Doctors say RSV is in season

By: Cari DeLamielleure-Scott | West Bloomfield Beacon | Published March 3, 2016

Jacek Chabraszewski/Shutterstock

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METRO DETROIT — During the winter months, the average child contracts about six colds, according to Dr. Irvin Kappy, service chief of pediatrics for Henry Ford West Bloomfield Hospital. 

And oftentimes, the cause of the cold is the respiratory syncytial virus, or RSV, Kappy added.

RSV is a highly contagious virus that infects the respiratory tract. In most cases, the infection causes nothing more than the symptoms of a common cold; however, it can be dangerous for premature infants, older adults, and adults and children with pre-existing lung and heart conditions. RSV is the most common cause of respiratory infections in children under 1 year of age, Kappy said. 

According to the Centers for Disease Control and Prevention, almost all children will contract RSV by their second birthday. Of those children exposed to the virus for the first time, 25-40 out of 100 children have signs or symptoms of bronchiolitis or pneumonia, and 5-20 out of 1,000 will require hospitalization. 

“Unfortunately, you can get infected repeatedly with RSV … though as you get older, the symptoms tend to be a bit milder,” Kappy said. 

RSV is transmitted in two ways — direct contact and from large aerosol droplets that occur during sneezing and coughing. Cold-like symptoms include a cough and runny nose, and they typically last about a week, Kappy said. However, in young children, symptoms can last up to four weeks. In extreme cases, those who are at risk of severe infection can experience — in addition to the cold-like symptoms — difficulty breathing, a high fever and a thick discharge from the nose. RSV can lead to serious problems such as bronchiolitis — inflammation in the small airways of the lungs — or pneumonia, Kappy said.

While RSV can be seen year-round, it peaks in January and February and is more common during the winter, according to Dr. Seth Faber, a pediatrician with Beaumont Health System’s Orchard Pediatrics in West Bloomfield.  

“All viruses thrive when we’re in crowds. Every virus has its favorite environmental condition, and these months fit RSV,” Faber said. “It’s like taxes. It comes every year. You can count on it.”

Treatment
Because there is no treatment that changes the course of the illness, doctors tackle the virus through supportive treatment — fluids, rest and isolation — Faber said. In cases where a child is having trouble breathing, doctors may prescribe breathing treatments to make the kid more comfortable, he added. 

The virus is “pretty predictable” every year, but what has changed is the way it has been treated, Faber said.

“We used to do the breathing treatments on everyone with RSV, and we realized some children don’t respond well to them,” Faber said, adding that doctors are now more selective on treatment. 

Kappy said besides supplemental treatment, prevention is key. Adults should avoid smoking around children, and children and adults should wash their hands with soap and water or alcohol-based hand rubs. Kappy said isolation also prevents the virus from spreading and, if possible, infants and high-risk children should be kept out of areas where they’re exposed to a lot of children. 

While there are no vaccines for RSV, palivizumab can be used to help prevent the infection in severely premature infants — those born before 29 weeks, Kappy said. 

Kappy also recommended that children 6 months of age and older receive the influenza vaccine. While the vaccine doesn’t prevent RSV, it does help prevent complications.

When to be concerned 
During the winter months, it may seem like a child is constantly sick with colds, but what makes RSV different from other viruses is that it causes a coating over the smallest airways, Faber said. 

RSV can be tested for using a nasal swab, but Kappy said that most of the time, it’s fairly obvious when a child has RSV.

For children under 6 months of age, parents should watch for difficulty breathing and retracting, which is when a baby pulls his or her chest in at the ribs. If a parent thinks a child has a pause in their breathing, especially longer than 10 seconds, they should call their doctor. Parents should also watch for severe coughing spells and a fever over 100.4 degrees Fahrenheit. If a child’s lips or inside of the mouth look blue, or if they are unable to drink enough to stay hydrated, parents should call their doctor, Faber said.  

“The vast majority of times, the children are not hospitalized; they’re managed at home, so that’s the good news,” Kappy said.

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