The number of infants and young children hospitalized in the U.S. with respiratory syncytial virus (RSV) may be on the rise again as we move into the fall and winter months. This surge in admissions for RSV and other contagious respiratory viruses may push many hospitals to capacity. And, while the news headlines are concerning, RSV is actually quite common and most often mild.
“About 97% of children will get RSV at least once before age two,” says Christina Gagliardo, MD, a physician with the Division of Pediatric Infectious Diseases at Atlantic Health System’s Goryeb Children’s Hospital. “For most healthy children, RSV is like a cold; only about two in every 100 children who get RSV will need hospitalization.”
1. Vaccine protection is encouraged.
People at any age can get RSV. However, it typically only causes severe infection in newborns and children up to age two, as well as older adults over age 60.
The American Academy of Pediatrics recommends that all infants — especially those at high risk — receive the new preventive antibody, nirsevimab, to protect against this highly contagious virus.
2. Some infants have higher risk of RSV than others.
Those at higher risk include infants who are about 12 months or younger at the start of RSV season, premature or low-birth-weight infants (especially those born before 29 weeks’ gestation), and those with weak immune systems due to illnesses or treatments. Chronic lung disease and certain types of heart defects also raise an infant’s risk for contracting RSV.
3. It can be hard to tell RSV apart from other viruses.
RSV most often causes a cold, which is a type of upper respiratory infection that brings a fever (100.4 degrees Fahrenheit or higher), cough, congestion, runny nose, sneezing, fussiness or poor feeding. A cold may be followed by bronchiolitis, a type of lower respiratory tract infection that brings cold symptoms plus fast breathing, flaring of the nostrils, head bobbing with breathing, rhythmic grunting during breathing, belly breathing or wheezing.
4. RSV symptoms last for five to seven days on average.
RSV spreads just like the common cold, from one person to another. It spreads through person-to-person contact and through unclean hands or objects. Symptoms can appear two to eight days after contracting RSV. “People with RSV are typically contagious for between three to eight days,” says Dr. Gagliardo.
5. RSV symptoms are typically at their worst from Day 3 – Day 5.
You should call the doctor if your child has any symptoms of bronchiolitis, dehydration (less than one wet diaper every eight hours for infants), pauses or difficulty breathing, significantly decreased activity and alertness, or develops a grey or blue color on the tongue, lips or skin. Also call a doctor if your child’s symptoms don’t improve after seven days or when your child’s temperature rises above 104 degrees Fahrenheit repeatedly. Children younger than 12 weeks of age should see a doctor anytime their temperature goes above 100.4 degrees Fahrenheit.
6. There is no cure for RSV.
Medications like steroids and antibiotics do not help. To help your child feel more comfortable, treat RSV’s symptoms similar to the way you’d treat a cold. Use nasal saline with gentle suctioning to allow for easier breathing and feeding. Use a cool-mist humidifier in your child’s room. Keep your child well hydrated. “If your child is older than six months, you may use acetaminophen or ibuprofen to help with low-grade fevers,” Dr. Gagliardo says. Never give young children aspirin or cough-and-cold medicines.
7. Prevention is key.
You can prevent RSV by washing your hands, keeping your child up to date on their other vaccines (including Tdap (tetanus, diphtheria, and pertussis) and COVID-19), limiting your child’s exposure to crowds, disinfecting objects and surfaces in your home regularly, and feeding your baby breastmilk.
8. RSV may return quickly.
Children and adults can get RSV multiple times — even during the same season. However, repeat infections are often less severe than the first one. The best news: “Most children recover well from RSV and grow into healthy adults,” Dr. Gagliardo says.
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