RSV Season

Even though it took a while, cooler weather has set in. While we can all look forward to lower electric bills and getting out winter clothes, this time of year brings its own set of challenges for parents to be aware of. One of the most dangerous is RSV, or Respiratory Syncytial Virus.
RSV is a virus that can cause respiratory infections in nearly anyone, but it is typically much more severe in younger child

ren. In fact, 60% of children will have an RSV infection in the first year of life. The virus is spread by direct contact, meaning it can stay on hands, toys, and countertops for up to 5 hours, making it very contagious.

Bronchiolitis – an infection of the smaller airways in the lung – is commonly caused by RSV, and it is usually only seen in children younger than 2 years old. On exam in a child with bronchiolitis, the lungs will sounds crackly – almost like Velcro separating – and wheezes, or high-pitched whistling noises, can be present as well. While other viruses can cause bronchiolitis, the progress of the infection gives a clue to the culprit. If it is caused by another virus, the infection will be at its worst within 2 days of being sick; if RSV is the cause, there is usually a 4-5 day period of runny nose, irritability, cough, and possibly fever followed by a progression to true bronchiolitis, indicated by a worsening cough, possible wheezing, and faster and deeper breathing.

While there is unfortunately no medicine to treat RSV directly, most children infected with RSV can be treated at home. However, this may require multiple visits to your physician during the 10-14 day course of illness, and occasionally severe cases may even call for hospitalization for dehydration and problems breathing. Caring for a baby with RSV can be very demanding as it usually requires frequent suctioning of the nose, especially before eating and sleeping, and extra efforts to keep your little one hydrated. Sometimes humidifiers and Vicks VapoRub can help alleviate some of the respiratory symptoms, and if there is wheezing due to the bronchiolitis, albuterol (a medicine given via a nebulizer) often provides some relief.

Premature infants and those with weakened immune systems or heart or lung problems are at higher risk of being hospitalized with RSV and for having secondary complications such as ear infections and pneumonia, which could be life-threatening inn some cases. For this reason, there is a monthly RSV preventative injection that the very high-risk children receive during RSV season. Several companies are currently researching other ways to prevent RSV infections in infants, but at the moment old-fashioned hand washing and extra cleaning of toys, clothes, and countertops are the best bet for keeping your little ones safe during RSV season.

Having a child with RSV can be a scary and fast-moving process and is often exhausting for both parents and children, but typically there are only 2-3 days of the more severe symptoms. A cough may linger for a week after everything else seems to be better. In total this illness usually lasts 10-14 days. Every child’s infection is different, so do not hesitate to call your doctor with any concerns or questions. Repeat visits may be required as the illness runs its course, but that is normal. Between those visits, the most important thing you can do at home is to keep your baby comfortable and well hydrated. That is the best way to ensure that your little one is back to his happy self in no time.

Jennifer Adair M.D.

Jennifer Adair, M.D., was born and raised in Mobile. She graduated from Davidson High School in 2002 and received her Bachelor of Science in Chemistry at The University of Alabama in 2006. She completed her medical training at the University of South Alabama College of Medicine, and pediatric residency at the University of Nevada College of Medicine – Las Vegas and the University of South Alabama. She joined Children’s Medical Group in July 2013 and currently practices at their Airport office. Jennifer and her husband, Cory, reside in Mobile with their dogs, Fitz and Barkley.