RSV in Children: Symptoms, Treatment and What Parents Need to Know


In September an 8 month old baby walked into Dr. Juanita Mora’s office in Chicago with an infection the doctor didn’t expect to see for two months: RSV.

Like his peers across the country, the allergist and immunologist treated the little ones with the cold-like virus long before the season started.

« We are seeing RSV infections spreading across the country, » Mora said.

Almost all children get RSV at some point before age 2, according to the US Centers for Disease Control and Prevention. Most adults who catch it have mild illness; for those who are elderly or have chronic heart or lung disease or weakened immune systems, it can be dangerous. But RSV can be especially tricky for infants and children.

Mora, a volunteer medical spokesperson for the American Lung Association, says it’s important for parents, caregivers and daycare that workers know what to look out for with RSV, which stands for respiratory syncytial virus. This way they know whether a sick child can be cared for at home or needs to be hospitalized.

« The emergency department is completely inundated with all these sick children, so we want parents to know that they can go to their pediatrician and get tested for RSV, the flu, and even Covid-19, » Mora said. .

Here’s what else parents need to know about the rise in respiratory disease.

For many, RSV causes a mild illness that can be managed at home.

On average, an infection lasts from five days to a few weeks, and it will often go away on its own, says the CDC. Sometimes the cough can persist for up to four weeks, pediatricians say.

Symptoms may resemble a cold: runny nose, decreased appetite, coughing, sneezing, fever and wheezing. Young infants may only seem irritable or lethargic and have trouble breathing.

Not all children will have all of the potential symptoms of RSV.

« Fevers are really random with RSV infections, especially in young infants, » said Dr. Priya Soni, assistant professor of pediatric infectious diseases at Cedars Sinai Medical Center.

Parents should watch for any changes in behavior, she said, including taking longer to eat or not showing any interest in food at all. The child may also develop severe coughing and wheezing.

It’s also important to watch for signs that your child is having trouble breathing or breathing with their ribs or stomach – « symptoms that can sort of overlap with many other viruses that we’re seeing a resurgence of, » Soni added.

Since it is not easy for parents to tell the difference between respiratory diseases like, for example, RSV and influenza, it is good to take a sick child to a pediatrician, who can carry out tests to determine this. the cause.

« You may need to bring your baby in for evaluation as soon as possible, » Soni said.

Regarding RSV, parents should be especially careful if their children are premature babies, newborns, children with weakened immune systems or neuromuscular disorders, and those under 2 years of age with lung and heart disease. chronicles, according to the CDC.

« Parents should be very alert to any changes, such as in their activity and appetite, and then pay close attention to any signs of respiratory distress, » Soni said.

Testing is important because treatment for things like flu and Covid-19 can differ.

There is no antiviral or specific treatment for RSV like there is for the flu, nor a vaccine. But if your child is sick, there are things you can do to help.

Fever and pain can be managed with non-aspirin pain relievers like acetaminophen or ibuprofen. Also, make sure your child drinks enough fluids.

« RSV can make children very dehydrated, especially when they’re not eating or drinking, especially when it comes to infants, » Mora said. « Once they stop eating or their urine output has decreased, they don’t have as many wet diapers, that’s a sign they may need to go to the pediatrician or the ER. »

Talk to your pediatrician before giving your child over-the-counter cold medicines, which can sometimes contain ingredients that are not good for children.

Your pediatrician will check the child’s respiratory rate – how fast he is breathing – and their oxygen levels. If your child is very ill or at high risk of serious illness, the doctor may request that he be hospitalized.

« RSV can be very dangerous for some young infants and young children, especially those under the age of 2, » Soni said.

Mora said labored breathing is a sign that a child is having trouble with this virus. RSV can develop into more serious illnesses such as bronchiolitis or pneumonia, which can lead to respiratory failure.

If you see a child’s chest moving up and down when they breathe, their cough won’t let them sleep, or the situation is getting worse, « it could be a sign they need to seek help. their pediatrician or take them to the emergency department, because then they might need supplemental oxygen, or they might need nebulizer therapy.

CNN medical analyst Dr. Leana Wen says this difficulty breathing — including a bobbing head, flaring nose, or grunting — is one of the two main signs of trouble with any respiratory infection. The other is dehydration. “This especially applies to babies with stuffy noses. They may not be feeding.

Much of the care provided by hospital staff will involve helping with breathing.

“We provide support for RSV and these children with oxygen, intravenous fluids and respiratory therapies, including suctioning,” Soni said.

A thin tube may need to be inserted into their lungs to remove the mucus. A child can get extra oxygen through a mask or tube that attaches to their nose. Some children may need to use an oxygen tent. Those who struggle a lot may need a ventilator.

Some babies may also need to be fed by tube.

Doctors say the best way to prevent RSV infections is to teach children to cough and sneeze into a tissue or their elbows rather than their hands. Also try to keep frequently touched surfaces clean.

If a caregiver or older sibling is sick, Mora says, they should wear a mask around others and wash their hands frequently.

And above all, if someone is sick – child or adult – they must stay at home so as not to spread the disease.

Monoclonal antibody therapy is available for children most at risk for severe disease. It’s not available to everyone, but it can protect those who are most vulnerable. It comes in the form of an injection that a child can receive each month during the typical RSV season. Ask your doctor if your child is eligible.

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