Who’s Afraid of the RSV?

Lisa-GoldI know all of you are aware of influenza infections this winter, and I hope by now you have gotten a flu shot or nasal spray if not medically contraindicated. I don’t want to be an alarmist, but you need to know there is more than influenza illness, ear infections, strep throat or pneumonia that can impact an infant’s health. Have you heard of RSV? It means respiratory syncytial virus and causes acute respiratory tract infections in people of all ages. RSV is a significant virus in the winter season. It is one of the many viruses that cause a URI or “cold.”

RSV causes a URI or cold in almost all children at least once before they are 2 years old. Majority of the time the illness remains mild but 20 to 30% of the time the virus can cause lower respiratory infection and cause wheezing or pneumonia. About 60,000 children are hospitalized each year due to RSV infection and about 500 of these children will die. Any infant can have an RSV infection but we are worried about certain high risk infants. Infants that are born premature, especially before 32 weeks of pregnancy, or who are born with severe lung or heart disease are considered high risk.

Symptoms

  • Are similar to a common cold and are a runny nose, nasal congestion, coughing, and possibly a low-grade fever.
  • Worse symptoms include wheezing, rapid or difficult breathing, poor appetite and irritability.

 

Treatment

If your infant’s doctor is suspicious of RSV a simple nasal swab can be done in the office to test for the virus. Most of the time nasal suctioning and home URI care is advised. We know keeping the infant well hydrated is definitely important in treatment. Sometimes wheezing is helped with inhaled medication. If the infant shows concern of respiratory function or need for supplemental oxygen hospitalization is required.

Prevention

What can be done to prevent RSV?

  • Don’t smoke. If you do smoke always keep it outside and not in your car with your infant inside.
  • Everyone needs to wash their hands before touching your infant.
  • Try and avoid exposing your infant to crowded areas like shopping malls.
  • Avoid having sick people with cold symptoms, a fever or runny nose around your infant.
  • There is an antibody called Palivizamab, also known as Synagis that can be used as a prevention medication for RSV infection. The medication is indicated for certain at risk infants. If the infant has chronic lung disease, a history of prematurity less than 35 weeks or certain types of congenital heart disease they may get this monthly injection during the months RSV is in the community. This medication is very costly and does not help in treatment of the disease. If you think your infant is high-risk and you have questions about this medication ask your child’s doctor.

 

Stay warm, stay away from illness and enjoy your healthy infant!

Dr. Lisa Gold is a pediatrician practicing in Crown Point, Indiana, at the Franciscan Physician Network - Crown Point Pediatric Health Center.