Protect your family from RSV, because it isn't just a cold

 

Respiratory syncytial virus (RSV) is a common respiratory virus that causes mild, cold-like symptoms. According to the U.S. Centers for Disease Control and Prevention (CDC), RSV leads to approximately 58,000 hospitalizations in children under the age of 5 each year. This year, however, the CDC is reporting a major increase in RSV detections and RSV-associated emergency department visits, with some regions of the country nearing peak seasonal levels. We spoke with Elizabeth Meade, M.D., FAA, IBCLC, a Providence Swedish pediatric medical director, for answers to some of your questions about RSV, including how to treat the virus and when to see a doctor. 

 

 

RSV stands for Respiratory Syncytial Virus; it is one of the many respiratory viruses that causes what we know as cold symptoms, typically from late fall through early spring. Almost all children get RSV at least once before they are 2 years old, and children and adults can get it multiple times (even during a single season or year).

 

While RSV is a common virus that circulates every year, in the last few years we have had winter seasons with high numbers of RSV causing many times the normal amount of hospitalizations and ICU stays, and filling hospitals in our region to capacity. Keeping up to date with routine immunizations as well as flu and COVID vaccines will help, as we know that children who have been vaccinated against flu and COVID are dramatically less likely to develop severe illness or need hospital care for these infections.

 

For many older children and adults, RSV looks and feels like a typical cold – runny nose, fever, cough, congestion, sneezing, etc. In addition to these findings, younger infants are more likely to have symptoms affecting the lungs, like fast breathing, difficulty breathing or respiratory distress, difficulty feeding, wheezing, or need for oxygen support. This type of infection in the lungs is called “bronchiolitis” and typically affects babies and young toddlers.

 

For most people, the illness is at its worst on days 3 through 5 of symptoms, though this can vary. Fortunately, almost all children recover from RSV infection on their own or with supportive care, but some will need medical treatments and/or hospitalization to get better. Occasionally, RSV can lead to development of a bacterial infection like pneumonia or an ear infection.

 

It can be difficult to tell, as all these illnesses can have similar symptoms. Loss of taste or smell is more specifically associated with COVID, but often there is no way to know for sure without testing.

 

Young infants under 3 months of age, babies who were born premature or at a low birth weight, infants and children with heart or lung disease, and children exposed to smoke during pregnancy or in the home are at higher risk of severe disease. Children who have a history of asthma/allergies/eczema, or anyone with a very compromised immune system or a serious chronic disease, may be at higher risk of complications with RSV.

 

The great news is, we now have ways to prevent severe RSV in the most at risk infants (those who are very young, premature, or with serious medical conditions)! Pregnant patients can receive an RSV vaccine between 32 and 36 weeks of pregnancy that works to protect their newborn from severe RSV illness through their first fall/winter season. This vaccine is typically given between September and March in most of the United States. The vaccine is most effective when given at least 14 days prior to delivery of the baby. If a pregnant person is unable to get the maternal RSV vaccine or the baby is delivered less than 14 days after the maternal vaccine, the newborn can receive a dose of the infant RSV vaccine. This is given to babies in their first fall/winter season if they are less than 8 months old and are not protected by the maternal vaccine given as above. Some older infants with underlying heart or lung conditions may also qualify to receive this vaccine.  

For everyone else, our best tools are those we use to prevent the spread of illness in general – handwashing, mask-wearing, staying home from work, school or daycare when sick, and avoiding anyone who has respiratory symptoms. If you are breastfeeding your child, they are likely to get some great antibodies from your breast milk which can help prevent illness as well! Additionally, not smoking can help decrease risk of RSV in your child.

Treatment of RSV is supportive. At home this may look like gentle suctioning of the nose to make breathing and feeding easier, a cool-mist humidifier, medications like acetaminophen or ibuprofen (if older than 6 months) to help with fevers and discomfort, and making sure babies and children stay hydrated. Children with respiratory illness may need to eat and drink smaller amounts more frequently, as congestion and illness symptoms can alter their normal feeding patterns. In the hospital, we provide supportive care as well with suctioning, hydration (which may need to be given through an IV or a feeding tube if the baby is unable to feed well), and oxygen or breathing support when needed.

When should patients contact their medical provider?

If your child is having difficulty breathing (fast and/or short breaths, grunting noises, unusual movements of the chest or belly with breathing, tugging between the ribs, wheezing), has a gray or blue color of the tongue, lips or skin, is unable to eat/drink normally or is showing signs of dehydration, or has a significant change in their level of activity or responsiveness, they should be seen by a medical provider right away. Any baby who has a fever of 100.4 F or more and is less than 2-3 months of age should be seen by a provider as well.

 

If you think your child may have RSV and they are younger than 3 months of age or in one of the other high-risk categories described above, call your provider for guidance. Older children and adults who are not having difficulty breathing or staying hydrated can often be monitored at home.

 

If you have questions about vaccinations or your child’s wellness health, Swedish Pediatrics can help. If your kids aren’t up to date on immunizations, particularly the measles vaccine, call their pediatrician today to schedule a visit.

You can contact Swedish Primary Care to schedule an appointment with a primary care physician or advanced care clinician. If you or a child has symptoms, you can connect virtually with a member of your care team who can review the symptoms, provide instruction and follow up as needed. With Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. If you don’t have a doctor, use our provider directory to find a specialist or primary care physician near you.

Information for patients and visitors

Additional resources

Is it strep throat or a sore throat?

Whooping cough is making a comeback. Here’s what you should know.

Measles cases are on the rise. Here's what you should know.

Growing Up Safely: Immunizations + Health | Talk with a Doc Podcast

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This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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