RSV: A Respiratory Infection That Attacks Children

The Centers for Disease Control and Prevention (CDC) says it's concerned about the spread in recent weeks of respiratory syncytial virus (RSV). It's the leading cause of viral pneumonia among infants. With symptoms including a cough and runny nose, it's often brushed aside as just another common cold. Doctors say more attention should be paid to the potentially life-threatening virus which usually hits during the winter. Most children recover from within a week or two, but as many as 500 children die every year from RSV infection.

We talked to Dr. Bernadine Healy about RSV, the symptoms, treatments and ways to prevent it.

1. WHAT IS RSV?

RSV is a wintertime virus that causes infections of the upper respiratory tract such as a cold and the lower respiratory tract such as pneumonia and bronchiolitis--a severe infection of the breathing tubes. It usually appears during late fall, winter and early spring. It follows a typical seasonal pattern and activity most commonly peaks in December, January or February of each year. Although anyone can contract RSV, it is the most frequent cause of lower respiratory infections in infants between one and two years of age. The virus continues to affect people later in life and usually causes less severe cold-like symptoms in adults. However, researchers have discovered that RSV is also a significant cause of illness among the elderly.

2. WHAT ARE SOME OF THE SYMPTOMS OF RSV?

RSV begins most frequently with fever, runny nose, cough, and sometimes wheezing. During their first RSV infection, between 25-40% of infants and young children have signs or symptoms of pneumonia or bronchiolitis. Most children recover from the illness in eight to 15 days. A small number may have to be hospitalized and those are usually children under 6 months of age.

3. HOW SERIOUS CAN A RSV INFECTION BECOME?

A RSV infection can range from very mild to life threatening or even fatal. Underweight or premature infants, or those with chronic conditions such as asthma, cystic fibrosis or congenital heart defects are at increased risk of developing severe infection and complications. Even though we've seen a rise in the number of RSV infections among young children, we don't want to sound the alarm for parents. Nearly all children have a bout with RSV before age two. But, if a cough persists or there is a continued low-grade fever or signs that the child is struggling to get a breath or their breathing is irregular, then the parent should bring the child to the physician.

4. HOW CAN PARENTS TELL IF THEIR CHILD HAS A RSV INFECTION OR JUST A BAD COLD?

Aside from the usual cold symptoms, if a child is wheezing, coughing or breathing hard, then they need to be seen immediately by a physician. A smear called an immunological fixation test can confirm the diagnosis within minutes using sputum or nasal secretions. Also, a chest X-ray may show pneuonia or bronchiolitis which usually results from an RSV infection.

5. HOW ARE RSV INFECTIONS TREATED?

For children with mild disease, no specific treatment is necessary other than the treatment of symptoms such as reducing fever. Most will be fine in about eight to 15 days. However, children with severe disease may require oxygen therapy and sometimes the help of a breathing machine. There are some medications given by injection that can be administered preventively to children with immune system problems. But because the virus has many different strains, these injections aren't always 100% effective.

6. IS THERE ANYTHING PARENTS CAN DO TO REDUCE THEIR CHILD'S RISK OF GETTING AN RSV INFECTION?

RSV is highly contagious! It's spread from respiratory secretions through close contact with infected persons or contact with contaminated surfaces or objects. Infection can occur when infectious material contacts mucous membranes of the eyes, moth, or nose and possibly through the inhalation of droplets generated by a sneeze or cough. So, make sure you wash your hands frequently! Also, don't share items such as cups, glasses and utensil with people who have RSV illness. There's almost no way to prevent getting an RSV infection at daycare or school. Once one child in a group is infected with RSV, spread to others is rapid and frequently, a child is infectious even before symptoms appear.

7. IS THERE A RSV VACCINE AVAILABLE?

Although it's a high priority, there is no vaccine yet.

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