Putting on my doctor hat for this week’s blog post. Unless you have been living under a rock, you have probably heard grumblings over the last few weeks about RSV. Whether from a friend with a kid or from the news, cases are on the rise. RSV has been around forever, it’s not a new thing in this Post-COVID world.

Unfortunately, cases are up this year for probably a couple reasons. 1. Kids are back in school, in person – RSV is highly contagious. 2. A lot of younger kids may have been more isolated over the last few years and were less likely to be exposed previously so their immune systems are just now getting introduced to RSV. 3. In general, as a society, we were pretty good at isolating ourselves when sick (COVID or not) and now, we may have gotten a little more relaxed with that practice.

I thought I would give an overview of what RSV can look like, measures to try to prevent it and what to do if you or your family gets sick. Management of RSV (at least from home) can really be applied to any kind of upper respiratory infection and unfortunately ‘tis the season. 

What is RSV?

RSV or respiratory syncytial virus is one of the many viruses that can cause the common cold. We talk about it so much as its own entity though because it is the most common cause of serious respiratory infection in infants – especially babies under 1. It can cause bronchiolitis (inflammation in the small airways) and pneumonia. It can also cause severe infection in older adults generally because of their weakened immune system. 

Symptoms

Symptoms of RSV in most cases include typical cold symptoms – fever, cough, runny nose, sneezing, decreased appetite, wheezing, and general malaise. In babies – we may see these symptoms but also general irritability and poor feeding. Symptoms typically start days after exposure and can last up to 2 weeks. If you have any of these cold symptoms, I would recommend staying clear of young infants – especially those under 1! 

Severe RSV Infection

Symptoms to look for especially in babies include increased work of breathing and dehydration. If your baby seems to be breathing faster than normal and / or is using a lot of muscles to breathe they should have an urgent medical evaluation. If your baby is sick, take their shirt off and watch the muscles near their neck, their collar bones and in their abdomen – any excess movement here signals increased work of breathing.

Dehydration in infants can be monitored via wet diapers –  generally infants should have at least 6 wet diapers in a 24 hour period. Toddlers should be going to the bathroom at least once every 8 hours. 

Most of the time infants or kids that need hospitalization for RSV require only a day or two of supportive care – this can look like oxygen support or IV fluids. Still a scary thing to have to live through. It’s never fun to see your baby suffering. 

How does RSV spread?

RSV can spread in several ways – respiratory droplets – think a cough, sneeze, etc and with direct surface contact – it can actually stay on hard surfaces for a few hours. You can see how it can easily spread in daycare centers or schools. Once a person is infected with RSV, they can be contagious for up to 8 days. Frequent hand washing is so important to try to minimize our own personal contact. It would be really nice if at home testing for RSV was readily available as it is for COVID-19 now. 

How to treat?

Unfortunately, there is not a specific medication or treatment for RSV. Medications and vaccines are in development but nothing is currently available to RSV specifically. We have to manage the symptoms and kind of let the illness run its course. These general principles can apply to pretty much any cold your kids may experience! 

Manage the Fever

A true fever is any temperature over 100.4. Medications for fever include acetaminophen (Tylenol) or ibuprofen (Motrin). Babies under 6 months of age should only receive Tylenol. Consult your pediatrician or family doctor to make sure you are giving the right dosage of medication. It is weight based so it changes as your child grows! I should mention here, if your infant is younger than 3 months and they have a fever over 100.4 – that really should immediately prompt an ER visit – especially if they are younger than 1 or 2 months old.

A rectal thermometer should be used for infants under 4 months old (fun I know). An axillary (armpit) or ear thermometer can be used for older infants and toddlers. Once a child is over 4 you could also use an oral thermometer.

Encourage Sleep!

When kids are sick, sleep is so, so important. Keep them comfortable with appropriate management of the fever as above and make sure they stick to their normal sleep schedules – bonus if they are able to get extra sleep during this time!

Hydration, hydration, hydration

Maintain regular nursing or formula feedings for baby and encourage water, Pedialyte, Gatorade etc. for your older kids.

Dealing with a Stuffy Nose

There aren’t really any over the counter medicines that are recommended for children for congestion / runny nose. Saline nasal sprays can help with congestion. There are tons of different suction devices too that can help when babies / toddlers are unable to blow their nose. Vaseline or other topicals can be used around the mouth and nose to help with the repeated irritation of using tissues.

As always, consult your own pediatrician or family doctor for any medical advice or for questions you may have!

Hopefully some of these tips can help get you through the cold, flu and RSV season! Stay safe and wash your hands!

If you like seeing posts like this – comment below! If you have any other ideas or medical topics I should cover let me know! I’ll try to keep things timely and relevant for whatever season we are in.

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