RSV

1 What is Respiratory Syncytial Virus (RSV)?

A virus that is commonly affecting children by age 2 that causes infections of the lungs and respiratory tract is called Respiratory syncytial virus (RSV). Although RSV is most common to children, the virus can still affect adults.

The symptoms of respiratory syncytial virus are mild and typically mimic the common cold both for adults and children. Hence, to relieve the discomfort only self-care measures are being recommended instead of medication.

In premature babies and infants with underlying medical conditions, infection with respiratory syncytial virus can be life-threatening.

This is also true for adults especially those with existing heart and lung diseases or anyone who is immunocompromised or with a very weak immune system.

2 Symptoms

The incubation period of the respiratory syncytial virus (RSV) is about four to six days after exposure to the virus hence signs and symptoms starts to appear.

In adults and older children, RSV manifest as mild cold-like symptoms which include:

In severe cases which normal affects infants, pneumonia or bronchiolitis may develop due to the respiratory syncytial virus, this is an inflammation of the small airway passages entering the lungs.

Signs and symptoms may include: fever, severe cough and wheezing which is a high-pitched noise that's usually heard on breathing out (exhaling), rapid breathing or difficulty breathing, which may make the child prefer to sit up rather than lie down and bluish color of the skin due to lack of oxygen (cyanosis).

Infants severely affected by RSV may appear, markedly draw in their chest muscles and the skin between their ribs, indicating that they're having trouble breathing with short, shallow and rapid breathes.

Coughing may be observed or they may show few, if any, signs of a respiratory tract infection, but will eat poorly and be unusually lethargic and irritable.

Recovery time for most children and adults happen in one to two weeks but in young babies, infants born prematurely or infants or adults who have chronic heart or existing lung problems, the virus may cause a more severe and life-threatening condition which requires hospitalization.

Be aware of the signs and symptoms of RSV infection especially for mild and severe cases. Immediate contact your health care provider if your child or anyone is at risk of having severe disease and is experiencing difficulty breathing, runs a high fever or turns blue, particularly on the nail beds and lips as this signify decreased oxygenation which is life-threatening.

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3 Causes

Occurrence of respiratory syncytial virus (RSV) is caused by bodily contact with the virus.

Respiratory syncytial virus can spread in a number of ways especially through bodily fluids. As an infected person can spread the virus in the first few days after infection and up to a few weeks after the start of infection.

A person infected with Respiratory Syncytial Virus is contagious and can spread the virus through eyes, nose or mouth as mode of entry to the body even with just shaking their hands after they have sneezed or coughed.

The virus can easily be passed along from person to person from direct contact to the infectious respiratory secretions, from coughing and sneezing.

The virus can also remain potent and active for hours on objects such as toys, door handles, countertops and many more. You will most likely be infected with the virus if you touch your mouth, eyes and nose after getting in contact with a contaminated object.

4 Making a Diagnosis

Immediate medical attention for you or your child is important once signs and symptoms of respiratory syncytial virus (RSV) appear in order to receive a diagnosis. To be able to maximize the time spent with your health care provider make necessary preparations prior to your doctor’s appointment.

First, make a list of all the signs and symptoms you or your child is experiencing including all those that you feel are unrelated to upper respiratory infection and when the symptoms started. Be prepared to disclose medical information to the doctor such as underlying heart and lung problems and if the child was born prematurely.

Here are some common questions related to understanding respiratory syncytial virus as having a better understanding of the condition can help you deal with the disease and treatment:

  • What is likely causing these symptoms?
  • Are there other possible causes?
  • What tests might be needed?
  • How long do symptoms usually last?
  • What is the best course of action?
  • Will I or my child need to take medication?
  • If you're prescribing a brand-name medication, is there a generic alternative?
  • What can I do to make my child feel better?
  • Are there any brochures or other printed material that I can take home with me?
  • What websites do you recommend visiting?
  • To what extent should I isolate my child while infected?

You can also write down details about potential exposures, note where might your child or you have been exposed to respiratory infections, such as at school or work.

Having enough knowledge about the virus and the condition will help you better adjust with the treatment plan.

Be prepared to answer questions from the doctor as well as part of their assessment and completion of your or your child’s medical history. Your doctor may ask:

  • When did you first notice symptoms?
  • Have symptoms been continuous or occasional?
  • How severe are your or your child's symptoms?
  • What, if anything, seems to improve symptoms?
  • What, if anything, appears to worsen symptoms?
  • Is anyone else in the family ill?
  • What symptoms does he or she have?

Based on the results of the physical exam as well as your answer to the possible exposure to respiratory infections and time of the year, the doctor might suspect an infection caused by respiratory syncytial virus.

Auscultation of the lungs, use of stethoscope, to listen for wheezing or other abnormal breathing sounds will be performed during physical exam. Also, to check the oxygen level in the bloodstream, whether the level of oxygen available in the bloodstream is lower than usual, and the doctor might use a pulse oximetry which is a painless skin monitor.

Blood tests would have to be run to check the white blood cell counts and look for the presence of a viral, bacterial infection or other organisms.

Chest x-ray will also be beneficial to check for pneumonia. Respiratory secretions from your nose will also be cultured to check for the presence of the virus.

Some minor remedies that you can do to alleviate the child’s discomfort from fever is to give acetaminophen (Tylenol, others), also keep the child hydrated aat all times by drinking plenty of fluid will also help.

Lastly, to help relieve congestion keep the child in an upright position and use an air moist with humidifier.

5 Treatment

Mild infection from respiratory syncytial virus will most likely be treated with supportive care or self-care measures which aims to alleviate symptoms experienced especially by the child. But in severe cases, hospitalization is necessary.

Support care or outpatient treatment for mild cases may involve: administration of over-the-counter medication such as acetaminophen (Tylenol, others) to relieve fever, if the patient has been diagnosed with bacterial complication such as bacterial pneumonia then antibiotics will be prescribed by the doctor.

Mainly, be observant of what the child is feeling and be sensitive to reliving discomfort. Make sure to watch out for signs of dehydration, such as dry mouth, little to no urine output, sunken eyes and extreme fussiness or sleepiness, so keep the child hydrated by periodically offering plenty of fluids.

Meanwhile, hospital care is needed for severe RSV infections as intravenous (IV) fluids and humidified oxygen would need to be administered.

A mechanical ventilator, breathing machine, can help ease breathing for hospitalized infants and children. In some severe cases to relieve wheezing, a nebulized bronchodilator such as albuterol (ProAir HFA, Proventil-HFA, Ventolin HFA) might be given as this medication opens air passages in the lungs by administering a fine mist upon breathing.

In some instance, a nebulized bronchodilator such as albuterol (ProAir HFA, Proventil-HFA, Ventolin HFA). Depending on the presentation of some symptoms of the RSV infection, the doctor might also recommend an injection of epinephrine or a form of epinephrine that can be inhaled through a nebulizer which is called racemic epinephrine.

6 Prevention

As of this time, there is no available vaccine to prevent the infection from respiratory syncytial virus (RSV). Scientists are working to find a vaccine against the respiratory syncytial virus not only in infants but also in older adults and high-risk adults.

Understanding how the virus is caught and easily spread is the best way to make sure that you and your child can have the necessary precautions to prevent from being infected with RSV.

Since the mode of entry is from direct contact with the infected respiratory secretions, make sure that frequent hand washing is done especially before touching the baby as well as teaching your child the importance of hand washing before taking their mouth, eyes and nose.

Be aware of your surroundings and avoid getting in contact with people who has upper respiratory infections as manifested with fever, colds and cough, especially when you are with your infant or young children since their immune system is not yet fully developed specifically for infants born prematurely.

Make it a habit to regularly clean countertops in the bathroom and kitchen, furniture and equipment, as well as doorknobs, if someone in the house has a cold.

Also, wash toys regularly especially if your child’s playmate is sick. Right away discard used tissues and wash used towels or handkerchiefs.

Use your own glass or disposable cups when you or someone is sick and avoid sharing drinking glasses with others, it might even be helpful to label person’s cup.

Do not smoke, as infants exposed to tobacco smoke have a higher risk of developing RSV and potentially have more-severe symptoms. If smoking can’t be avoided, then do so outside the house and car and not near an infant or a young child.

Children under age of 2 who are at high risk of serious complications when they get RSV, such as in the case of pre-mature infants or with underlying congenital heart or lung disease, a protective medication which is palivizumab (Synagis) can be given.

Although, this medication will no longer have an effect or be of value as treatment if the child has already developed the respiratory syncytial virus infection.

7 Alternative and Homeopathic Remedies

The two main homeopathic remedies for respiratory syncytial virus (RSV) are Ipecacuanha and Antimonium Tartaricum that can cover most of the symptoms of RSV.

8 Lifestyle and Coping

A child infected with respiratory syncytial virus will not be able to cope on their own. The discomfort from the different symptoms will be felt for a duration of time without proper guidance and care from their parents or primary caregiver.

Always be observant of what the child is experiencing and offer relief based on the presented symptoms as discomfort and anxiety will be mostly felt by the child which would cause them to be irritable as well, hence focus on alleviate the discomfort and offer a means of distraction such as playing a quiet game with the child, frequently cuddle, read a book and even do art works.

Other things that can be done to help the child relieve symptoms of the infection are as follow: sitting upright makes breathing easier hence keep your child in an upright position, placing your infant in a car seat may even help.

When sleeping, place your infant on his or her back on a firm mattress as usual, but elevate the head of the mattress about 3 inches (7.6 centimeters) with an object underneath the mattress.

Second is to create moist air by keeping your room or your child's room warm but not overheated. If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing. Be sure to keep the humidifier clean, to prevent the growth of bacteria and molds. An ideal indoor humidity is around 50 percent.

Third is increase the child’s fluid intake by encouraging your child to drink fluids frequently. Always have a cool water at the bedside to make it readily available, and offer warm fluids, such as soup, which may help loosen thickened secretions. Ice pops may be soothing as well. Also, continue breast-feeding or bottle-feeding your infant as you would normally do and try saline nasal drops as it offers some comfort for congestion.

Fourth is the use of Over-the-counter (OTC) drops which are a safe and offer effective ways to ease congestion, even for young children. Do this before feedings and before putting your baby down to sleep. Drip several drops into one nostril to loosen hardened or thick mucus, then immediately suction that nostril, using a bulb syringe. Repeat the process in the other nostril.

Fifth is to use Over-the-counter pain relievers such as acetaminophen (Tylenol, others) which may help reduce fever, relieve a sore throat and improve ability to drink fluids. Keep in mind that before purchasing or even using over-the-counter medications, always check with your doctor first about age appropriate use and doses especially for infants and younger children.

Lastly is to eliminate factors that can aggravate the symptoms such as being exposed to cigarette smoking.

9 Risks and Complications

There are several risks associated with respiratory syncytial virus (RSV).

Being aware of the risks and complications of respiratory syncytial virus (RSV) infection can help in limiting and even avoiding exposure to the virus.

RSV infection can become recurring and prevalent to younger children especially those attending day care centers or who have siblings who attend school.

Typically the beginning of fall and end of spring is considered the peak RSV season as it has been observed that susceptibility to this infection is greater at this time.

People that are at a greater risk of developing severe and life-threatening RSV infections include: Infants younger than 6 months of age and younger children, especially under 1 year of age, who were born with an underlying congenital condition such as a heart or lung disease as well as children who were born prematurely.

Also, children who are immunocompromised or with weakened immune systems, such as those undergoing chemotherapy or transplantation, congestive heart failure or chronic obstructive pulmonary disease, people with immunodeficiency including those with certain transplanted organs, leukemia or HIV/AIDS, infants in crowded child care settings and even older adults with asthma.

Hospitalization is required when the RSV infection is causing severe illness, so that the doctors can monitor and treat breathing problems and give intravenous (IV) fluids.

Most at risk of hospitalization are babies younger than 6 months old, babies who are born prematurely, and babies with congenital heart or lung disease.

Common complications that arise from respiratory syncytial virus infection include:

(a) Asthma. There may be a link between severe respiratory syncytial virus and the chance of developing asthma later in life as recurring infections is common once you've been infected with the virus, usually in the form of a common cold.

(b) Middle ear infection. When microorganisms infiltrate the space behind the eardrum, a middle ear infection (otitis media) can result. This happens most frequently in infants and young children.

(c) Pneumonia or bronchiolitis. When the respiratory syncytial virus moves from your upper respiratory tract to your lower respiratory tract, inflammation of the lungs (pneumonia) or the lungs' airways (bronchiolitis) can result.

This complication can be quite serious in infants, young children, immunocompromised individuals, or people with chronic heart or lung disease.

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