Respiratory Syncytial Virus is one of the major causes of respiratory tract infections in children. According to the National Institute of Allergy and Infectious Diseases, in the US, nearly all children become infected with RSV by age 2, with 75,000 to 125,000 of them hospitalized every year. Globally, RSV affects an estimated 64 million people and causes 160,000 deaths every year. It also affects adults exposed to the virus, and for elderly people with heart or lung ailments or a weakened immune system and preterm infants, it can lead to serious consequences.
What is RSV?
Respiratory Syncytial Virus is the leading cause of infection in the respiratory tracts and lungs of infants as well as growing children. Most children below the age of 2 years have been affected by RSV. In children above 3 years of age and elderly, it shows symptoms of upper respiratory infection and common cold, but in young infants and children below 3, it can have more intense symptoms leading to hospitalization and in some cases – death. In such children, RSV affects the lower respiratory tract leading to bronchiolitis and/or pneumonia.
How does it spread?
RSV is generally prevalent in the months between autumn and summer (November to March in upper hemisphere countries). RSV is highly contagious and spreads quickly through air (indirect contact) and fluid secretions from the nose and mouth of an infected child (direct contact). The virus is sturdy and can easily survive for a few hours to a day on surfaces such as counters, doorknobs, books and clothes. This means, it spreads quickly through schools and childcare centres. Affected children carry the virus home and infect their siblings at home.
According to the National Centre for Biotechnology Information (NCBI), maternal smoking is an independent risk factor for infection. So also, low vitamin D level in cord blood was found to be associated with a 6-fold increased risk for lower respiratory tract infection caused by RSV, in children below 1 year of age.
Preterm or prematurely born infants and those with congenital heart or lung disease are at high risk. So also, children of any age group with weakened immune systems, such as those undergoing chemotherapy or transplantation are at risk.
Elders with asthma, chronic lung disease, cystic fibrosis, congenital heart disease, nerve and muscle system diseases, primary and secondary immune deficiencies including those with certain transplanted organs, leukemia or HIV/AIDS, broncho-pulmonary dysplasia are all high-risk candidates for RSV.
Signs and Symptoms
Symptoms of RSV show up in 4 to 6 days after exposure to the virus. Depending on how severe the infection is and whether it’s affected the upper or both upper and lower respiratory tract, the symptoms can last between 10 days to several weeks. When the symptoms are mild or intense, parents of the child should seek medical help at the earliest and when they are severe, it calls for emergency medical help.
- Mild symptoms are similar to that of common cold and include congested or runny nose, mild headache, low-grade fever, sore throat and dry cough.
- Intense symptoms include poor appetite, unusual tiredness (lethargy), irritability and fever.
- Severe symptoms include high fever, rapid breathing, wheezing noise during breathing, deep breathing and bluish skin or nails due to lack of oxygen (a condition called as cyanosis).
Complications from RSV
RSV that progresses rapidly in children can lead to bronchiolitis and pneumonia both of which require hospitalization for a week to 10 days. In some children below 2 years of age, RSV can also cause infection in the middle ear, also called otitis media. Children who have suffered an intense bout of RSV in childhood face the risk of developing asthma as adults. Further, children who have had one instance of infection can develop a second or third infection, sometimes in rapid succession.
Diagnosis and Treatment
Doctors usually look for symptoms of common cold and then assess the medical history of the child. Thereafter, using cotton swabs or a bulb syringe, samples of the nasal fluid are collected and analyzed for RSV. Treatment includes giving intravenous fluids, monitoring the breathing constantly and treating fever using drugs such as acetaminophen. Hot water and steam humidifiers must not be used as they can cause scalding.
Since RSV spreads through both direct and indirect contact, preventive care is possible and must be exercised as much as possible. Both children and adults who have spent time with a child that has cold like symptoms must wash their hands with soap and wash the clothes worn at that time. Children with common cold like symptoms must be kept at a distance from siblings at home, especially babies. Finally, ensure your home is adequately ventilated so that germs can exit the house easily.