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Respiratory syncytial virus (RSV) is a viral infection affecting the upper and lower respiratory tracts, and the number one cause of pneumonia and bronchiolitis in children under one year old. Although it is typically a mild infection, RSV can progress to severe bronchiolitis, which results in approximately 125,000 hospitalizations of infants every year. Although older children can also contract the illness, it usually affects very young children and infants. Most children will have had the infection by age two.
Symptoms of RSV start out innocently enough, seeming very similar to the common cold. Cold and flu-like symptoms such as low grade fever, cough and runny nose are usually all present. Wheezing may accompany the other symptoms, especially if the RSV is progressing to a more serious infection. The first infection can be more serious: up to 40 percent of young children develop bronchiolitis or pneumonia, or show symptoms of them. A typical case of RSV with no complications usually resolves itself within a week.
Parents should be especially vigilant regarding the illness and consult a doctor immediately if their newborn or young infant exhibits signs of RSV bronchiolitis. Symptoms of this illness are wheezing, fast breathing, nostril flaring and retracting. Retracting is when the muscles around the chest, neck and shoulders pull in when the child takes in a breath — this means that he is working hard to breathe. Because infants have smaller airways than adults, their airways can become compromised very quickly.
RSV is very contagious. Although it is fairly vulnerable once outside the body, it can survive on surfaces for a few hours, where it is easily picked up by an unsuspecting person. It is spread through sneezes, coughs, saliva and contact with the mouth, nose or eyes. The number of infections spikes during the typical flu season months, which last from late fall through early spring.
To make a diagnosis, the doctor will take a swab of nasopharyngeal secretions from the area of the throat behind the nose. Because RSV is a viral infection, the only treatment is treatment of the symptoms. Pain relievers are prescribed for discomfort and fever. If the RSV has progressed to a more serious case, oxygen therapy or medication will be administered to improve oxygen saturation and open the airways.
There are groups of children who have increased risk factors that contribute to RSV. Preemies and newborns, defined as infants younger than six weeks, are at a higher risk for contracting the infection. Children born with congenital heart defects, chronic lung problems and compromised immune systems are also at higher risk.
Certain living conditions also contribute to the risk. Children in daycare or crowded living situations, as well as those who are frequently exposed to second-hand smoke, are more prone to developing RSV. Older siblings, a history of asthma, and lack of breastfeeding also contribute.
For children in these high risk groups, a doctor may prescribe a monthly medication containing RSV-specific antibodies to help your child avoid developing a serious case of RSV. Some doctors advise parents of at-risk children to stay out of public as much as possible during the period of high risk. As with any illness, proper handwashing is imperative in avoiding contact with the virus, especially during the RSV season.