Respiratory Syncytial Virus (RSV) on the Rise: What Parents Need to Know

The respiratory illness known as RSV is a very common but potentially serious virus, and the leading cause of infant hospitalization around the world. Almost all children get RSV at some point before age two, and for most, RSV is like a cold. But for some infants and children, RSV can cause more concerning illness.

Annual outbreaks of RSV occur in the late fall through early spring months, but in 2022, outbreaks began earlier than usual. The Centers for Disease Control (CDC) has issued a health advisory regarding higher instances of the virus and stressing the importance of preventative measures. Millie Driggers, MSN, CPNP, CNNP with CaroMont Pediatric Partners in Gastonia answers common questions regarding this year's elevated concern for RSV, especially in young children.

What is RSV?

You may have seen signs posted in your community or at your provider's office that read "RSV Awareness" or "RSV Prevention." The abbreviation stands for Respiratory Syncytial Virus, which is a common cause of severe respiratory illness in infants and young children. It can also be transmitted to adults.

Infants and young children with RSV may have:
• a stuffy or runny nose
• fever (often high)
• cough
• Difficulty breathing (fast breathing, wheezing or belly breathing where there is tugging between the ribs and/or lower neck)
• Poor feeding
• Fussiness
• Flaring nostrils

Older children and adults with RSV may have milder symptoms, such as:
• fever
• runny nose
• sore throat
• Coughing
• Decreased appetite

How does RSV spread?

RSV is transmitted via direct contact with infected mucus from an infected person’s nose or throat, or when someone touches their mouth after touching a contaminated surface (e.g., toys). RSV can also spread by inhaling small droplets from an infected person's coughs or sneezes, or close, prolonged exposure with an infected individual.

How is RSV diagnosed?

Providers diagnose children with a cold or wheezing by talking to parents about their child’s symptoms and performing an exam. A provider may choose to do a nasal swab to test for RSV or other viruses. Because most babies and children recover well and because there is no treatment for RSV, these tests are not typically not necessary.

What can you do to prevent the RSV spread?

The best way to prevent RSV is to wash your hands frequently and avoid touching your face. If possible, avoid being around sick people, especially if they have symptoms of a cold or flu. If you have been around someone who is sick, be sure to wear a mask before handling your child. Masking can be an effective way to avoid spreading your germs to an infant, child or vulnerable adult in your care.

If you’re caring for a baby or child who has RSV, be sure to wash your hands often with soap and water. Avoid touching your mouth, nose, and eyes with unwashed hands and always cover coughs or sneezes in your arm.

Who is most at risk for severe RSV infection?

• Infants under 6 months are more likely to be hospitalized with severe respiratory syncytial virus (RSV) than older children and adults. A few questions that can help you determine your child’s elevated risk are:
     o Is your baby 12 weeks or younger at the start of RSV season?
     o Is your baby premature or of low birth weight, especially if born before 29 weeks' gestation?
     o Does your baby have chronic lung disease of infancy?
     o Does your baby have a heart defect?

• Children younger than 2 years old may also have a high chance of hospitalization.

• For pregnant women, RSV poses an elevated risk, potentially causing premature birth or miscarriage during the second or third trimester. If you experience symptoms of RSV during pregnancy, call your provider immediately so that treatment options are offered before any complications arise.

• Individuals with asthma or other lung diseases such as cystic fibrosis should also take precautions when they're around someone who has been infected by the virus. These conditions make individuals more vulnerable to RSV infection.

• Immune-compromised individuals, such as those whose immune systems have been weakened by chemotherapy treatments should take care and limit interactions and proximity to those who have recently had RSV.

• Additional risk factors for severe RSV infections include low birthweight, having siblings, a mother's smoking during pregnancy, exposure to secondhand smoke in the home, history of allergies and eczema, not breastfeeding, and being around children in a child care setting or living in crowded conditions.

When should you call your provider?

Some children with RSV may be at greater risk of developing a bacterial infection, such as an ear infection. Call your provider if your child has:

• A fever (with a rectal temperature of 100.4 or higher) and is less than 12 weeks old
• A fever that rises above 104 degrees Fahrenheit repeatedly for a child of any age
• Symptoms of RSV that last longer than a week, or if symptoms return after being gone for several weeks
• Poor sleep or fussiness, chest pain, ear pain symptoms.

CaroMont Pediatric Partners has an after-hours nursing line to ensure parents of small children have access to a healthcare professional, no matter the time of day.

Is there anything available to help with symptoms of RSV?

Normal cases of RSV can be treated as you would care for cold symptoms. Some options are:

• Cool mist humidifier
• Nasal saline and suction
• Fluids and feeds (though may be reduced compared to normal)

Only a very small percentage of children will require a hospital stay, and most go home after a two to three day stay. Parents should stay vigilant with their sick child, especially infants, and be aware of the signs and symptoms of RSV. If you or your child have been diagnosed with RSV, contact your provider for more information about the condition and how best to treat it. The earlier you begin treatment, the better chance there is of limiting potentially serious complications.

Millie Driggers is a board-certified Pediatric Nurse Practitioner, practicing with CaroMont Pediatric Partners since 2001. She is currently accepting new patients. Call 704.671.6300 to make an appointment.