So what’s the big deal, it’s just a cold, right? RSV is the Respiratory Syncytial Virus. This virus causes mild cold-like symptoms lasting 1-2 weeks in most of the population. Symptoms include runny nose, sneezing, cough, wheezing, fever, and decreased appetite. However, this virus can cause severe illness for at risk infants and toddlers. Almost all children will have contracted the virus by the time they reach their 2nd birthday. Approximately 1-2% of those with the virus require hospitalization.
RSV is more than “just a cold”. The year of 2022 in general has seen a significant increase in the number of diagnosed cases of RSV and other respiratory illnesses. According to the CDC respiratory viruses cold, flu, RSV started earlier with high RSV activity in all regions of the United States leading to substantial numbers of hospitalizations. Usual RSV season starts in late fall with a peak in early February.
So, who is most at risk for severe illness? Infants born prematurely especially those born before 29 weeks gestation, infants younger than 6 months of age during their first fall/winter season, young children with congenital heart disease or chronic lung disease, infant’s with weakened immune systems, and children with neuromuscular disorders.
How do I protect my baby from severe illness? RSV is a viral illness and there is no medication or treatment to cure the virus. For infants at the highest risk for severe complications from RSV there is a monoclonal antibody treatment Palivizumab recommended by the American Academy of Pediatrics (AAP). This does not prevent illness but is used to decrease the likelihood of hospitalization due to RSV. Talk with your pediatrician to see if your infant qualifies. What if my baby doesn’t qualify for Palivizumab? What can I do? The single most effective prevention is handwashing. It seems so simple yet is so underrated. Always wash your hands before touching your baby. Wash your hands after sneezing, coughing or blowing your nose. Wash your hands after touching high traffic areas like door knobs, your phone, or tablet. This virus is transmitted via droplets in the air and on surfaces. The RSV can last up to 6 hours on objects and up to 30 minutes on hands. Avoid and limit close contact with people showing symptoms of a cold, close contact in public spaces, and daycare.
Oh no, my baby has cold-like symptoms, now what? For mild symptoms there is no need to run to the pediatrician office in the middle of the night. The goal is treating the symptoms. For low grade fever, pain and discomfort you can give acetaminophen and/or ibuprofen. (Never give aspirin to an infant). You can call your pediatrician or your on-call/after hours service to verify dosage. Encourage your infant to take in fluids. Dehydration can occur when infants don’t take in as much due to decreased appetite and discomfort when feeding from nasal stuffiness. This might mean giving smaller volume feedings more frequently. Use of nasal saline solution and suctioning of the nares to relieve nasal stuffiness. Use of a cool mist humidifier to help with congestion. Do not use over the counter cold medication without first consulting your pediatrician. Many over-the- counter cold medications can be harmful if given to an infant. Extra cuddles and patience. Your baby isn’t feeling well and may be clingy, whiny, and want to be held all the time. Symptoms will usually be worse on day 3-5 of illness. Sometimes RSV can lead to other illnesses such as ear infections, bronchiolitis and pneumonia. Monitor for signs of worsening of symptoms and call your pediatrician if symptoms are not starting to improve or getting worse.
When to seek immediate medical treatment? These are signs that more urgent medical care is needed.
-If at any point your infant appears blue/gray in face or lips.
-If your infant is having difficulty breathing, gasping, breathing really fast, or stops breathing.
-If you are having a hard time or unable to wake your infant.
-If they have less than 1 wet diaper in 8 hours.