MURRAY — Until this year, I was not aware of this virus. Now that I have a nine-month-old grandson who was recently diagnosed with this virus, I quickly learned that this can be a frightening illness. There were also children of my colleagues at work and grandchildren of friends of mine who have also been diagnosed. It seems there is an epidemic going around affecting babies and small children.
So what is RSV? Those three letters stand for respiratory syncytial virus and refers to a virus that causes bronchiolitis and has a more profound effect on younger children than older children and adults.
According to Dr. Joyce Hughes, pediatrician at Primary Care Medical Center and Dr. Heath Cates, pediatrician at Murray Pediatrics, this year has seen a rise in these cases in Murray and Calloway County.
“It is a viral infection common in the winter,” said Hughes. “Adults and older children may have it as a cold. But young babies, in the first years of life, are affected more because they have a decreased immune system.”
As Hughes and Cates explained, this virus causes the swelling of the small bronchioles in a baby’s lung.
“In babies, this swelling can mean that if there is a build-up of fluid, it obstructs their breathing and can cause respiratory difficulty,” said Hughes.
Cates said that children who are born premature or with, for instance, congenital heart disease, are more at risk and have a more difficult time fighting off this virus.
“Most children can get over RSV without problems,” said Hughes. “It does take a while. It’s a chest, not head virus. It takes longer to get over because it is more invasive.”
Both doctors agree that it is very contagious and because so many children are in daycare, it is easier for this virus to be shared.
“RSV spreads like a cold,” said Cates. “Symptoms appear two to eight days after contact and they can be contagious from three to eight days.”
“If you know there are children in the daycare where your child attends who have been sent home with RSV, you will need to watch for the symptoms a few days after exposure,” said Hughes. “If they start breathing faster, hear squeaking noises coming from their lungs, not eating well and running a high fever, they should see their child care provider.”
Cates also said that if you notice a baby’s stomach expanding and deflating while trying to breathe, that is a sign that they are having difficulty.
Hughes and Cates both emphasized that in treating RSV, it is a virus and that is why it can take two to three weeks to get over.
“The younger the child, the longer it might take for them to get well,” said Hughes. “It is a virus that has to run its course.”
“RSV causes a build-up of mucus in the lower part of the bronchial tubes, which are very small and even more so in a baby,” said Cates.
Hughes explained that if there is a small blockage in a small tube, that means the blockage is more profound. If the tube is larger and there is a small blockage, it doesn’t cause as many problems.
Hughes and Cates both emphasized that children with RSV need to be kept home for at least five days.
“It is important to keep them from being exposed to any other type of illness while they have RSV,” said Hughes. “You don’t want their immune system to be trying to fight off a secondary infection also.”
“Day one of the virus is not too bad, day three through five are usually the worst days,” said Cates.
The treatment of RSV is rest, extra fluids, using a cool mist vaporizer to keep the mucous loose, treat with saline drops and suction their nose clear of mucous which should also help the coughing.
“We only give children an antibiotic if there is a secondary infections,” said Hughes. “But the antibiotic will not make RSV go away any faster.”
Cates said to use the saline drops and suction before they eat and before bedtime which will help to alleviate the coughing associated with this virus.
The season for RSV is from October/November through March. This year both doctors have seen an increase in RSV.
Children may need to be hospitalized if their oxygen levels are too low.
“We put babies in the hospital if we find their oxygen levels are too low,” said Cates. “We can closely monitor them in the hospital and be sure they are receiving the oxygen they need.”
“We have seen a lot of cases of RSV this year,” said Hughes. “Last year I saw more flu cases than RSV. The children who have had RSV this year will probably not be affected in the future, at least for a few years, so it may be that next season, we won’t see as many RSV cases.”
Cates stated that the past few weeks they have begun to see a lot of flu cases.
“There is a vaccine for the flu that babies can be given when they are six months,” said Cates.
According to Hughes, there is a preventive treatment for RSV but only for those babies who were born premature or have heart disease.
“The vaccine can be given from October to March,” said Hughes. “It is given once a month to prevent RSV during the first year of life, but it is very expensive.”
Cates said there is a clinical trial right now on an RSV vaccine so hopefully in the near future, there might be a preventative measure for this virus.
There is no easy way to prevent RSV, but diligent hand washing will go a long way, said both doctors
Adults may have a cold and are coughing,” said Cates. They could have the RSV virus, but it only affects them the same as cold.”
Hughes and Cates both say that most children do OK with RSV, but those with other health problems have to be careful. It is important to watch for the signs of this virus and get to a doctor so they can be properly diagnosed.
“Expect the cough to last three to four weeks,” said Cates.
One of the possible reasons for so many RSV cases being diagnosed now versus years ago might be because now there is a nose swab that can be done in the doctor’s office that can identify this virus.
“This probably wasn’t available a few years ago,” said Cates.
Cates recommends a website for parents, HealthyChildren.org.
Parents that know first-hand how scary RSV can be are Jenny and Circuit Judge James Jameson. Their six-month old son, Austin, was hospitalized with RSV.
“He started sneezing and coughing the Saturday before New Year’s Day,” said Jenny. “It looked like a typical cold, but early Sunday morning, his fever was 101.7. We took him to the doctor and he tested negative for flu and RSV. The doctor thought he might have a mild ear infection. By Wednesday, he was not better and had kept running a constant fever and sweating profusely at night.”
They again took him to the doctor.
“It usually takes 15 to 20 minutes for the RSV test to show positive,” said Jenny. “In Austin’s case, it showed up in two minutes.”
Jenny said she could tell he was deteriorating the next day, coughing a lot and throwing up phlegm so badly that he would get choked and she would have to use the baby Heimlich maneuver. He also was very fussy, not eating and Jenny could just tell he didn’t feel well.
“He just seemed lifeless,” said Jenny.
They decided to take him to Vanderbilt Children’s Hospital in Nashville.
“His oxygen levels were terrible,” said Jenny. “We were told it wasn’t the worst case they had seen, but it was close. He was given oxygen for four days and wasn’t able to eat because they were afraid he would aspirate, so he had to have a feeding tube.”
When I first talked to Jenny, they had been home for a week. She called me a day later to tell them they had to take Austin to the emergency room the night before.
“He was running a fever again, had chills, and started throwing up,” said Jenny. “We were told this virus could also turn into a bacterial infection or pre-pneumonia. So now he is on an antibiotic.”
Jenny says she wants to emphasize to parents to trust your gut and never be ashamed to get a second opinion.
Hughes and Cates both said RSV can cause a lot of stress and worry for parents, but in most cases, it runs its course. They both emphasized that you should try to limit a baby’s exposure to people with colds as much as you can, wash hands and toys often, and if you do see any of the symptoms of RSV, get them to their medical provider so a diagnosis can be confirmed.
“It is scary for parents and we offer as much support as we can,” said Cates. “We have someone available 24 hours a day to help support parents if they need help or just reassurance.”