I’m certain you have seen the headlines and heard about hospitals across the country being stretched to their brim with sick children right now. Hospitals are not only being stretched they’re bursting! RSV and other viral illnesses prevalent during this time of year seem to have taken a virulent turn this year. Thus, causing pediatric-focused healthcare providers and facilities to feel its pressure.
Let’s talk about RSV and learn how parents and guardians can help to stop or slow its spread and help children dealing with RSV feel better.
What is RSV?
Respiratory Syncytial Virus (RSV) is a common respiratory virus that affects the lungs and the smaller air passageways called bronchioles. It’s one of the most common causes of childhood illness that infects most children by the age of 2. Despite RSV being a common virus amongst infants and toddlers, older children, teens, and adults are not exempt from contracting RSV. RSV usually occurs in late fall to early spring. Symptoms can last 7-14 days. Children at the greatest risk of contracting RSV are those who were born premature or had a low birth weight, those with a weakened immune system, those with a chronic illness, children experiencing secondhand smoke, and children attending daycare.
What does RSV look like?
RSV’s common presentation is a runny nose, nasal congestion, cough, fever, and decreased appetite. Most healthy children who contract RSV will only get mild cold-like symptoms. However, some children develop more serious illnesses such as pneumonia and bronchiolitis; which in most instances require hospital admission.
Is RSV contagious?
Yes. The RSV virus is highly contagious. It’s spread through respiratory droplets that enter a host's body through the nose, mouth, or eyes. Because RSV can live on surfaces for hours, it can also be spread by touching surfaces that have been contaminated with the infected person’s respiratory secretions and by touching your nose, mouth, or eyes.
Children being in close contact with each other, and the sharing of toys and personal items such as pillows and blankets can serve as a mode of transmission of RSV.
How is RSV treated?
There is no treatment for RSV. Parents and caregivers can become angry and frustrated when bringing an ill child to their Pediatricians office and they are told that no medication will be prescribed for their child’s current condition. Because RSV is a virus, medications such as antibiotics will not do anything to lessen the symptoms of the virus or shorten the virus's course. But all is not lost, there are some things that parents and caregivers can do to help give their little ones some relief.
How can I help a child with RSV?
If I was tasked with giving only one recommendation to parents and caregivers about the management of RSV I would stress the importance of nasal suctioning. As mentioned above, one of the symptoms of RSV is a runny nose; copious, thick, and sometimes sticky. Ensuring that the child’s nasal passages are free from mucous is important to helping them breathe effectively. Tools such as a bulb syringe (this is my favorite), and the popular NoseFrida are great tools to have and use. To optimize nasal suctioning, make sure nasal saline is used. Using nasal saline while suctioning helps to loosen secretions to remove them from the nasal passages easily. Saline has health benefits as well.
I would like to mention that expelling mucous from a child’s nose using a syringe and water or with the mouth-to-mouth technique must be used with caution. These techniques, if not done properly could introduce bacteria & viruses into the child's respiratory system and may also cause harm.
Along with nasal suctioning, managing fever, maintaining adequate hydration, and ensuring that the child gets restful sleep is also important.
When should I be concerned?
Every parent or caregiver should be aware of what to look for in a child with RSV if they are not improving. The most important sign is difficulty breathing also referred to as respiratory distress. A child who displays signs of respiratory distress should immediately be seen by their Pediatrician or taken to the closest Emergency Department. Some signs of respiratory distress are noisy breathing (wheezing, stridor, grunting), increased respiratory & heart rate, color changes, nasal flaring (a puffing out of the nostrils with breathing), retractions (a sucking in of the chest or area right below the neck with breathing), excessive sweating and altered mental status. Also, a child refusing to eat or drink even if offered small portions should be a red flag.
Discolored nasal drainage, should I be worried?
Despite most people's belief, yellow or green nasal drainage does not always indicate that a person has an infection. Upon waking, those who deal with allergies or any sort of upper respiratory virus may have yellow, dark yellow, or even green nasal discharge. This is the body’s normal immune response to what’s going on. You should applaud your immune system for doing its job!
I’m sure you’ve guessed it. Red specks in nasal discharge may indicate a ruptured blood vessel in the nasal passages or nasal trauma due to suctioning, or forceful nose blowing. Brown specks in nasal discharge may be a result of old blood existing in the nasal passages.
If the appearance of the nasal discharge is yellow, green, red, or brown immediately after waking or intermittently throughout the day it should not be any cause for concern. Consistent yellow or green nasal discharge and a prolonged illness of 12 days or more suggest a visit to the Primary Care Provider. Persistent red nasal drainage may indicate a nosebleed. If home treatment of the nosebleed is unsuccessful or if it is persistent or occurs frequently, a visit to the Primary Care Provider would be beneficial.
How can RSV be prevented?
Adequate and frequent handwashing, staying away from those who are sick, covering coughs and sneezes, keeping hands out of the face, and frequently cleaning frequently touched surfaces several times a day are a few things that could be done to decrease the chance of contracting RSV. If possible, keep sick children home. Allowing children to go to daycare or school while they are sick may introduce the virus to other children. Reinfection is possible.
There is a monthly injection given to certain infants to help prevent serious RSV complications. If you would like to know more about this injection or want to know if your child meets the criteria for the injections, speak with your child's Pediatrician.
RSV is a highly contagious common childhood virus that most children contract before the age of 2. However, older children, teens, and adults are not exempt from getting RSV. There is no specific treatment for RSV however there are some things that parents and caregivers can do to help their child through its course. Frequent handwashing, avoiding those who are sick, and cleaning frequently touched surfaces often are just a few things that can be done to lessen a person's chance of contracting RSV. Most children who contract RSV will recover within 7-14 days however, some children may develop serious illnesses and require hospital admission. Reinfection of RSV is possible, however, symptoms are usually less severe.
Check out this video by the American Academy of Pediatrics that gives a visual example of what respiratory distress can look like in children. https://youtu.be/_2qh31Wndls