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RSV Infection - Part II

Last week we talked about RSV infection, caused by the Human Respiratory Syncytial Virus.  This winter season has seen a higher than usual number of RSV infections, with more severe illnesses and more hospitalizations.  We don't really know why the RSV season is worse this year, but we need to be aware and try to keep our most vulnerable children healthy.  Today we are talking about how the diagnosis is made and how the infection is treated.  I also think it is worth repeating when you should call a doctor.

RSV InfectionWhen should you call a doctor?

  • If your child is less than 6 months old and has symptoms of a cold,
  • If your child has a fever lasting more than a few days,
  • If your child is wheezing, breathing more rapidly, or having some difficulty feeding, call your doctor right away.

When is this an emergency?

  • If your child has more serious symptoms, such as difficulty breathing, discoloration of the lips, skin, or fingernails, or other signs of respiratory distress, you should call 911 for immediate help.

How is the diagnosis of RSV made?

The symptoms of RSV infection overlap with many other illnesses.  Only a health care provider can make a diagnosis of RSV.

  • Your doctor will do a careful exam, listening for abnormal sounds in the chest, as well as looking for sometimes subtle signs of respiratory distress.
  • A chest X-ray can show signs of bronchiolitis.
  • A test for RSV can be done on a sample of mucous obtained from the nose.

How is RSV treated?

RSV is a virus so antibiotics do not help it and are not recommended.  Unlike the flu, there is no specific antiviral medication that works to treat RSV.  Treatment is aimed at relieving the symptoms, and providing supportive care while the body fights the infection.

Here are some home treatments that you can use for less severe illness:

  • Use saline and a bulb syringe to improve nasal congestion and clear mucous from the nose.  Use this link for specific help in how to do this. https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/suctioning-the-nose-with-a-bulb-syringe
  • Use a cool mist vaporizer.  The moist air can improve coughing and make breathing easier.
  • For children older than 6 months, give plenty of liquids such as water.
  • Give acetaminophen or ibuprofen (Only for babies over 6 months of age) for fever.  Do NOT give aspirin.  Aspirin use in children with viral illness has been linked to a very serious disease called Reye's syndrome.

Treatments that may be given at a health care facility or hospital include:

  • Supplemental oxygen through a mask 
  • IV fluids

In the past, we treated bronchiolitis with the asthma inhaler albuterol.  However, recent studies have found that albuterol does not actually provide any benefit, and can cause uncomfortable side effects, so the American Academy of Pediatrics now advises explicitly against using albuterol for bronchiolitis.

How long does RSV infection last?

The symptoms from this infection can last 2 weeks or longer.  However, most kids will improve within 7-10 days.

How can the spread of RSV be prevented?

Remember that your common cold symptoms could be due to RSV.  It may not be dangerous for you, but it is dangerous for babies!

  • Keep people who have colds away from your baby!  This includes your older children.
  • If you have a cold, try to avoid face-to-face contact, and try to sneeze or cough away from babies and children.
  • Wash your hands often, including after you sneeze or cough, before your touch a baby, before and after you touch a baby or child who is ill, and before handling any food.
  • Do not send your child to school or day care if they are sick, especially with a fever.
  • Do not share pacifiers, toothbrushes, dishes or utensils, wash clothes or towels, etc.
  • Wash your baby's toys and clothes often, especially when they are sick.
  • Do NOT smoke around your baby or allow anyone else to smoke around them either.
If you have any questions about RSV infection, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor
 
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