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 it seems like your daughter is having trouble breathing, so you go to the emergency room. They inform you that she has RSV and needs to be admitted. What is this? Why is it so serious? How is it treated?
Respiratory syncytial virus, or RSV, is an infection of the lungs and respiratory tract that is so commonplace most children have been exposed to it by the age of 2. It is seasonal and tends to be more prevalent starting in the fall lasting to 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 in an infected person. Since it can live on hard surfaces, like countertops and toys, for several hours it’s easily spread. This is why children who go to child care centers or have older siblings who go to school are at high risk of being exposed. 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 and symptoms usually appear within four to six days of exposure. Adults and older, healthy children usually just have mild symptoms that appear 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 who were born premature), older adults, anyone with heart/lung diseases or anyone who has a weakened immune system. Symptoms of a severe infection include fever, severe cough, wheezing, rapid/difficult breathing and bluish color of the skin, especially around the mouth and fingernails. Severe symptoms just pertaining to 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, development of asthma and repeated RSV infections.
For mild cases of RSV, the treatment is supportive care measures to make you or your child more comfortable. It’s important to reduce the fever, so use over-the-counter medication, like acetaminophen. Nasal saline drops and suctioning can help to remove mucous from the nose. For infants and young children, be sure to do this before feedings and putting them to bed. Stay calm or 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 fluids 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, just be sure to clean the device regularly. Secondhand smoke can make symptoms worse, so stay away and keep your child away from it.
For those with a severe infection, it’s critical that you 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 in order 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 have not been shown to be helpful treatment options for those with RSV.
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 type of 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 premature. Make sure hard surfaces are kept clean by disinfecting regularly, 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. It’s imperative that you don’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 a chronic lung disease, children under 12 months of age who have a congenital heart disease, children under 2 who needed to be on supplemental oxygen for at least a month after birth and continue to need lung-related treatments and children under 2 who are immunocompromised. The medicine must be given once a month for five months during RSV season. It’s key to note that it won’t treat an infection once the person has developed symptoms.
RSV is usually something that’s 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