MyKidsPhysician.com

Frequently Asked Questions About Respiratory Syncytial Virus

What is it?

Respiratory syncytial virus (RSV) is a virus that causes infections of the lungs and breathing passages. This virus is a major cause of respiratory illness in young children. Illnesses can range from severe (like pneumonia) in infancy to mild (like a simple cold) during adulthood. Repeated infections can occur, but later RSV infections are usually less severe than infections occurring earlier in life.

RSV can be passed from person to person through contact with infected fluids from the nose or mouth of someone with an RSV infection. The virus usually enters the body when a person touches her eyes or nose with fingers contaminated by RSV. Contagiousness is highest during the first two days to four days of the infection, but RSV may be spread for up to three weeks (or even longer) after the infection has begun. Once a person has been exposed to RSV, it usually takes four days to six days for symptoms to start.

RSV infections occur most often in epidemics, usually from late fall through early spring. The highest rates of RSV illness occur in infants from about two months to eight months of age. Because RSV can be "caught" by a school-aged child and passed to a younger one, infants are at increased risk for RSV infection when they have older brothers or sisters in day care or school.

What are the Symptoms?

In adults and in children over age 3, RSV usually causes symptoms of an upper respiratory tract illness (cold). These symptoms include a stuffy or runny nose, sore throat, mild headache, mild cough, fever, and a general "ill" feeling.

In children younger than age 3, RSV often causes a lower respiratory tract illness, such as bronchiolitis. Symptoms may include high fever, severe cough, wheezing, abnormally rapid breathing, and difficulty breathing. In infants with severe RSV infection, there may be retractions (drawing in) of the chest muscles and skin between the ribs, indicating that the infant is having severe difficulty breathing.

How is it Treated?

RSV infection is not treated with antibiotics, since these drugs do not work against viruses. If you are caring for a child who has an RSV infection, the goal is to make the child comfortable while the body's defense mechanisms fight the virus. Using a cool-mist humidifier to add moisture to the air may soothe your child's irritated breathing passages and help relieve cough. If a humidifier is used, follow the manufacturer's recommendations for keeping it clean and mold-free. Encourage your child to drink plenty of fluids, such as water and fruit juice.

If it is necessary to loosen mucus that blocks your child's nose, you can use nonprescription saltwater (saline) nose drops. If your child is too young to blow her nose and blocked nostrils are causing her discomfort, use a bulb syringe to gently remove sticky nasal fluids.

Treat fever using a nonaspirin fever-reducing medicine, such as acetaminophen. Unless instructed by your child's doctor, do not give aspirin to a child who has a viral illness, since the use of aspirin in certain viral infections has been associated with the development of Reye's syndrome.

Infants and younger children who have severe RSV pneumonia or bronchiolitis may need to be treated in a hospital. Treatment may include humidified oxygen and medicines that help open up breathing passages.

How Long Does it Last?

RSV infection usually lasts about a week, but may last somewhat longer. Children who are hospitalized for an RSV illness may spend five days to seven days in the hospital.

How Can Respiratory Syncytial Virus be Prevented?

There is currently no vaccine to prevent RSV infection, although testing to develop one continues.

In practical terms, preventing RSV is difficult. Because RSV is spread on hands that have touched contaminated body fluids or objects, it is important to wash your hands after touching anyone who has a cold or an RSV infection. To help prevent RSV infections in infants, keep persons who have cold symptoms at a distance from your baby.

Since RSV can contaminate toys in schools and day-care centers, teachers and caregivers should carefully wash and disinfect toys regularly.

A medicine called respiratory syncytial virus immune globulin has been approved to try to prevent severe RSV infections. This medicine is recommended for use only in certain babies born prematurely and in some infants who have serious chronic lung problems.

When Should the Doctor be Called?

Call your doctor if your child has any of the following symptoms: high fever; severe, prolonged, or unusual cough; or difficult, irregular, or rapid breathing.

In infants, in addition to symptoms already mentioned, call your doctor if your child is unusually irritable or inactive, has retractions (drawing in) of the chest muscles and skin between the ribs when breathing, or difficulty feeding.

© Copyright 1999 American Medical Association
All rights reserved.

DISCLAIMER