Respiratory Syncytial Virus (RSV) is the most common cause of bronchiolitis. The severity of this illness can range from mild cold symptoms such as fever, cough and congestion to more severe symptoms such as wheezing, difficulty breathing and apnea. Most children who need to be hospitalized are usually younger than six months. Those at an increased risk for infection include premature babies less than 35 weeks at birth, the elderly, babies with congenital heart disease, immunodeficiency and lung disease. RSV can be spread by coming into close contact with respiratory droplets from an infected person or touching contaminated surfaces or objects such as toys and grocery carts. The season for RSV is usually from fall to spring.

The spread of RSV can be prevented by washing hands frequently especially after coming into contact with someone who is sneezing or has cold symptoms. If you have school aged children and an infant, it is best to limit contact between them until the symptoms have passed. It is also advised to avoid crowded conditions and to wash toys and bedding frequently. The extent of RSV infection in healthy babies is usually a cold but for premature babies, it can cause serious infection. Thus, babies born prematurely may be eligible for the Synagis vaccine. This vaccine consists of RSV antibodies and is given at the start of the season and every month until the end of the season. If you have an infant who is premature, your pediatrician will determine eligibility for Synagis by asking the following questions:

  • How many weeks premature was the baby?
  • Did the baby have heart disease at birth?
  • Does the baby have Bronchopulmonary Dysplasia or other chronic lung disease?
  • Do you have any family members with Asthma?
  • Does anyone smoke in the home?
  • Is the baby a product of multiple gestation?
  • Did the baby weigh less than 5.5 pounds at birth?
  • Will the baby be exposed to other children in the home or daycare?

Since most RSV infections tend to be mild, outpatient management is usually all that is needed. Most infants will need help with clearing nasal congestion with saline drops and suction with a bulb syringe, Tylenol for fever and a cool mist vaporizer. If there is excessive coughing, an albuterol inhaler or nebulizer may be necessary. In the event of respiratory distress including difficulty breathing, rapid breathing or apnea (cessation of breathing), the infant should be evaluated by an emergency room physician. These symptoms would require hospitalization, oxygen therapy and placement on a ventilator if necessary. Antibiotics would not be given as RSV is a viral illness. It may take one to two weeks for infants to recover from RSV infection. Infants can have RSV more than once so be sure to notify your pediatrician if symptoms return.

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