Dreaded RSV

March 6, 2013 § Leave a comment

Sick baby

It was one of every parents’ nightmares – my little girl was in the hospital, looking so tiny and helpless in that huge bed, hooked up to an IV and oxygen. How did we go from my crazy, nonstop kid to this in just a matter of days??

After a week of being sick, 2 doctor visits, and a day sitting in the ER, we finally learned that she had RSV – Respiratory Syncytial (sin-SISH-ul) Virus. And not only was it going around, this year, it was going around with a vengeance. Basically, RSV is an infection of the lungs and breathing passages. Everyone gets it. Most people will get it at least once a year. In healthy adults, it just presents as a bad cold – stuffy nose, cough, mild fever. But for young children (as well as the elderly), RSV can turn into a major respiratory illness.

The most frequent cause of lung infection in infants and young children, RSV usually lasts 5-15 days. The child’s airways will become inflamed and swell, the muscles around them will tighten and they will often fill with mucus, dead tissue, and fluid. RSV occurs in epidemics and peak season is typically November – April in the US. Virtually all children will have been infected by RSV at least once by the time they are 3 years old. Most children can be treated at home, but higher risk babies and those who have it morph into a severe lower respiratory infection may need additional support.

RSV is spread easily through aerosols and droplets, which means that any time a person coughs or sneezes, those around them can catch it just by being in close contact. You can breathe in the virus or get it by touching an infected surface, then touching your mouth, nose, or eyes. Your child may be a higher risk baby if s/he:

  • Is less than 6 months old
  • Is premature or a small baby
  • Has another condition such as cystic fibrosis, neurological diseases, lung, or heart problems
  • Is around cigarette smoke or other tobacco smokes
  • Has a weak immune system due to immune system disorders, HIV, or transplants

It’s hard to tell at first if your child has RSV, as it presents similar to many other things. It initially starts out like a cold with a runny or stuffy nose, cough, fever, trouble sleeping and/or eating. If the illness becomes more severe, you may notice:

  • The fever not going away even with medication
  • Wheezing
  • Faster breathing
  • A “chestier” cough
  • Constantly sleepy
  • Lethargic
  • Fussy
  • Increased heartbeat
  • Decreased appetite
  • Vomiting with the cough
  • Dehydration

It’s time to high-tail it to the doctor if these symptoms worsen and/or you also notice:

  • Grunting or noisy breathing
  • Very fast breathing
  • Refusal to eat/drink
  • Pauses in breath
  • The nostrils becoming wider when breathing in
  • Pale or blue color of the skin – especially around the lips or nails
  • Pulling in of the skin around the ribs and neck with each breath
  • Dry mouth/cracked lips
  • No tears when crying
  • Low or no urine output
  • Sunken soft spot (if under 1)

These are signs that the illness has progressed to the lower respiratory track and is likely turning into bronchiolitis or pneumonia. They are also signs that your child is becoming dehydrated, not getting in enough oxygen, and needs additional support measures at the hospital, since both of these conditions can rapidly turn into much more serious problems in young children.

As parents, we want to protect our children as much as possible, but unfortunately, there’s not a whole lot we can do for this one. They have not yet been able to develop a safe and effective vaccine. High risk infants can get a series of the RSV immunoglobulin to help with some protection. However, this medicine is not right for all children so be sure to discuss the options with your pediatrician if you think your child may be high risk. The most important thing we can do to try to prevent infection is to wash hands with soap and water frequently (for at least 20-30 seconds) – especially before eating. Even though many of these things are hard to do in everyday life, also try to:

  • Keep hands away from mouth, nose, and eyes as much as possible
  • Keep your child away from large crowds during peak season
  • Avoid other sick people as much as possible
  • Breastfeed your infant since the mother’s antibodies will carry over through the milk
  • Clean toys and other objects that are shared with other people regularly with soap and water or another disinfectant
  • Do not expose your child to smoke – cigarette, other tobacco sources, or even a wood burning stove
  • Keep them away from any chemical fumes or dust
  • Cover faces when coughing or sneezing
  • Be sure that used tissues are immediately discarded in a lined trash can
  • If a school aged sibling comes down with a cold, try to keep them away from the infant or toddler as much as possible

For treatment at home:

  • Give your child a non aspirin fever medicine like acetaminophen or ibuprofen (Tylenol or Advil) to help control the fever
  • Use a cool mist vaporizer to help keep the air moist and to thin mucous (be sure to clean it daily)
  • If the nose is really blocked, use a nasal aspirator or bulb syringe to remove some of the fluids
  • Make sure your child drinks more than usual
  • Allow your child to rest with plenty of time at home to fully recover before going back out to daycare or normal activities

Unfortunately, this is a nasty virus that kids can (and probably will) get again and again. But if we as parents are aware of what to look for and what we can do to help, hopefully we can protect our littlest ones as much as possible.

At least Spring is almost here and this terrible bug season is winding down. Hopefully next year won’t be as nasty!

Other places for info:
American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
847-434-4000
http://www.aap.org

Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30333
800-311-3435
http://www.cdc.gov

Resources:
http://virology-online.com/viruses/RSV.htm
http://kidshealth.org/parent/infections/lung/rsv.html
Micromedex Solutions
http://www.dshs.state.tx.us/immunize/docs/RSV.pdf


A Personal Rant:
Superbugs, Superstorms, SuperFrustrated

Photo Creditkourtlynlott via photopin cc

This article was originally published at The IF Factor and has been used with permission. 

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