21-Feb-11 4:00 PM EST

Respiratory Syncytial Virus - Not Always Just a Cold

What is respiratory syncytial virus (RSV)?

RSV is a virus that causes colds in people of all ages. However, RSV can cause a serious lung infection in infants and young children. Most children will get RSV by the age of three. RSV is most common during the winter months.

How can my child get RSV?

RSV, like other cold viruses, is easy to spread to other people by touching, kissing, and shaking hands. Sometimes it can be spread by close contact with a person who is sneezing or coughing or touching things that have RSV on them. The most common way to spread RSV is by hand contact. People “catch” RSV from other people who have colds caused by RSV.

Who is at risk?

Premature infants born more than 4 weeks early
Low birth weight babies
Babies with chronic lung disease
Babies with serious heart disease
Babies with severe neuromuscular disease
Infants who attend daycare
Infants exposed to smoke
Family history of asthma
Infants who live with school age siblings
Infants who cannot fight infections well

What are the Symptoms of RSV?

Runny nose
Cough
Fussiness
Your child may seem very tired, less active
Your child may not want to eat
Loud or fast breathing
Wheezing (a tight whistling or musical sound heard when your child breathes)
Your child’s chest sinks in with each breath
Low grade fever (in some children)
Difficulty breathing, gasping for breath

Why is respiratory syncytial virus (RSV) a concern?

Worsening symptoms can lead to severe lung infections, and may become life threatening.

How can I prevent my child from getting RSV?

There are two ways to help prevent your child from getting RSV:

1. Take everyday steps to prevent the spread of RSV, especially good hand washing;

Wash your hands before touching your baby
Ask other people to wash their hands before touching your baby
Wash hands with soap and water or alcohol-based rub
Keep your baby away from crowds
Keep your baby away from people with colds
Wash your baby’s toys and bedding often
Keep your baby away from cigarette smoke

2. A medication called palivizumab (Synagis®) is recommended for babies at high risk for RSV. It is usually given monthly during the RSV season (late fall through spring). It is not a vaccine, but it can help your baby’s immune system fight against the virus.

What is palivizumab (Synagis®)?

Some high-risk children under the age of 24 months may benefit from palivizumab, which is a medicine to help prevent RSV infections and is given as a shot into the baby’s thigh muscle. Each dose helps build the body’s immune system to fight viral infections caused by RSV for about one month. It is usually given in 1-5 monthly shots, depending on your child’s age during the RSV season. It is important that your child gets all the required doses.

How do I know my child has RSV?

It is sometimes hard to know whether your child has RSV because it can look like other infections. Illness in other family members or the time of the year may provide clues. Symptoms also differ with age. Babies under one have the most trouble breathing. If you notice a bluish skin color (not enough oxygen), difficulty breathing or labored breathing, coughing, fever, nasal flaring, fast breathing, shortness of breath, stuffy nose, or wheezing in a baby, contact the doctor. Your doctor may examine your child and also test your baby’s nose drainage to see if RSV is present. Older children may just look like they have a mild cold.

What do I do if my child gets RSV?

Make sure your baby gets enough fluids to drink
Keep your baby’s nose clean using a bulb syringe
If you are concerned, call your doctor

How is RSV Treated?

Most children get better without medical treatment. Some children, especially newborns, premature infants or infants with heart or lung problems can be sicker and may need to be hospitalized. In the hospital, your child will be watched closely. Because a virus causes the illness, antibiotics will not be useful. Some children may need oxygen, breathing treatments, medicine for fever, or fluids by IV.

Can my child get RSV again?

Yes, your child can get RSV again, but most likely it will be milder than the first time.

References:

Redbook Online. Respiratory syncytial virus. Accessed on 10/13/10
American Academy of Pediatrics. Diagnosis and management of bronchiolitis. Pediatrics 2006; 118(4): 1774-1793.
A.D.A.M. Respiratory syncytial virus. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002531. Accessed on 02/21/11.