through droplets when someone infected with the virus coughs or sneezes. The virus can also live on hard surfaces such as countertops and doorknobs. One of the best lines of defense against RSV, Pickens said, is washing your hands and by making sure children follow your lead. However, it might not be possible to avoid it completely.

“By the time your child turns 2, it is highly likely that he or she has been exposed to RSV,” Pickens said.

While there isn’t a vaccine to prevent RSV for the general population, some at-risk children may get injections that help guard against an infection. “Children who were born prematurely or have chronic lung problems or heart disease are considered to be at-risk for an RSV infection,” Pickens said.

Symptoms of RSV
Early symptoms of an RSV infection are a mild cough with wheezing, runny nose, congestion and fever (greater than 100.4°F). There may also be a decreased appetite. The virus typically lasts up to five days, worsening on the third and fourth day. There could be some residual symptoms, including a lingering cough, for up to two weeks.

Parents should be aware of more serious symptoms associated with RSV. These signs could be rapid breathing, sinking of the skin between the ribs and above the neck as well as nose flaring.  “When the child is taking more than 60 breaths per minute, it’s time to call your doctor,” Pickens said.  Very young babies can also turn blue, or stop breathing completely.  This is an emergency, and parents should see a doctor immediately.

Severe cases of RSV may lead to other illnesses and even require hospitalization.

Treating RSV
One of the primary symptoms of an RSV infection is nasal congestion. If your child is unable to blow his or her own nose, you may need to assist with a bulb syringe or nasal aspirator.

“It’s so important to keep the child’s nose clear. Squirt a saline nasal spray or drops in each nostril. Wait about 30 seconds, and then clear the nose with an aspirator or bulb syringe. Most kids don’t like the aspirator, but it really does work,” Pickens said. She recommends repeating that process several times throughout the day, especially before eating or drinking and at naptime or bedtime.

Pickens also suggests acetaminophen or ibuprofen to reduce fever and liquids to stay hydrated. “You may have to have your child drink small amounts throughout the day. You want them urinating at least three times a day to ensure they aren’t dehydrated,” Pickens said.

A cool-mist humidifier may help alleviate congestion. Just remember to clean the humidifier regularly to prevent mold growth. “A dirty humidifier can cause even more respiratory issues,” she said.

One other treatment is even sweeter than the others: honey. “If your child is over a year old, you can treat with 5 mL (1 teaspoon) of honey three to four times a day,” Pickens said.

Treating mild cases of RSV is all about managing the symptoms. Sometimes all your child may need is time to rest and recover as the virus runs its course.

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