RSV - Facts, Prevention, Treatment, and when to see a doctor.
Many parents are terrified now as they watch 75% of our nations pediatric hospital beds fill up. A large portion of this rise is due to Respiratory Syncytial Virus (RSV), which is a very common virus leading to mild symptoms in adults but leading to many hospitalizations in young children and older adults. Hospitalizations frequently occur in severe disease where there is significant respiratory distress needing temporary ventilator support or close monitoring. Along with RSV, influenza is also rising. These two viruses paired with Covid-19, staff shortages at clinics and hospitals, and supply chain delays for equipment is causing many parents and family members to figure things out on their own until they are able to see their doctor. This is for you!
The Facts
RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States. Each year in the United States, an estimated 58,000 children younger than 5 years old are hospitalized due to RSV infection. Virtually all children get an RSV infection by the time they are 2 years old. Most of the time RSV will cause a mild, cold-like illness, but it can also cause severe illness leading to a hospitalization in about 2 out of every 100 children younger than 6 months of age with RSV infection. Most improve with supportive care and are discharged in a few days.
Children at the greatest risk for severe illness from RSV include
Infants born prematurely
Infants 6 months and younger or children younger than 2 years old with chronic lung disease or congenital (present from birth) heart disease
Children with weakened immune systems or children who have neuromuscular disorders, especially those with difficulty swallowing or clearing mucus secretions
Older adults are also a high-risk population. Each year, it is estimated that more than 177,000 older adults are hospitalized and 14,000 die in the United States due to RSV infection.
Adults at highest risk for severe RSV infection include:
Older adults, especially those 65 years and older
Adults with chronic heart or lung disease
Adults with weakened immune systems
Prevention
Prevention is key and should be the focus in all acute illnesses and chronic disease. Unfortunately, unlike influenza and COVID-19, there is no vaccine for RSV. But, there are steps you can take to help prevent the spread of RSV. Specifically, if you have cold-like symptoms you should:
Cover your coughs and sneezes with a tissue or shirt sleeve (not your hands)
Wash your hands often with soap and water for at least 20 seconds
Avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others. Ideally, people with cold-like symptoms should not interact with children at high risk for severe RSV.
Frequently clean touched surfaces such as doorknobs and mobile devices
Stay home when you’re sick. Whether it be school, work, or public events, staying home will help prevent the spread of disease.
RSV is spread when an infected person coughs or sneezes causing droplets in the air, which someone breaths in. Or virus droplets come in contact with the eyes, nose, or mouth after someone may touch an object (door nob, cell phone) and then touch their face prior to washing their hands. Or, an individual directly contacts the virus, like a person with the virus kissing the face of a child.
People infected with RSV are usually contagious for 3 to 8 days. However, some infants, and people with weakened immune systems, can continue to spread the virus even after they stop showing symptoms, for as long as 4 weeks.
Treatment
People infected with RSV usually show symptoms within 4 to 6 days after contact with the virus. Symptoms of RSV infection usually include runny nose, decrease in appetite, coughing, sneezing, and fever. These symptoms usually appear in stages and not all at once. In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties.
Thankfully, most RSV infections go away on their own in a week or two and for mild symptoms, a doctor’s appointment or in-person visit may not be necessary. There is no specific treatment for RSV infection. Remember, an important factor when focusing on treatment of a sick loved one is to also focus on protecting others and those who may be high-risk for severe disease. The household should focus on hand washing, cleaning frequently contacted objects, and staying home from school or work, especially if symptomatic.
There are some ways to help ease the symptoms of RSV:
Manage fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. Never give aspirin to children and contact your doctor with questions before administering any medications to children.
Drink enough fluids to prevent dehydration. Those with kiddos should keep track of how many times per day their child is urinating.
Talk to your healthcare provider before giving your child nonprescription cold medicines. Some medicines contain ingredients that are not advised for children.
Take to Emergency Department when:
Respiratory Distress - severe difficulty breathing, wheezing, or using stomach and neck muscles to help breathe.
Consistent high fever - if your child is having temperatures greater than 100.4 F, this is considered a fever. Consistent high fevers, especially despite the use of ibuprofen or Tylenol (age appropriate), is concerning.
Lack of eating or drinking - Not many children eat and drink normally when they’re sick. However, if your child refuses to drink, it’s a good idea to let your doctor know. The time frame of when it may be concerns depends on the child’s age.
Overly fussy or overly sleepy - if your child is so fussy you are unable to console them, or if your child is so sleepy you are having a hard time to waking them up, please call your doctor.
It’s always a good idea to give your doctor’s office a call if you ever have any questions.
At Caravel Health DPC, we hope you and your family are staying safe, healthy, and happy! We offer direct access via text, call, and email, and same-day telemedicine video visits to our NC and CA members and same-day in-person visits in Redlands, CA to our members without any additional co-pays or visit fees for both children and adults.
Best,
Dr. Landen B. Green, D.O.
Caravel Health DPC
