The ABCs of RSV

Parents need to know that, sometimes, seasonal sniffles mean more than just a cold. Respiratory syncytial virus (RSV) is a common virus that usually causes cold-like symptoms in adults and children. But for some babies, especially those born premature or susceptible to other risk factors, RSV can be very serious.

All About RSV

RSV is very common, with virtually all babies contracting it at least once by the age of two. RSV infects the upper respiratory system with symptoms similar to a common cold or influenza. It is the leading cause of hospitalization of children under the age of one and accounts for more than 55,000 hospitalizations of children under 5 in the United States annually.

RSV recurs yearly throughout the world and can be contracted more than once over a person’s lifetime. In most of North America, the typical RSV season begins in October/November and lasts four to five months.

RSV In Tulsa

According to Dr. Amanda Foster, Clinical Professor of Pediatrics at OSU Medicine Pediatrics, RSV began to rise in December in Tulsa, and Tulsa pediatricians are busy with admissions of children with RSV. She says that the timing of the start of the RSV season coincides with the rise of other respiratory illnesses as well, such as influenza, keeping OSU Medicine pediatricians busy caring for children in and out of the hospital.

Babies Who Are Most At-Risk

All babies are at risk for contracting RSV, particularly within the first six months of life. Babies born premature (earlier than 37 weeks) are particularly vulnerable to contracting RSV because they generally have underdeveloped lungs and lack important antibodies they need to fight off infections.

Additional factors, such as low birth weight (less than 5.5 pounds), age less than six months, contact with other children, exposure to crowds and exposure to tobacco smoke, also put babies at high risk for contracting RSV.

Preemies and babies suffering from lung disease, heart disease or immune deficiency should be watched more closely for a longer period of time because RSV can lead to life-threatening lower respiratory tract infections, including bronchiolitis or pneumonia.

What To Look For

Common symptoms of RSV include typical cold symptoms, such as fever, cough, nasal congestion or runny nose. Possible signs of a more serious infection that may require a trip to the emergency room include a severe persistent cough, wheezing, rapid breathing, retractions (when the skin between ribs pulls in with breaths), apnea (if the baby stops breathing), turning blue or breathing so fast that you can’t feed the baby.

Foster recommends that parents contact their physician if their infant is less than two months of age with symptoms of RSV and/or fever, at high risk with symptoms of RSV, or if their infant/child is unable to drink sufficient fluids.

If your child does get RSV, most cases last 7-14 days, although the cough can persist for a few weeks.

Caring For Your Baby

Prevention is the key to helping your baby stay healthy. RSV lives on surfaces like countertops and in tissues for up to several hours and is easily transferred through direct contact, especially from the hands to the baby. Keep other children and adults who have coughs, colds or are sneezing away from your baby. Additionally, frequently clean your baby’s bedding, toys and personal items, and anyone handling your baby should wash his/her hands or use antibacterial gels.

If your baby has nasal congestion or a runny nose, a few drops of nasal saline can be used in nostrils to thin secretions, and a nasal suction bulb can be used to clear secretions from the nasal pasages as needed. Ensure your baby is receiving enough fluids and continuing to have wet diapers.

Tips For Protecting Your Baby

Parents should remember the following during RSV season and beyond:

• Check with your pediatrician to see if your baby is at a higher risk for RSV. Some high risk patients qualify for a passive immunization for RSV available through the pediatrician’s office.
• Ask visitors to wash their hands before touching your baby (and keep hand sanitizer nearby).
• Limit your baby’s exposure to small children who attend daycare or school.
• Monitor your baby for persistent coughing, wheezing or difficulty breathing, and seek a pediatrician’s care if symptoms develop.
• Monitor your baby for persistent coughing, wheezing or difficulty breathing, and seek a pediatrician’s care if symptoms develop.
• Remember that you know your baby best. If you are at all concerned, call your pediatrician.

Foster says that the best way parents can protect their child from RSV is good hand washing. If the child has siblings, parents should teach them good hand-washing techniques and encourage frequent washing. They should also try to discourage older siblings from touching the infant’s face and wipe the infant’s hands routinely.

Also, Foster says that parents can do their best to minimize exposure by avoiding contact with people who are ill, children who attend school or daycare, and avoiding crowds.

This article was originally published in TulsaKids’ May 2009 issue. It was written by Phyllis Dennery, Professor Of Pediatrics/Chief Division of Neonatology at the University Of Pennsylvania/Childrens Hospital of Philadelphia. It was updated in Jan. 2018 and Jan. 2020 by and with the help of Amanda Foster, D.O.

Dr. Foster is the Clinical Professor and Interim Department Chair of Pediatrics at OSU Medicine Pediatrics. She practices at The OSU Medicine Pediatrics Clinic.