RSV stands for respiratory syncytial (sin-SIH-shul) virus. It infects half of all children by the time they are a year old, and almost all by the age of two. RSV is the most common cause of lower respiratory tract infections, including pneumonia and bronchiolitis, in children. About 10,000 children are hospitalized in Canada each year with RSV infection. Infections mainly occur from November to April.
Everyone. Even after being infected with RSV, children and adults get infected again and again throughout their lives. The disease is much more severe in younger infants. Children at highest risk tend to come from lower socio-economic families. Luckily, out of 50 to 100 children with RSV, only about one child will be sick enough to be admitted to hospital.
This virus spreads though respiratory droplets that can live for up to six hours on countertops. It usually enters the body through the eyes and nose. Symptoms appear about five days later. People are usually infectious for about a week.
It is very common for the virus to spread through a family. Very often an older child with a normal ‘cold’ brings the virus home to an infant, who then develops more serious disease.
After being infected with RSV, kids can develop illness ranging from a mild ‘cold’ to pneumonia. It starts with a runny nose, sore throat and cough, and may include fever. If it progresses, children may breathe rapidly, wheeze, and have trouble taking breaths.
Wheezing is the most common reason for kids to go to the doctor’s office. Swelling in the small, lower airways, called bronchiolitis, causes the wheezing. Of most concern are babies less than three months old, and those with other health problems like heart or lung disease. Very young infants are at risk of stopping breathing. In older children and adults, most RSV infections cause only nasal congestion and cough.
Usually, a doctor can diagnose RSV after doing a complete history and exam. However, the only way to know for sure if a child has RSV is to take a sample of nasal secretions and test them in a lab. This is usually only done if the child is likely to be admitted to hospital.
Most children with RSV require no treatment at all. Their bodies simply need time to fight off the infection. Parents and caregivers need to make sure breathing is easy and watch for dehydration. When in doubt, it is always safest to have a nurse or doctor examine the child.
If breathing is an issue, normally the child will be admitted to and watched in hospital. Often, a small amount of oxygen is given to the child through short tubes that fit into the nose. Sometimes medications that open the airways are given, such as salbutamol (Ventolin™) or epinephrine.
Rarely, children with RSV cannot breathe properly by themselves and must be supported with mechanical ventilation (breathing machine) for a few days while their bodies fight off the virus.
Handwashing is the most important thing we can do to prevent spreading the virus. Children whose parents smoke are at higher risk. Keep young infants away from sick people and out of crowded places during the RSV season. Breastfeeding has also been shown to be protective.
There is no routine vaccine for RSV. However, an immunization is available in Canada for premature babies (born more than two months early), and babies with heart and lung disease. It is called palivizumab (Synagis™), and is given by injection each month throughout the RSV season.