A Seasonal Illness Affecting Children

Respiratory syncytial virus (RSV) is a highly contagious seasonal viral infection of the lungs. It is the leading cause of bronchitis and pneumonia. Anyone can become infected with RSV, but very young children and older adults with other underlying health conditions are at the greatest risk of serious complications from an infection. The CDC estimates that approximately 57,000 children under the age of 5 years in the United States are hospitalized due to RSV. The season starts in mid-September and continues through mid-May. It differs in length and severity every year and by region. Florida has the longest season for RSV infection in the U.S. 

Severe Infection Causes Bronchitis, Pneumonia

RSV is considered to be a serious children’s virus. This is because severe infection in children can lead to the development of bronchitis and pneumonia, and ultimately, hospitalization. Among children, up to 90% of bronchitis hospitalizations and 40% of pneumonia hospitalizations are due to RSV. Premature infants and children with heart or lung disease are at highest risk of developing severe complications of the disease. Globally, RSV is one of the leading causes of death for children younger  than age 1 year.

RSV is spread from person to person via close personal contact. Secretions released when coughing, talking, or sneezing carry the virus and spread it to others directly or from touching hard surfaces like telephones, computers, and door knobs. Those infected with RSV are contagious for 3 to 8 days. Some people, especially young children with compromised immune systems, can continue to spread the virus for up to 4 weeks.

Symptoms start within 2 to 8 days of exposure and resemble those of the common cold, including stuffy, runny nose, sore throat, fever, and cough. When the virus spreads to the lower respiratory tract, the coughing intensifies and is accompanied by wheezing due to inflammation of the lungs’ small airways. Symptoms in infants can appear differently than in older children and adults. Infants with severe RSV may have a loss of appetite, low energy, and short, shallow, and rapid breathing. Their mouth, lips, and fingernails may turn a bluish color due to lack of oxygen.

A physician will use medical history, time of year, and physical exam to determine likely infection with RSV. Less commonly, the doctor may run laboratory tests to confirm the diagnosis. The most common is a mouth swab or a blood test to check white blood cell counts and look for viruses. With severe infections requiring hospitalization, additional testing may be needed. Imaging tests, such as a chest x-ray or CT scan, can check for pneumonia. Blood and urine tests may be necessary when infants are very sick, as RSV-related bronchiolitis can occur with a urinary tract infection in newborns.

No Vaccine Available to Prevent Infection

Most RSV infections will resolve within a week or two without treatment. OTC medications to reduce fever and inflammation, such as acetaminophen and ibuprofen, are used to manage symptoms. Children under the age of 18 years should not be given aspirin because it has been linked to a serious illness called Reye syndrome. RSV is a virus, so antibiotics are not an effective treatment. To date, there is no vaccine available for RSV or antiviral medication to treat the infection once it starts.

Palivizumab (Synagis) is a monthly injection approved by the FDA for the prevention of RSV in premature infants aged less than 6 months during RSV season and for children aged 2 years or younger at the start of RSV season who have lung or heart disease. Fever and rash are the most common side effects reported.

The best way to manage RSV is to adopt preventive behaviors for minimizing the spread of infection. These include washing your hands regularly; avoiding close contact with a child if you are experiencing symptoms of a cold; minimizing young children’s exposure to large groups of people during cold and flu season; and cleaning and disinfecting hard surfaces often.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.