By: Ben Spitalnick, MD, MBA, FAAP
As we get into Fall there are many cough and cold viruses circulating, especially in younger children getting their first school or daycare exposures. Many of these illnesses are short-lived with minimal symptoms, but one that often leads to a visit to the Pediatrician this time of year is Respiratory Syncytial Virus, known as RSV. In the United States, nearly all children get infected with RSV at some point by age 2, and RSV is the most common cause of bronchitis and pneumonia under age 1.
In most cases, RSV presents as a common cold, and symptoms will include a runny nose, mild cough, and low-grade fever. However, it can be more severe in some cases and leads to about 100,000 hospitalizations a year in the United States and approximately 150,000 deaths worldwide each year. Younger infants, especially those born prematurely, are most at risk for severe cases, which include wheezing, higher fever, and respiratory distress that leads to decreased appetite and poor sleep.
RSV is most commonly spread by respiratory droplets, so coughing and sneezing are the most common form of transmission. Someone infected with RSV is usually contagious for 3-8 days, but in some cases, especially infants, the RSV contagious period can last for weeks. The diagnosis is often made by office laboratory testing using a nasal swab, or by sent out testing as part of a more comprehensive panel. However, in most mild upper respiratory illnesses, testing is not indicated, so often the diagnosis is made clinically. This is because there is no “treatment” for RSV, it’s a virus that has to run its course, and we treat the symptoms based on severity.
For most mild cases of RSV, the treatment is as mild as rest, fluids, and management of low-grade fever. But in severe cases, especially in infants, hospitalization is necessary for the management of respiratory distress and dehydration. In some cases, management may involve “breathing treatments” or medicines that are given by way of a nebulizer machine that turns liquid medicine into steam that is inhaled into the lungs.
As we get into cough and cold season, the best way to prevent the spread of RSV is to practice healthy hygiene whenever you or your child have cold symptoms. These include:
- Sneezing into your elbow or a tissue, not into your hands
- Proper hand washing techniques which means using soap and water for at least 20 seconds
- Sanitizing touched surfaces, such as doorknobs
- Minimizing contact with others when symptoms are heavy, which may include staying home from work or keeping children home from school or daycare
If you ever have concerns that your child’s cold symptoms seem worse than you are comfortable with, especially for infants, please be sure to see your Pediatrician! Pediatric Associates of Savannah is open every day (365 a year!), including weekends and holidays, for exactly this reason. Kids don’t take a day off from being sick, so neither do we.