Respiratory syncytial virus (RSV) causes a viral infection of the respiratory system similar to that of a cold and cough. It is a common illness and will affect most children at least once by the time they reach the age of two years. It can cause a flare up of bronchitis, croup and lower respiratory diseases, such as bronchiolitis and pneumonia if left unchecked.
Preterm infants with a weakened immune system or chronic lung or heart disease are more likely to get a lower respiratory tract infection. Since it is highly contagious, RSV infections are easily transferred to health care workers or parents of infected infants. Adequate precautions should be taken to prevent transmission of respiratory syncytial virus.
Mild Respiratory Syncytial Virus
Symptoms show up three to six days after exposure to the virus. A mild case of RSV will begin with the infant showing a drop in appetite often accompanied by a leaky nose. The sneezing, coughing and fever above hundred degrees Fahrenheit may present by the second or third day. The infected infant is often irritable and may also exhibit some wheezing.
Healthy infants who develop RSV symptoms do not need to be hospitalized, as full recovery usually takes place within two weeks. The infant should be given plenty of fluids, as reduced appetite and fever can result in dehydration.
A nasal aspirator such as a bulb syringe can be used to expel mucus from the nose to make it easier for the infant to breathe. Saline drops may also be used to loosen the mucus. A mist vaporizer with cold water can help to help soothe the dry breathing passages of the infant. Steam inhalation should be avoided due to the increased risk of burns.
Medication to control the fever, such as acetaminophen, may be suggested. There is no medicine to target the virus specifically, and antibiotics are not indicated. The aim of treatment is to make the child as comfortable as possible while the body’s immune system battles the infection.
Severe Respiratory Syncytial Virus
Preterm infants with low immunity and weakened lungs are likely to experience more severe symptoms of the RSV infection. It may cause them to have difficulty breathing, resulting in low oxygen levels in the blood. Infants may become dehydrated with a blue-tinged skin, and expel thick nasal discharge. They may also have a fever above hundred and one degrees Fahrenheit.
In case of severe RSV infection, the infant may need to be hospitalized for treatment. Upper or lower respiratory tract infections such as bronchitis, croup, bronchiolitis and pneumonia can cause more complications. The infant will have great difficulty breathing, and there is a very real possibility of lung failure.
Blocked airways need to be treated with a bronchodilator especially if the child is asthmatic. Those who develop bronchiolitis may need to be given oxygen treatment. In case the child is unable to feed due to the blocked nose, dehydration may set in. To ward off dehydration, the child may be given intravenous fluids.
In rare cases where the infant stops breathing naturally, the doctor may put him on a respirator to aid regular breathing. Intubation or mechanical ventilation may be needed in extreme cases when the infant’s airflow passages are completely blocked with mucus. Most infants respond well to treatment and should make a complete recovery within a month.
When to Get Medical Help
While most cases of RSV infection are not life threatening, it is a good idea to get the infant to a doctor when rhinorrhea (runny nose) and pharyngitis (sore throat) are combined with constant fever after three days. A mild case of Respiratory Syncytial Virus infection can clear up on it’s own, but if complications develop within the respiratory tract, it could take longer.
Preventing Transmission of RSV
Since the respiratory syncytial virus is extremely contagious, precautions should be taken to avoid the transmission of the infection to other family members. Tips to prevent this include:
- Wash hands with warm water and soap before and after touching affected individuals.
- Keep older siblings away from affected individuals or getting them to wear a mask to cover the nose and mouth.
- Keep wet wipes handy to sterilize all toys and surfaces that the infant is likely to touch.
- Avoid smoking inside the home or car, as exposure to tobacco smoke has been linked to increased vulnerability to RSV.
- Remember that infection can still be transferred for up to three weeks post the illness, so keep the checks and safeguards in place during this time.
Reviewed by Yolanda Smith, BPharm