Amanda Martin, M.D.
What is RSV?
Respiratory Syncytial Virus (RSV) is a common lower respiratory infection. In infants and toddlers, it causes bronchiolitis, which is swelling and mucous production of the small airways in the lungs, or pneumonia. In infants and toddlers, the most common symptoms are cough, runny nose, difficulty breathing, and fever. In rare cases, it can cause apnea (not breathing for more than 15-20 seconds).
RSV can be particularly dangerous for very young infants or infants and toddlers with underlying medical problems such as chronic lung disease, congenital heart disease, born before 35 weeks, or conditions causing them to have a weakened immune system. It is possible (and likely) to get RSV multiple times during your lifetime; but the good news is, repeat infections are usually not as severe. In healthy older children and adults, RSV often causes cold-like symptoms. RSV most often occurs from October to February.
How is RSV spread?
RSV is spread by bodily secretions (snot, saliva, or coughing) from someone with the virus or objects contaminated with the virus coming into contact with the eyes, nose, or mouth. RSV can survive for several hours on your hands or objects, so hand washing is very important to prevent spread.
Can RSV be tested for?
There is a test available for RSV. However your provider may not recommend that the test be performed, as bronchiolitis is diagnosed by the symptoms your child is having and how their lungs sound during the exam. Since there is no medication to treat RSV, whether your child has bronchiolitis due to RSV or another virus, the test would not change the treatment.
My child was diagnosed with bronchiolitis (caused by RSV or another virus). What now?
Take a deep breath. You will probably get even less sleep than usual, but most infants and children will do fine at home and do not need to be hospitalized. Younger babies breathe through their nose, unless they are crying.
With bronchiolitis, a lot of times there’s a lot of snot in the nose, and suctioning their nose with a bulb suction can help make it easier for them to breath and make them more comfortable. Most of the time when infants are sick, they eat less than usual, and it’s very important to make sure they stay hydrated. This can be achieved by feeding them more frequently. If they are not able to take formula or breast milk, then Pedialyte can be given in its place.
Since bronchiolitis is caused by a virus, there is no medicine that will help. The illness usually will last 7-9 days, with the worst occurring on or about day 5. The cough will often last for 2-3 weeks.
Important signs/symptoms to watch for
How hard your infant/child is working to breathe – When your infant/child is calm (not crying or running around) and the skin under their ribs, between their ribs or above their collar bone is going in and out with their breathing, their nostrils are flaring, or they are breathing more than 60 times a minute, then they are working hard to breath. Try suctioning out their nose and if their labored breathing does not improve, then they need to be seen right away by a health care provider.
Are they hydrated? – Ensure your infant/child has at least 3 wet diapers in 24 hours (about one every 8 hours). Other signs of dehydration include a sunken soft spot, crying without tears, and dry mouth. If there are any signs of dehydration, then they need to be seen by a healthcare provider.
Is their oxygen saturation normal? – When your infant/child is seen in our office, we will check their oxygen saturation. There are devices that can check it at home, but they are often not accurate and unless they are prescribed by a doctor, I would not recommend using them. If you check the oxygen saturation at home and it is less then 92%, then your child needs to be seen right away.
References
Piedra, MD, P. A. & Stark, MD, A. R. (June 12, 2019), Patient education: Bronchiolitis (and RSV) in infants and children (Beyond the Basics).
Retrieved from https://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print
Barr, MD, F.E. & Graham, MD, PhD, B.S. (August 8, 2019) Respiratory syncytial virus infection: Clinical features and diagnosis.
Retrieved from https://www.uptodate.com/contents/respiratory-syncytial-virus-infection-clinical-features-and-diagnosis