Respiratory Syncytial Virus (RSV) in Children

RSVis
a viral illness that causes symptoms such as trouble breathing. It’s
the most common cause of inflammation of the small airways in the lungs (bronchiolitis)
and pneumonia in babies.

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.

A child is more at risk for RSV if
he or she is around other people with the virus. RSV often occurs in yearly outbreaks in
communities, classrooms, and childcare centers. RSV is more common in winter and early
spring months.

RSV can affect a person of any
age but causes the
most problems for the very young and very old. Most babies have been
infected at least once by the time they are 2 years old. Babies can also be reinfected
with the virus. Infection can happen again anytime throughout life. RSV infection in
older children and adults may seem like an episode of severe asthma. Babies born
prematurely or with heart, lung, or immune system diseases are at increased risk for
more severe illness.

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

The early phase of RSV in babies
and young children is often mild, like a cold. In children younger than age 3, the
illness may move into the lungs and cause coughing and wheezing. 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.

The most common symptoms of RSV
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 

The symptoms of RSV can
seem
like other health conditions. Make sure your child sees his or her healthcare provider
for a diagnosis.

The healthcare provider will ask about your child’s symptoms and
health history. He or she may also ask about any recent illness in your family or other
children in childcare or school. He or she will give your child a physical exam. Your
child may also have tests, such as a nasal swab or wash. This is a painless test to look
for the virus in fluid from the nose.

Treatment will depend on your
child’s symptoms, age, and general health. It will also depend on how severe the
condition is.

Antibiotics are not used to treat
RSV. Treatment for RSV is done to help ease symptoms. Treatment 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.
  • Oxygen. This
    is extra oxygen given through a mask, nasal prongs, or an oxygen tent.
  • Suctioning of mucus.  A thin tube is
    put into the lungs to remove extra mucus.
  • 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.

Talk with your child’s healthcare
providers about the risks, benefits, and possible side effects of all treatments.

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

The American Academy of Pediatrics
(AAP) recommends that babies at high risk for RSV get a medicine called palivizumab. Ask
your child’s healthcare provider if your child is at high risk for RSV. If so, ask about
monthly injections during RSV season to help prevent infection.

To reduce the risk for RSV, the AAP
recommends all babies, especially preterm infants:

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

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms

  • RSV is a viral illness that causes
    trouble breathing. It is more common in winter and early spring months.
  • Most babies have been infected at
    least once by the time they are 2 years old. Babies can also be re-infected with the
    virus. Infection can happen again anytime throughout life.
  • Treatment for RSV may include extra
    oxygen. This is extra oxygen given through a mask, nasal prongs, or an oxygen tent. A
    child who is very ill may need to be put on a breathing machine (ventilator) to help
    with breathing
  • In high-risk babies, RSV can lead to
    severe respiratory illness and pneumonia. This may become life-threatening. RSV as a
    baby may be linked to asthma later in childhood.
  • Babies at high risk for RSV receive a
    medicine called palivizumab. Ask your child’s healthcare provider if your child is at
    high risk for RSV.

Tips to help you get the most from
a visit to your child’s healthcare provider:

  • Know the reason for the visit and what
    you want to happen.
  • Before your visit, write down
    questions you want answered.
  • At the visit, write down the name of a
    new diagnosis, and any new medicines, treatments, or tests. Also write down any new
    instructions your provider gives you for your child.
  • Know why a new medicine or treatment
    is prescribed and how it will help your child. Also know what the side effects
    are.
  • Ask if your child’s condition can be
    treated in other ways.
  • Know why a test or procedure is
    recommended and what the results could mean.
  • Know what to expect if your child does
    not take the medicine or have the test or procedure.
  • If your child has a follow-up
    appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s
    provider after office hours. This is important if your child becomes ill and you have
    questions or need advice.