Respiratory Syncytial Virus

Respiratory Syncytial Virus (RSV) is a common childhood viral illness. It is often the cause of a respiratory condition called Bronchiolitis (a viral infection of the small airways of the lungs). RSV infection usually occurs within the first 3 years of life but can occur at any age. Infections are most common in the late fall and winter season. Children less than 2 year of age, especially premature infants, children born with heart or lung disease or other chronic medical problems are most at risk for worsening illness. It is one of the most frequent reasons infants are admitted to the hospital.

SYMPTOMS

RSV usually begins with fever, runny nose, nasal congestion, cough, and sometimes wheezing. Infants may have a hard time feeding due to the nasal congestion and may develop vomiting with coughing. Older children and adults may also have flu like symptoms such as sore throat, headache, and a general feeling of tiredness (malaise). Cold symptoms may be moderate-to-severe and worsen over 1 to 3 days. Severe lower respiratory tract symptoms such as difficulty in breathing, persistent cough and wheezing may occur at any age but are most likely to occur in young infants and children. Wheezing may sound similar to asthma but the cause is not the same. Children with asthma are likely to develop asthma symptoms during the course of their illness. Most children recover from illness in 8 to 15 days. Since bacteria are not the cause of this illness, antibiotics (medications that kill germs) will not be helpful.

DIAGNOSIS

  • In well appearing children the diagnosis of RSV is usually based on physical exam findings and additional testing is not necessary. If needed nasal secretions can be sent to confirm the diagnosis.

  • A caregiver may order a chest X-ray if difficulty in breathing develops.

  • Blood tests may be ordered to check for worsening infection and dehydration.

HOME CARE INSTRUCTIONS AND TREATMENT

  • Treatment is aimed at improving symptoms. Usually no medications are prescribed for RSV.

  • Feeding infants and children smaller amounts more frequently may help if vomiting develops.

  • Try to keep the nose clear by using saline nose drops. You can buy these drops over-the-counter at any pharmacy.

  • A bulb syringe may be used to suction out nasal secretions and help clear congestion.

  • Elevating the head of the bed may help improve breathing at night.

  • A cool mist vaporizer may be useful in the home but is not always necessary.

  • Your child may receive a prescription for a medicine that opens up the airways (bronchodilator) if a caregiver finds that it helps reduce their symptoms.

  • Keep the infected person away from people who are not infected. RSV is very contagious.

  • Frequent hand washing by everyone in the home as well as cleaning surfaces and doorknobs will help reduce the spread of the virus.

  • Infants exposed to smokers are more likely to develop this illness. Exposure to smoke will worsen breathing problems. Smoking should not be allowed in the home.

  • The child's condition can change rapidly. Carefully monitor your child's condition and do not delay seeking medical care for any problems.

  • Children with RSV should remain home and not return to school or daycare until symptoms have improved.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child is having more difficulty breathing.

  • You notice grunting noises with your child's breathing.

  • The child develops retractions when breathing. Retractions are when the child's ribs appear to stick out while breathing.

  • You notice nasal flaring (nostril moving in and out when the infant breathes).

  • Your child has increased difficulty with feeding or persistent vomiting of feeds.

  • There is a decrease in the amount of urine or your child's mouth seems dry.

  • Your child appears blue at any time.

  • Your child's breathing is not regular or you notice any pauses when breathing. This is called apnea. This is most likely in young infants.