RSV in children: symptoms, treatment and what parents need to know



CNN

In September, an 8-month-old baby Juanita entered Dr. Mora’s Chicago office for another two months with an infection the doctor didn’t expect: RSV.

Like his colleagues across the country, the allergist and immunologist has been treating little ones with the cold-like virus long before the season normally begins.

“We’re seeing an increase in RSV infections across the country,” Mora said.

Almost all children catch RSV before the age of 2, says the US Centers for Disease Control and Prevention. Most adults who catch it have a mild illness; For those who are elderly or have chronic heart or lung disease or a weakened immune system, it can be dangerous. But RSV can be especially difficult for babies and children.

Mora, a volunteer medical spokeswoman for the American Lung Association, says it’s important for parents, caregivers and child care providers. know what workers should watch out for with RSV, which stands for respiratory syncytial virus. That way, they know if a sick child can be treated at home or if they need to go to the hospital.

“The emergency department is completely overwhelmed with all these sick kids, so we want parents to know that they can go to their pediatrician and get tested for RSV, flu, and even Covid-19,” Mora said.

Here’s what else parents need to know amid the rise in respiratory illnesses.

For many, RSV causes a mild illness that can be managed at home.

On average, an infection lasts five days to a couple of weeks, and will often go away on its own, says the CDC. Sometimes the cough can last up to four weeks, pediatricians say.

Symptoms can look like a common cold: runny nose, loss of appetite, cough, sneezing, fever and wheezing. Young children may only seem irritable or lethargic and have trouble breathing.

Not all children will have all the potential RSV symptoms.

“Fever is really dangerous with RSV infections, especially in young children,” said Dr. Priya Soni, assistant professor of pediatric infectious diseases at Cedars Sinai Medical Center.

She said there should be behavioral changes in parents, including taking longer to eat or not being interested in food. The child may also develop severe coughing and some wheezing.

It’s also important to watch for signs that your child is struggling to breathe or breathing through their ribs or abdomen — “symptoms that can be consistent with many other viruses that we’re seeing a resurgence of,” Soni added.

Because it’s not easy for parents to tell the difference between, say, RSV and respiratory illnesses like the flu, it’s a good idea to take a sick child to a pediatrician, who can run tests to determine the cause.

“You may need to take your baby in for evaluation sooner rather than later,” Soni said.

When it comes to RSV, parents should be especially careful if their children are newborns, newborns, children with weakened or neuromuscular systems, and children younger than 2 with chronic lung and heart disease, the CDC says.

“Parents need to be very clear about any changes, like in their activity and appetite, and then pay special attention to signs of respiratory distress,” said Soni.

Getting tested is important because the treatment for things like the flu and Covid-19 can be different.

There is no antiviral or specific treatment for RSV like there is for the flu, nor is there a vaccine. But if your child is sick, there are things you can do to help.

Fever and pain can be managed with non-aspirin relievers such as acetaminophen or ibuprofen. Also make sure your child is drinking enough fluids.

“RSV can make children very dehydrated, especially when they’re not eating or drinking, especially when we’re talking about babies,” Mora said. “When they stop eating or the urine flow is reduced, they don’t have as many wet diapers, it’s a sign that they need to go to the pediatrician or the emergency room.”

Talk to your pediatrician before giving your child over-the-counter medicines, which can sometimes contain ingredients that are not good for children.

Your pediatrician will check your baby’s respiratory rate (how fast he breathes). and their oxygen levels. If your child is very sick or at high risk of serious illness, the doctor may want you to go to a hospital.

“RSV can be very dangerous for some young babies and children, especially those younger than 2 years old,” Soni said.

Mora said that labored breathing is a sign that a child is having trouble with this virus. RSV can develop into more serious illnesses such as bronchiolitis or pneumonia, which can lead to respiratory failure.

If you see a child’s chest moving up and down when he breathes, if the cough does not let him sleep or if it is getting worse, “this may be a sign that he needs to seek help or take him to the pediatrician. in the emergency department, because they might need supplemental oxygen, or they might need nebulization treatment.’

CNN medical analyst Leana Wen says this difficulty breathing (including head bobbing, nose blowing or grunting) is one of the two main problems with respiratory infections. The other is dehydration. “This applies especially to children with stuffy noses. Maybe they are not fed.’

Much of the care provided by hospital staff will be to help you breathe.

“We provide supportive measures for RSV and these children with oxygen, IV fluids and respiratory therapy, including suctioning,” Soni said.

A thin tube may be inserted into the lungs to remove mucus. The child may receive supplemental oxygen through a mask or through a tube attached to the nose. Some babies may need to use an oxygen tent. Those who are struggling a lot might need a ventilator.

Some babies may need to be fed through a tube.

The best way to prevent RSV infections, doctors say, is to teach children to cough and sneeze into their elbows rather than their hands. Also try to keep frequently touched surfaces clean.

If a caregiver or older sibling is sick, Mora says, they should wear a mask around other people and wash their hands frequently.

And above all, if someone is sick – child or adult – they must stay at home to avoid spreading the disease.

A monoclonal antibody treatment is available for children at highest risk of severe disease. It is not available to everyone, but it can protect the most vulnerable. It comes in the form of a shot that a child can get every month during the RSV season. Talk to your doctor to find out if your child qualifies.