Dear Doctors: What can I do to protect my baby from RSV? What are the symptoms? People are talking about a “triple epidemic” and my husband and I are worried. We are both vaccinated against the flu and COVID-19, and are being extra careful when we are out. What else can we do?
Dear Reader: RSV is short for respiratory syncytial virus. It is a common winter virus that can affect people of any age. In most cases, RSV infection causes mild symptoms similar to the common cold. However, infants and children under 2 years of age, whose immune systems are still developing, are at greater risk of serious illness.
RSV is the most common cause of pneumonia in infants and young children in the United States. It is also the leading cause of bronchiolitis in this age group. This is a lung infection in which the smaller airways become inflamed and swollen, and an increase in mucus production prevents the flow of air in and out of the lungs.
This year, as with the flu, RSV season has arrived early. Hospitals in the United States are reporting an increase in serious infections among infants and younger children.
The virus enters the body through the respiratory tract and mucous membranes. It can remain viable on hard surfaces such as a doorknob, nightstand or tableware for several hours. It can also persist on softer surfaces such as fabric or skin. Someone can become infected by breathing in viral particles left in the air after a cough or sneeze, or by touching their mouth, nose, or eyes after direct contact with contaminated droplets.
Someone who is sick with RSV usually remains contagious for four to eight days. However, because of their still-developing immune systems, babies may continue to spread the virus for several weeks, even after the symptoms of the disease have subsided. There is no vaccine for this virus, and no specific treatments. Prevention is based on the same precautions you use to avoid any respiratory illness. That is, keep your baby away from sick people, avoid close contact with people outside your home, and pay attention to hand hygiene.
Symptoms of RSV appear three to six days after infection. They can include a runny nose, sneezing and coughing, fever, decreased appetite, and lung congestion that can lead to wheezing. These symptoms tend to be progressive, arriving in stages as the body begins its attack against the virus. But in very young patients, the first, and sometimes only noticeable, symptoms of RSV may be increased restlessness, decreased activity, and difficulty breathing.
Treatment for RSV is to control the symptoms. The specific pathway of care depends on the child’s age, general health, and symptoms. In infants, treatment of RSV includes a focus on adequate hydration and being alert for any signs of breathing problems. Most RSV infections run their course within a week to 10 days. Parents of younger infants should consult their pediatricians for guidance on treatment, especially medications. If your child has trouble breathing, isn’t drinking enough fluids, or has worsening symptoms, call your doctor right away.
Eve Glazier, MD, MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, MD, is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Due to the volume of mail, Personal responses cannot be provided.