Many viruses can affect children; for most, they run their course, and the child gets better. Some are relatively benign, like the common cold, and some cause more severe symptoms, like the Respiratory Syncytial Virus. This virus has been around for years, but there is increasing awareness of its existence and potential severity in recent years with the current pandemic the world has experienced.
I see and manage many children with RSV, and I will educate you on the disease and answer the common questions I get from concerned parents. There are recent welcome developments in RSV prevention that I will discuss later on.
WHAT IS RSV?
Respiratory syncytial virus (RSV) is one of the viruses that can cause infections in the respiratory tract. Most symptoms are mild, and the symptoms are like the common cold, but some can be severe.
According to the CDC, 58,000 – 80,000 children under five in the US are hospitalized YEARLY for this infection. According to the CDC, RSV is associated with 100 -300 deaths per year in children under five years in the US. (CDC Advisory Committee on Immunization Practices ACIP. https://www.cdc.gov/vaccines/acip/recs/grade/nirsevimab-season1-rsv-infants-children-etr.html. September 27, 2023)
Also, most children are already infected by this virus by two years of age.
RSV is seasonal and occurs usually from Fall to spring of every year.
HOW IS RSV SPREAD?
Your child can get infected if an infected person coughs or sneezes out infected droplets around them, which get into their mouth, nose, or eyes.
Also, when these infected droplets land on hard surfaces, the viruses can survive for hours, and if your child touches these surfaces and their face, they can be infected.
An infected child may become contagious 1-2 days before showing symptoms! And may remain infectious for about 3 – 8 days.
WHAT ARE THE SYMPTOMS TO LOOK OUT FOR?
Infections caused by this virus can present as mild cold symptoms, i.e., upper respiratory symptoms, or as more severe lower respiratory symptoms causing bronchiolitis or pneumonia.
Children under a year old, born premature, with immune system deficiencies, Chronic Lung Disease, or Congenital Heart problems are at a much higher risk of severe symptoms.
This infection will get worse before it gets better.
The symptoms include:
. Cough
. Congestion
. Runny nose
. Fever (100.4 F and above)
. Poor appetite
. Fussiness
. Sneezing
. Difficulty breathing: the child may bob head up and down while breathing or tugging between ribs during breaths
. Wheezing
WHAT IS THE TREATMENT FOR RSV?
Treatment is mainly supportive for your child.
. Control fevers: give over-the-counter fever reducers (Acetaminophen, i.e., Tylenol or Ibuprofen ) depending on the child’s age and dose. Do not give Ibuprofen to a child less than six months. Contact your Pediatrician if you need clarification on the medication dose.
. Support your child’s breathing: use nasal saline drops with gentle suctioning to clear your child’s nose. Also, use a cool mist humidifier.
. Keep your child well hydrated.
. Take your child to the Pediatrician if your child is not better or worsening.
CAN RSV BE PREVENTED?
RSV can be prevented by practicing good hygiene.
. Teach your child to wash hands for 20 seconds with soap and water.
. Cover cough and sneezes with tissue or in sleeves, not directly on hands.
. Disinfect hard surfaces in your home frequently.
. Avoid unnecessary exposure of children less than six months by avoiding crowded areas during the RSV season (Fall-Spring)
. The newest prevention strategy is the use of immunizations for RSV! These were approved this year by the FDA.
One of the vaccines, the bivalent RSVpreF vaccine (trade name Abrysvo TM), can be given to a pregnant woman between 32 – 36 weeks gestational age during the RSV season. According to the CDC, This vaccine reduces hospitalization risk by 57% in the first six months of life.
The second RSV preventive antibody is the Nirsevimab (Beyfortus), recommended for children under 8 months born during the RSV season or entering their first RSV season. This preventive antibody can be given to high-risk children between 8 – 19 months of age, as mentioned above. Per the CDC, the risk of severe RSV is reduced by 80% by this vaccine.
. Palivizumab (Synagis): is an RSV antibody product similar to Nirsevimab, which was approved by the FDA 25 years ago in 1998 for children less than 24 months for monthly administration during the RSV season. It has rigorous criteria for use.
There is no lifelong immunity to Respiratory Syncytial virus infection, and your child may get repeated infections. And I strongly recommend the prevention strategies above.
Have an outstanding Fall and Winter, and protect your precious little ones!
OUR KIDS DOC 
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