Why is your child having trouble breathing?
You wake up one morning and find that your infant daughter is congested. At first, you don’t think too much about it because your 3-year-old son has had a cold the past few days. A day goes by, and you notice that your daughter is having trouble breathing, so you go to the emergency room. They tell you that she has RSV and needs to be admitted. What is this? Why is it so serious? How is it treated?
Definition
Respiratory syncytial virus, or RSV, is an infection of the lungs and respiratory tract that is so commonplace that most children have been exposed to it by the age of 2. It’s seasonal and tends to be more prevalent starting in the fall and lasting until the end of spring. It’s spread as respiratory droplets that typically enter the air through an infected person sneezing or coughing. You can also get it if you have direct contact with an infected person.
Since it can live on hard surfaces, like countertops and toys, for several hours, it’s easily spread. Children who go to childcare centers or have older siblings who go to school are at high risk of exposure. The virus enters your body through your eyes, nose, or mouth. While an infected person is most contagious in the first few days, they can continue to spread the virus for a few weeks.
It can infect anyone. Symptoms usually appear within four to six days of exposure. Adults and older, healthy children typically have mild symptoms similar to the common cold, such as congested/runny nose, dry cough, low-grade fever, sore throat, and mild headache. Most of the time, these individuals recover within a week or two. The issue is that certain populations are at higher risk of developing more severe symptoms. These groups include infants (especially those born prematurely), older adults, anyone with heart/lung diseases, or individuals with a weakened immune system.
Symptoms of a severe infection include fever, severe cough, wheezing, rapid/difficult breathing, and bluish skin color, especially around the mouth and fingernails. Severe symptoms seen just in infants are their chest muscles/skin pull inward with each breath, poor feeding, irritability, and unusual tiredness (lethargy). Due to the severity of the illness, it can cause several complications, such as pneumonia, bronchiolitis (inflammation of the small airway passages in your lungs), middle ear infections, the development of asthma, and repeated RSV infections.
Treatment
For mild cases of RSV, the treatment is supportive care measures to make you or your child more comfortable. Reducing the fever is important, so use over-the-counter medication, like acetaminophen. Nasal saline drops and suctioning can help to remove mucous from the nose. Be sure to do this for infants and young children before feeding and putting them to bed. Stay calm and keep your child as calm as possible, so they don’t get short of breath. You can try distracting them by reading, cuddling, or playing a quiet game.
Make sure to drink plenty of fluids so you or they don’t become dehydrated, which might present as dry mouth, little/no urine output, sunken eyes, and extreme fussiness/sleepiness. Cool fluids can help soothe a sore throat, and warm liquids can help loosen up secretions, so try using a combination of both. It’s also essential to continue to feed your child as you normally would. Another way to ease congestion and coughing is to use a cool-mist humidifier or vaporizer to moisten the air to 50% humidity. Since bacteria and mold like moist environments, clean the device regularly. Secondhand smoke can worsen symptoms, so stay away and keep it away from your child.
For those with a severe infection, you must seek help immediately if you are having trouble breathing or you notice that your child is having difficulty breathing. Once at the hospital, you or they will probably need to be admitted to receive intravenous (IV) fluids, humidified oxygen, and, in some cases, be placed on a ventilator to help you or them breathe. If you or they have a compromised immune system, the doctor might recommend an antiviral medication, ribavirin, that is inhaled. It’s important to note that inhalers and steroids haven’t been shown to be useful treatment options for those with RSV.
Prevention
Even though scientists are working on a nasal spray vaccine, there isn’t one available yet. So, preventive measures are precautions you should take to protect yourself and your children from any infection. One of the most important is frequent and thorough handwashing. Limit the time you and your children spend with those who have fevers or colds, especially during the first few months of your child’s life and if they were born prematurely. Make sure hard surfaces are cleaned by regularly disinfecting, especially countertops, door knobs, and your child’s toys. If you or someone in your family is sick, don’t share drinking glasses or eating utensils with them. You mustn’t smoke around your child.
There is a medication, palivizumab, that is available to protect those who are at high risk of a severe RSV infection. Those in the high-risk group would be infants under the age of 1 who were born before the 29th week of gestation, premature infants with chronic lung disease, children under 12 months of age who have congenital heart disease, children under two who needed to be on supplemental oxygen for at least a month after birth and continue to need lung-related treatments and children under two who are immunocompromised. The medicine must be given once a month for five months during RSV season. It’s vital to note that it won’t treat an infection once the person has developed symptoms.
RSV is usually a mild annoyance, but sometimes, it can be quite serious. By knowing what to look for, you’ll know when to get help. If you have any questions or concerns about RSV, please speak to your doctor. If you would like more information, please visit the American Lung Association’s RSV page at https://www.lung.org/lung-health-diseases/lung-disease-lookup/rsv