P E D I AT R I C H E A LT H
RSV: Respiratory Syncytial Virus >> Do what you can to keep your infant from catching RSV David Zipes, M.D., medical director, pediatric hospitalists, Peyton Manning Children's Hospital at St.Vincent
In the U.S., RSV infections generally occur during winter and early spring. Spreading quickly among people in close quarters (such as day care centers), RSV is passed by means of close contact and respiratory droplets. RSV can travel with a cough or linger on door handles and other surfaces for hours. Mostly, that’s not a problem. Older children and adults with RSV tend to develop a cough, runny nose, low fever and other mild cold symptoms. In fact, almost everyone has gotten RSV by the time they are two years old. However, for infants – especially those who are premature, have weakened immune systems or have other chronic illnesses – RSV can lead to bronchiolitis (inflammation of the bronchial or small airways), ear infections and pneumonia. Respiratory failure is also a danger. Of note, there are many other viruses that can cause bronchiolitis indistinguishable from that caused by RSV.
To prevent the spread of RSV: • Always wash your hands before handling your baby, and ask family and friends to do the same. • Don’t let anyone with cold symptoms kiss or breathe on your baby. • Don’t smoke or let smokers get near your baby without a little advanced preparation. Ask that smokers take a shower or bath before holding your infant and wear clothes that have not been worn while smoking. • Limit the time your baby spends in crowds. • Wash toys and common-use surfaces, such as door handles, frequently.
What to watch for: If your infant has cold symptoms that progress into high fever, thick, heavy mucous, dehydration or breathing difficulties, it’s time to call your medical provider. (It’s difficult to gauge how much infants are drinking, especially if they breastfeed. A dry diaper for more than six hours is one sign of dehydration.) Severely affected infants may need hospital-based care, including IV fluids, oxygen and sometimes treatments to open airways. Most studies show that nebulizer treatments are not very effective, but sometimes your physician may suggest them. Like other cold viruses, RSV will go away on its own, but RSV has been linked to asthma later in childhood. If your infant is at risk for serious RSV, your physician may prescribe medication (a monthly shot) to help keep him or her from getting sick.
12 INDYSCHILD.COM // JANUARY 2014