RSV is the abbreviation for the respiratory syncytial virus. It is a common cause of respiratory infections during the winter months. Some of these infections can be severe in very young children, leading to thousands of hospitalizations per year in the U.S.
The virus is a paramyxovirus by classification, related to other notorious human disease-causing viruses, including those responsible for the measles and mumps. The virus enters the respiratory system through the nose and mouth. It replicates itself and then can spread to the bronchioles, the small breathing tubes in the lungs.
In older children and young adults it causes mainly upper respiratory infections. Symptoms are similar to that of a cold, with nasal congestion, runny nose and cough. In those less than 2 years of age it can cause lower respiratory infections. These include pneumonia and bronchiolitis. Bronchiolitis is an inflammation of the smaller breathing passages deep within the lungs. The infection leads to swelling of the breathing passages, increased mucus production and obstruction of proper air flow.
These young children have cough, fever, runny nose and wheezing. The cough can often be croupy or barking in nature. With more severe infections, the breathing may become labored, with grunting, nasal flaring and retraction of the middle portion of their chest as they try to breathe. Blood oxygen levels can fall as a result of poor air exchange.
Children at risk for developing this type of severe respiratory infection are those less than 2 years of age who were born prematurely, have low weight and have pre-existing lung or heart trouble. It is important to note that children of parents who smoke cigarettes are also at higher risk.
Most children have been exposed to and recovered from an RSV infection by the age of 5. Many of the infections are mild and passed off as a cold. However, up to 40 percent of children who have had RSV will develop wheezing episodes through age 5. About 10 percent will have wheezing episodes beyond this age. It is not clear if the initial infection is simply the first manifestation of an asthmatic condition or the episode is the primary cause of the asthma.
Since RSV is a virus, the treatment is similar to that of a cold or other viral disease. Antibiotics will not be effective in eliminating RSV. Rest, plenty of fluids and proper nutrition are important.
When the respiratory system is severely compromised, especially in very young children, hospitalization may be needed to provide supplemental oxygen and inhaled or IV medications.
Unlike many respiratory diseases that are transmitted primarily through droplets emitted by coughing, RSV is primarily spread by contact with infected hands and/or inanimate objects.
Therefore, hand washing is of utmost importance in preventing the spread of the virus. Parents of small children should avoid cigarette smoking, as this will increase their child’s risk of severe RSV infection. Any respiratory infection that is prolonged in nature or that has more acute symptoms should be checked by a doctor, especially in very young children.
The content in this column is for informational purposes only. Consult your physician for appropriate individual treatment. Dr. Reynolds practices Family Medicine in Chesterfield.