RSV, or respiratory syncytial virus, is a very common virus. In fact we think nearly all children have been infected with RSV by the time they reach their second birthdays. It’s also likely a common cause of congestion and cough in adults.
The virus can cause a range of symptoms. Patients usually start showing symptoms within a week of being exposed. Symptoms usually start with congestion and decreased appetite. They can progress to include cough and fever a few days later.
There are some special characteristics of this virus that allow it to affect the lower respiratory tract. This makes the virus annoying and allows it to cause cough for a long time. Often the worst is over in 10 to 14 days. However, some kids can have a cough that takes up to a month to resolve.
In some it can cause bronchiolitis or lead to pneumonia. Some children need to be hospitalized and the sickest require a breathing tube and time in the intensive care unit. Premature infants, children under a year, or children with chronic medical problems such as chronic heart or lung conditions are at a higher risk of serious illness.
The virus typically makes its appearance in winter and the timing can vary from year to year.
What are the odds of getting RSV?
It is important to note there is a wide range of how RSV can affect a given child. A portion of these children (somewhere between 60% to 75%) will have symptoms consistent with a mild cold. Around 25% to 40% will have a more significant illness that involves the lower respiratory tract including the lungs. About 10 out of every 1,000 children will need to be hospitalized.
When to go to the doctor
Children who have RSV typically need medical care for a few very specific reasons. Hospitalization from RSV usually occurs when a child has severe changes in breathing, gets dehydrated or develops a secondary infection.
If you think your child has RSV or another respiratory virus, monitor their breathing. If your child is breathing fast for their age (in infants this is faster than 60 times a minute), take your child to the doctor.
Also, monitor how hard they are working to breathe. If your child is using extra muscles like the muscles between the ribs, go to the doctor.
Monitor how many wet diapers the child is having and notify your doctor if it is less than one every eight hours. Also, consider having your child seen if they are very young, have a chronic medical issue or the illness isn’t improving the way you think it should.
Isn’t there an RSV vaccine?
Technically, yes there is an RSV vaccine. Unfortunately, the vaccine isn’t for everyone. So far we have been unable to develop a traditional vaccine for RSV.
There is a vaccine called Synagis (palivizumab), but it doesn’t create an immune system protection like other vaccines. It instead, consists of antibodies that can help protect an infant against RSV. It has to be given once a month and is very expensive. It currently is only covered for a small population of premature infants and some children under 2 with serious heart and lung conditions.
How do I prevent RSV?
Wash your hands and your infant’s hands frequently. Wipe down shopping carts and other frequently touched public places. Wash foods that come from the grocery store that others’ hands may have touched (like produce). Avoid people who are ill and cover your cough.
We think many adults suffering mild winter colds may actually have and be passing around RSV. When in doubt, and especially if your child is under the age of 2 or has the serious symptoms discussed above, consider seeing your doctor.
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