Experts discuss symptoms and when to see a doctor for your child

  • Respiratory syncytial virus (RSV) can cause a cold-like illness that is usually mild.
  • But for infants, the elderly, and immunocompromised people, it can lead to more serious symptoms, including difficulty breathing.
  • RSV cases are increasing in parts of the United States

Parts of the United States are experiencing an upsurge in respiratory syncytial virus (RSV), which causes a cold-like illness that is usually mild but can lead to difficulty breathing for infants, the elderly and people with certain medical conditions.

RSV cases plummeted in 2020 at the start of the pandemic as communities implemented face mask policies and other measures to slow the spread of the coronavirus that causes COVID-19.

When these mitigations were lifted in the summer of 2021, the RSV returned – between the usual fall and winter seasons.

Now cases are rising again, with doctors fearing that a tri-demic of respiratory illnesses – RSV, seasonal flu and COVID-19 – will put additional strain on hospitals and doctors’ offices.

With that in mind, we asked three medical experts for their perspective on the current RSV outbreak and advice for parents of young children.

Dr. Daniel Ganjian is a pediatrician at Providence Saint John’s Health Center in Santa Monica, California.

Dr. Jonathan Maynard is a pediatrician at Providence Mission Heritage Medical Group in Orange County, California.

Dr. Juanita Mora is an allergist/immunologist and national volunteer medical spokesperson for the American Lung Association in Chicago.

Here’s what they had to say.

Ganjian: During the pandemic, many people wore a mask and did a good job of hygiene, so most of them have not contracted RSV in recent years.

Because of this, people’s antibody levels against RSV are now very low, so people are more susceptible to getting RSV, which includes adults, children, and babies.

Typically, when these RSV outbreaks occur, they are short-lived because many people catch the virus for a short time and it goes away. We therefore hope that the current surge will only last a few months.

More: Part of the push is due to us coming out of the pandemic. This is the first fall and winter that we will not have any COVID-19 restrictions in place in schools, or even in public places like airports.

We’ve also had kids who have done a lot of virtual homeschooling over the past two years, so they haven’t gotten sick as often. Usually, most children will have RSV by the age of two.

So now we have a whole population of younger children who have never seen RSV because they were home most of the time and wore masks to school.

On top of that, many children who have had RSV before are re-infected.

Ganjian: There is no special medicine for RSV. You treat it the same way you treat a cold – nasal saline solution, nasal aspirate, spray, acetaminophen or ibuprofen for any pain or fever, and lots of TLC.

Symptoms usually get worse on days three to four, then they start to clear up. It takes about a week or sometimes two weeks for the symptoms to go away completely.

Maynard: There is no proven treatment for the RSV virus itself. The management of RSV therefore focuses on the type and severity of symptoms.

In severe cases – especially those complicated by bronchiolitis, pneumonia or apnea – patients may need to be hospitalized for respiratory support and treatment for dehydration.

However, most children can rest and recover at home without the need for medication.

More: Because we’re currently living in a tri-demic with COVID-19, RSV, and influenza — which often have similar symptoms at first — one quick thing you can do at home is test your child for COVID-19. .

Then start giving medication to relieve their symptoms and provide supportive therapy – plenty of fluids, ibuprofen if needed for fever, etc.

If symptoms get worse, call your child’s pediatrician. They can take a nasal swab to test for COVID-19, influenza and RSV, with a response within minutes.

[NOTE: Do not use acetaminophen in a child under 12 weeks of age, or ibuprofen in a child less than 6 months old, unless recommended by your child’s doctor.]

Maynard: RSV often begins with nasal congestion and a runny nose. After a few days, people develop a cough, fever, and wheezing. For most patients, the symptoms are mild and disappear within a few weeks. For a small number of patients, respiratory symptoms may worsen and lead to breathing difficulties.

Parents should take their child to the emergency department if the child shows signs of difficulty breathing, which may include rapid breathing, flare of the nostrils, sagging of the skin between the ribs while breathing (intercostal retractions) , wheezing and decreased activity or body tone.

More: RSV begins with mild cold-like symptoms – runny nose, sneezing, etc. – but once it reaches the lungs, babies can start having trouble breathing.

So if there are any signs of respiratory distress – their chest wall rises and falls or they start to have a worsening cough – parents should definitely take the child to the emergency room.

Same with signs of dehydration. I tell parents to watch, especially babies, how many diapers they change. If the diaper count really starts to drop, it could be a sign of dehydration. If so, see a doctor immediately.

Ganjian: Children generally do well with RSV. Very young children and premature babies are most at risk of having a more serious illness.

Additionally, older people and adults with certain medical conditions have a higher risk of more severe disease with RSV. These conditions include heart disease, lung disease, and immune deficiencies.

Maynard: For young children (under 5 years old) and children with underlying health conditions (lung and heart disease, immunosuppression, etc.), serious RSV infections can sometimes cause significant difficulty breathing.

Breathing difficulties come with a risk of significant dehydration, as children are unable to drink enough due to shortness of breath. A small number of infants with severe RSV may even develop episodes of apnea, where they briefly stop breathing.

More: Children born prematurely – those born at less than 32 weeks gestational age – are at higher risk of complications from RSV because their lungs are not well developed.

Children with congenital heart disease, lung problems such as severe asthma, or a neuromuscular disorder that affects their breathing are also at greater risk.

Ganjian: If your child has RSV or cold-like symptoms, do not send your child to school without first seeing a doctor, especially if he or she has had a fever in the past 24 hours or if his cough is getting worse. You can ask your child’s doctor how long to keep him out of school.

More: If a child is sick, we want parents not to send their child to school or daycare. I tell them: “keep the germs at home”.

Ganjian: To help your child stay healthy, you need to make sure their immune system is working optimally. This means making sure they sleep well and eat well. In addition, they should practice good hygiene, such as washing their hands before eating.

If there’s a baby at home with an older child going to school, ask your older child to shower and change clothes when they get home from school. Then they can play with the baby.

Additionally, maintaining a happy home environment can support the immune system and help children fight off common viruses.

Maynard: RSV is highly contagious. It is mainly spread by direct contact with the respiratory secretions of an infected individual or with an object that these secretions have contaminated.

It can also spread up to 6 feet away when an infected person coughs or sneezes. Wearing masks, frequent hand washing and cleaning common surfaces are very effective ways to prevent infection.

More: Helping kids wash their hands frequently — or use hand sanitizer — is going to be important. Also, at home, especially in a multi-generational home, if a child is sick, have him wear a mask.

This is especially important if there is someone in the house who is immunocompromised, such as a grandparent, aunt, or uncle who might be on chemotherapy or have diabetes, COPD, or whatever puts them at risk. a high risk of complications.

More: Families will come together over the next few months for Halloween, Thanksgiving and other holidays. To protect children and their family members, eligible children should receive an updated COVID-19 booster and flu vaccine.

[NOTE: Children 6 months or older are eligible for the COVID-19 primary series; those 5 years and older are eligible for a COVID-19 bivalent booster. Children 6 months and older are eligible for a seasonal flu shot.]