Doc Talk: Respiratory Syncytial Virus or RSV

In our weekly feature, 'Doc Talk' we're learning more about a concerning virus for Valley Kids.

Pediatric Emergency doctor, Clint Pollack from Valley Children's Hospital talks about the dangers of RSV.

What is RSV and what causes it?

- Causes viral respiratory infections, especially during the fall and winter months.
- Usually peaks in January/February.
- Most common cause of lower respiratory (lung) infections in infants.
- Infection is spread the same way as a common cold virus, by contact with secretions or inhalation of droplets.

What kids are at a higher risk for serious cases?

- Usually takes about 4-6 days to develop symptoms after exposure.
- Children at higher risk for more serious infections include
- Infants younger than six-months-old

- Children with significant asthma
- Infants and children with underlying lung disease, such as chronic lung disease, or congenital heart disease
- Premature infants born before 35 weeks gestation
- Infants exposed to secondhand smoke
- Children with Down syndrome
- Immunocompromised patients (severe combined immunodeficiency, leukemia, or organ transplant)

What are the symptoms?

- Symptoms include cough, wheeze, fever, copious nasal secretions, and difficulty breathing.
- RSV can cause severe lung infections, especially in younger infants, with bronchiolitis, pneumonia, or respiratory failure.

- RSV can cause infants to stop breathing (apnea), especially very young or premature infants.

How is it diagnosed and treated?

- There is a test for RSV, done with a nasal swab, but diagnosis of RSV is usually based on clinical signs and symptoms. Testing is only done when the results will affect management.
- The treatment for RSV is supportive care, similar to a common URI: nasal suctioning, humidified air, medicine for fever, and good hydration.
- There is an antiviral medicine for RSV, but it is only recommended for immunocompromised or extremely ill patients.
- Antibiotics, inhaled albuterol, and steroids are not recommended.
- Cough medicines and decongestants should never be given to infants as they have never been proven to help and can have serious or fatal side effects.
- Children with mild cold symptoms can be managed supportively at home and do not need to see a doctor.
- Infants with more severe symptoms (difficulty breathing, increased work of breathing, shortness of breath, pale, dusky, lethargic, unable to feed, dehydrated) should be seen by a doctor urgently.
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