Respiratory syntactical virus (RSV)

An Overview

Respiratory syntactical virus (RSV) is a common, and very contagious, virus that infects the respiratory tract of most children before their second birthday. For most babies and young children, the infection causes nothing more than a cold. But for a small percentage, infection with RSV can lead to serious, sometimes life-threatening problems such as pneumonia or bronchitis, an inflammation of the small airways of the lungs. Most children get RSV before two years of age. Infection is easily spread in young children because of their close contact with other children who may be infected, through the sharing of their toys and constant touching of objects that may be contaminated with the virus.

Symptoms of Respiratory syntactical virus (RSV

Signs and symptoms of respiratory syncytial virus infection most commonly appear about four to six days after exposure to the virus. In adults and older children, RSV usually causes mild cold-like signs and symptoms. These may include:
• Congested or runny nose
• Dry cough
• Low-grade fever
• Sore throat
• Sneezing
• Headache

Causes of Respiratory syntactical virus (RSV)

Respiratory syncytial virus enters the body through the eyes, nose or mouth. It spreads easily through the air on infected respiratory droplets. You or your child can become infected if someone with RSV coughs or sneezes near you. The virus also passes to others through direct contact, such as shaking hands. The virus can live for hours on hard objects such as countertops, crib rails and toys. Touch your mouth, nose or eyes after touching a contaminated object and you’re likely to pick up the virus.

An infected person is most contagious during the first week or so after infection. But in infants and those with weakened immunity, the virus may continue to spread even after symptoms go away, for up to four weeks. RSV infection can spread to the lower respiratory tract, causing pneumonia or bronchiolitis — inflammation of the small airway passages entering the lungs. Signs and symptoms may include:

• Fever
• Severe cough
• Wheezing — a high-pitched noise that’s usually heard on breathing out (exhaling)
• Rapid breathing or difficulty breathing — the person may prefer to sit up rather than lie down
• Bluish color of the skin due to lack of oxygen (cyanosis)
Infants are most severely affected by RSV. Signs and symptoms of severe RSV infection in infants include:
• Short, shallow and rapid breathing
• Struggling to breathe — chest muscles and skin pull inward with each breath
• Cough
• Poor feeding
• Unusual tiredness (lethargy)
• Irritability

Diagnosis

Your doctor may suspect respiratory syncytial virus based on the findings of a physical exam and the time of year the symptoms occur. During the exam, the doctor will listen to the lungs with a stethoscope to check for wheezing or other abnormal sounds.
Laboratory and imaging tests aren’t usually needed. However, they can help diagnoseRSV complications or rule out other conditions that may cause similar symptoms. Tests may include:
• Blood tests to check white cell counts or to look for viruses, bacteria and other germs
• Chest X-rays to check for lung inflammation
• Swab of secretions from inside the mouth or nose to check for signs of the virus
• Pulse oximetry, a painless skin monitor, to detect lower than normal levels of oxygen in the blood.

Treatment

Hospital care

If the RSV infection is severe, a hospital stay may be necessary. Treatments at the hospital may include:
• Intravenous (IV) fluids
• Humidified oxygen
• A breathing machine (mechanical ventilation), in rare cases
Some young children who develop bronchiolitis may have to be hospitalized to receive oxygen treatment. If your child is unable to drink because of rapid breathing, he or she may need to receive intravenous fluids to stay hydrated. On rare occasions, infected babies will need a respirator to help them breathe. Only about 3% of children with RSV require a hospital stay. Most children are able to go home from the hospital in two or three days.

When to see a doctor:

Call your baby’s doctor if you notice any of the following RSV symptoms:
• A high-pitched whistling or wheezing noise when they breathe
• Being unusually upset or inactive
• A cough with yellow, green, or gray mucus
• Trouble breathing or pauses in their breaths
• Refusing to breastfeed or bottle-feed
• Signs of dehydration: lack of tears when crying, little or no urine in their diaper for 6 hours, and cool, dry skin

Lifestyle and home remedies

You may not be able to shorten the length of a respiratory syncytial virus infection, but you can try to relieve some signs and symptoms.
If your child has RSV, do your best to comfort or distract him or her — cuddle, read a book or play a quiet game. Other tips for relieving symptoms are:
• Create moist air to breathe. Keep the room warm but not overheated. If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing. Be sure to keep the humidifier clean to prevent the growth of bacteria and molds.
• Drink fluids. Continue breastfeeding or bottle-feeding your infant as you would normally. For older children and adults, keep a steady supply of cool water at the bedside. Offer warm fluids, such as soup, which may help loosen thickened secretions. Ice pops may be soothing as well.
• Try saline nasal drops. Over-the-counter (OTC) drops are a safe, effective way to ease congestion, even for young children. Follow your doctor’s recommendations and the instructions on the product.
• Use over-the-counter pain relievers. OTC pain relievers such as acetaminophen (Tylenol, others) may help reduce fever and relieve a sore throat. Ask a doctor for the correct dose for your child’s age.
• Avoid touching your eyes, nose and mouth to prevent the spread of viruses from your hands.
• Cover your mouth and nose with a tissue when sneezing and coughing or sneeze and cough into your elbow. Throw the tissue in the trash. Wash your hands afterward. Never cough or sneeze into your hands!
• Avoid close contact (within 6 feet) with those who have known RSV, coughs, colds or are sick. Stay home if you are sick.
• Don’t share cups, toys or bottles, or any objects. Viruses may be able to live on such surfaces for hours (and be transmitted to your hands).
• If you are prone to sickness or have a weakened immune system, stay away from large crowds of people.
• Clean frequently used surfaces (such as doorknobs and counter tops) with a virus-killing disinfectant.

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