NEW YORK CITY– In September, an 8-month-old baby came to the practice of Dr. Juanita Mora in Chicago with an infection the doctor didn’t expect for two months: RSV.
Like her colleagues across the country, the allergist and immunologist treated little ones with this cold-like virus well before the season started.
“We see that RSV infections are widespread across the country,” Mora said.
Almost all children start RSV sometime before age 2, says the US Centers for Disease Control and Prevention. Most adults who get it have a mild illness; It can be dangerous for the elderly, chronic heart or lung disease, or a compromised immune system. But RSV can be especially difficult for infants and children.
Mora, a volunteer medical spokesman for the American Lung Association, says it’s important parents, caregivers and daycare providers know what to look for with RSV, which stands for respiratory syncytial virus. In this way, they know whether a sick child can be treated at home or needs to be hospitalized.
“The ER gets completely flooded with all these sick kids, so we want parents to know they can go to their pediatrician and get tested for RSV, influenza and even Covid-19,” Mora said.
Here’s what else parents need to know as respiratory illnesses rise.
What to look out for
For many, RSV causes mild illness that can be treated at home.
On average, an infection lasts five days to a couple of weeks and often goes away on its own, the CDC says. Sometimes the cough can last up to four weeks, pediatricians say.
Symptoms can look like a common cold: a runny nose, decreased appetite, coughing, sneezing, fever, and wheezing. Small infants may only appear irritable or lethargic and have difficulty breathing.
Not every child will have all of the potential RSV symptoms.
“Fevers are really a godsend in RSV infections, especially in young infants,” said Dr. Priya Soni, assistant professor of pediatric infectious diseases at Cedars Sinai Medical Center.
Parents should watch for changes in behavior, she said, including longer meal times or no interest in food at all. The child may also develop a severe cough and some wheezing.
It’s also important to watch for signs that your child is having trouble breathing, or breathing with their ribs or stomach — “symptoms that can overlap with many other viruses that we’re seeing a resurgence of,” Soni added .
Because it’s not easy for parents to tell the difference between respiratory illnesses such as RSV and the flu, it’s a good idea to take a sick child to a pediatrician who can run tests to determine the cause.
“You may need to get your baby in for a checkup sooner rather than later,” Soni said.
When it comes to RSV, parents should be especially cautious if their children are premature babies, newborns, children with compromised immune systems or neuromuscular disorders, and children under the age of 2 with chronic lung and heart disease, the CDC says.
“Parents should be very alert to changes in things like activity levels and appetite, and then pay particular attention to signs of shortness of breath,” Soni said.
Testing is important as treatment for things like the flu and Covid-19 can be different.
There is no antiviral or specific treatment for RSV like there is for the flu, nor is there a vaccine. But if your child is sick, there are things you can do to help.
Fever and pain can be managed with non-aspirin pain relievers, such as acetaminophen or ibuprofen. Also, make sure your child is drinking enough fluids.
“RSV can be very dehydrating for kids, especially if they’re not eating or drinking, especially when we’re talking about infants,” Mora said. “Once they stop eating or their urinary output decreases, they don’t have as many wet diapers, which is a sign they may need to go to the pediatrician or the emergency room.”
Talk to your pediatrician before giving your child over-the-counter cold medicines, which can sometimes contain ingredients that are not good for children.
When to go to the hospital
Your pediatrician will check the child’s breathing rate — how fast they’re breathing — and their oxygen levels. If your child is very ill or at high risk of developing a serious illness, the doctor may ask that they be taken to a hospital.
“RSV can be very dangerous for some toddlers and younger children, especially those younger than 2 years old,” Soni said.
Mora said labored breathing is a sign a child has problems with this virus. RSV can lead to more serious conditions, such as bronchiolitis or pneumonia, which can lead to respiratory failure.
If you see a child’s chest heave as they breathe, if the cough keeps them from sleeping, or if they’re getting worse, “it may be a sign they need to seek or get help from their pediatrician.” the emergency room because they may need supplemental oxygen or nebulization treatment.
Medical analyst Dr. CNN’s Leana Wen says that these breathing difficulties — including a head bobbing, a flared nose, or grunting — are one of two main problem signs with any respiratory infection. The other is dehydration. “This is especially true for babies with stuffy noses. They may not be fed.”
Much of the care provided by hospital staff is to help with breathing.
“We provide supportive care for RSV and these children with oxygen, IV fluids and respiratory therapies, including suctioning,” Soni said.
A thin tube may need to be inserted into the lungs to remove mucus. A child can get supplemental oxygen through a mask or tube that attaches to their nose. Some children may need to use an oxygen tent. Those struggling a lot may need a ventilator.
Some babies may also need to be tube fed.
How to prevent RSV
The best way to prevent RSV infection, doctors say, is to teach children to cough and sneeze into a tissue or the crook of their arm instead of their hands. Also try to keep frequently touched surfaces clean.
If a caregiver or older sibling is sick, Mora says they should wear a mask around other people and wash their hands frequently.
And above all, if someone is sick – child or adult – they should stay at home so that they do not spread the disease.
There is monoclonal antibody treatment for children who are most at risk of developing serious disease. It’s not available to everyone, but it can protect the most vulnerable. It comes in the form of an injection that a child can have every month during the typical RSV season. Talk to your doctor about whether your child is suitable.
https://6abc.com/rsv-respiratory-syncytial-virus-cold-flu/12369419/ RSV in children: Symptoms, treatment and what parents should know