RSV: Protecting Your Baby During Cold And Flu Season

Runny nose, fever and a cough. For some it may be a sign of a nagging cold, COVID-19 or maybe the flu. But those symptoms also could stem from RSV, which can put young children and seniors especially at risk.

RSV, which stands for respiratory syncytial virus, is a viral illness that causes symptoms such as trouble breathing. It can cause inflammation of the small airways in the lungs (bronchiolitis) and pneumonia in babies.

The highly contagious virus affects the nose, throat and lungs. In most people, RSV causes cough, runny nose and sometimes a fever. Symptoms usually last seven to 10 days, but some kids develop a cough that takes up to six weeks to clear.

Read on for common questions about RSV and how to protect small children and infants during RSV season.

How Is RSV Different From Cold Or Flu?

"RSV is one of many viruses that cause upper respiratory infection or cold symptoms,"  said Lisa Gold, MD, pediatrician at Franciscan Physician Network Crown Point Pediatric Health Center. "It can cause significant symptoms of upper respiratory infection (URI) and more concerning lower respiratory infection."

RSV symptoms start about 2 to 5 days after contact with the virus.

In most people, RSV causes nothing more than cold-like misery, such as a runny nose and cough. But it can trigger serious lung infections in babies, especially preemies, and young children with certain medical conditions.

RSV is the most common cause of pneumonia in babies younger than 1, according to the U.S. Centers for Disease Control and Prevention. It's also behind most cases of bronchiolitis, where the small airways of the lungs become inflamed.

"In older children, it causes symptoms like the common cold," said Brittani Corbisiero, DO, pediatric hospitalist at Franciscan Health Indianapolis. "It can be more dangerous in young infants, causing severe respiratory illness that may require hospitalization." 

When RSV gets deep into the lungs, youngsters can struggle to breathe and may need to be hospitalized to receive oxygen and fluids.

What Are The Symptoms Of RSV?

Many of the symptoms of RSV are similar to signs of colds or the flu. In the beginning RSV presents with the humdrum signs of colds, flu or COVID: runny nose, congestion, coughing and fever. Diarrhea, a lack of appetite and headaches can also appear. RSV symptoms include:

• Runny nose
• Fever
• Cough
• Short periods without breathing (apnea)
• Trouble eating, drinking, or swallowing
• Wheezing
• Flaring of the nostrils or straining of the chest or stomach while breathing
• Breathing faster than usual, or trouble breathing
• Turning blue around the lips and fingertips

"When a child has an RSV infection they cough often and can have difficulty breathing," Dr. Gold said. "They can have stridor (a harsh noise on breathing in) or wheeze. The can difficulty breathing such as fast breathing or working to breathe, such as using belly muscles to breathe or retracting."

In some children, the infection turns to a severe respiratory disease. Your child may need to be treated in the hospital to help with breathing.

When Should I Call My Doctor About Possible RSV?

According to the American Academic of Pediatrics, almost all youngsters recover from RSV on their own. But if a baby is wheezing or showing other signs of labored breathing, parents should call their  doctor. Your child may have tests, such as a nasal swab or wash. This is a painless test to look for the virus in fluid from the nose.

"We know this virus and created testing for rapid detection because the RSV virus is one to make young children and infants very sick," Dr. Gold said.

Your child may also be tested for COVID-19, which can have similar symptoms.

Should I Take My Baby To The Hospital With RSV?

You should take your child to the hospital for RSV if your child's doctor instructs you to do so, Dr. Gold said.

"Reasons to go to the hospital instead of an outpatient visit would be signs of dehydration with the sick child or significant wheezing or work of breathing and no response to nebulized treatment," she explained.

How Is RSV Treated?

Most kids can recover from RSV at home. There is no medicine to treat the virus, but there are several ways to ease symptoms.

For a stuffy nose, use a saline spray and a bulb to suction out the mucus. A humidifier may help soothe respiratory passages. If your older child is coughing a lot, prop his or her head with a pillow.

Other treatments for more severe cases of RSV may include:

• More fluids. It's very important to make sure your child drinks plenty of fluids. If needed, your child will get an intravenous (IV) line to give fluids and electrolytes. "If an infant or child needs to be hospitalized many times IV fluid is an important treatment as dehydration can occur due to the illness," Dr. Gold said.
• Oxygen. This is extra oxygen given through a mask, nasal prongs, or an oxygen tent.
• Bronchodilator medicines. These may be used to open your child's airways. They are often given in an aerosol mist by a mask or through an inhaler.
• Tube feeding. This may be done if a baby has trouble sucking. A thin tube is put through the baby's nose and down into the stomach. Liquid nutrition is sent through the tube.
• Mechanical ventilation. A child who is very ill may need to be put on a breathing machine (ventilator) to help with breathing.
• Antivirals. Some children with severe infections may need treatment with an antiviral medicines.

Why Are Young Children Under 2 At Higher Risk Of RSV?

Children under 2 have airways that are smaller than in an older child or adult. Risk factors for RSV are being born prematurely or born with a heart defect or lung disease.

Why Does RSV Cause Severe Illness In Some Babies?

Most babies have been infected by RSV at least once by the time they are 2 years old, and infection can happen again anytime throughout life. Babies born prematurely or with heart, lung, or immune system diseases are at increased risk for more severe illness.

"Research is showing there is a potential genetic predisposition to severe RSV disease in some children," Dr. Gold explained.

For smaller children, particularly babies under the age of 2 or preemies, airways are smaller than an older child, putting them at greater risk for RSV.

"Children's airways are smaller than adults and their immune system is more susceptible since they have not been exposed to viruses that cause upper respiratory infections," Dr. Gold said. "The RSV virus causes immune system reaction in the tubes that bring air to the lung tissue that leads to airway obstruction, air trapping and increased airway resistance."

What Puts Babies At Greater Risk Of RSV Than Adults?

"Adults have many years of cumulative exposure to give them immune protection against the RSV virus."

RSV infection in older children and adults may seem like an episode of severe asthma.

"We adults can have an upper respiratory infection that is due to RSV, but we usually don't get very sick," Dr. Gold said.

What Are Possible Complications Of RSV In A Child?

RSV can lead to severe breathing illness, apnea and pneumonia. This may become life-threatening. RSV as a baby may be linked to asthma later in childhood.

When Is RSV Season?

RSV is a common virus during the fall and winter months. 

How Can I Help Prevent RSV In My Baby?

To reduce your baby's risk for RSV, the American Academy of Pediatrics recommends all babies:

• Be breastfed
• Be protected from contact with smoke
• Not go to childcare with lots of children during their first winter season
• Avoid contact with sick people

Also make sure that household members wash their hands or use an alcohol-based hand cleaner before and after touching a baby with RSV. Hand sanitizers are better than nothing, but soap and water is the best, Dr. Gold said.

"The best thing to do to prevent RSV is repeated handwashing and covering coughs and sneezes with the elbow technique," she said. "The virus stays on a surface for up to 2 hours."

Babies at high risk for RSV may receive a monthly injection of a medicine called palivizumab during RSV season to prevent infection. If your child is at high risk for RSV, ask your child's healthcare provider if this would be appropriate for your child. during RSV season to help prevent infection. There is no vaccine to prevent RSV infection yet, but scientists are working hard to develop one.

Is There An RSV Vaccine?

A new vaccine for RSV has been approved last year. According to a study published in the New England Journal of Medicine, the RSV vaccine is 82% effective in protecting newborns from hospitalization with a respiratory infection if an expectant mother receives it in her second or third trimester.

Are There Medications To Prevent RSV?

There are now medications approved to help prevent severe infections in certain high-risk youngsters: an injection medication called palivizumab and a long-acting drug called Beyfortus for the prevention of RSV in newborns and infants born during or entering their first RSV season.

The drug also is approved in children up to 2 years old who remain vulnerable to severe RSV disease through their second RSV season.

"There is a newer medication, Beyfortus, recommended by the CDC for all infants entering their first viral season," Dr.Corbisiero said. "Beyfortus helps prevent serious illness from RSV in infants less than 8 months of age." 

How Can We Limit RSV Exposure?

Like many viruses, RSV is spread when a child comes into contact with fluid from an infected person's nose or mouth. This can happen if a child touches a contaminated surface and touches his or her eyes, mouth, or nose. It may also happen when inhaling droplets from an infected person's sneeze or cough.

"We want people who are sick, just with a basic cold, to not be around an infant, especially one with risk factors," Dr. Gold said. "I have seen parents of children with RSV this season where the parent has chills, high fever, runny nose and cough and just feel tired and awful; they likely have the RSV virus too."

Reducing exposure to the RSV virus is the best way to protect your child, Dr. Gold said. If you are around young children, older adults or people with chronic heart or lung disease or weakened immune systems, take extra care to stay healthy.

"Avoid being around others with upper respiratory infections," Dr. Gold said. "It is impossible to avoid all virus illnesses, but if you can avoid large groups or big gatherings with kids during peak hours of use, the better."

If a family member is sick, take these precautions to reduce the spread of viruses within your home.

• Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands.
• Wash your hands often with soap and water.
• Avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others.
• Avoid touching your face with unwashed hands.
• Clean and disinfect surfaces.

HealthDay News contributed information to this article.