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Respiratory Syncytial Virus

WHAT YOU NEED TO KNOW:

What is a respiratory syncytial virus (RSV) infection?

An RSV infection is a condition that causes your child's airway to become inflamed and swollen. This virus is the most common cause of lung infections in infants and young children. An RSV infection often leads to other lung problems, such as bronchiolitis or pneumonia. An RSV infection can happen at any age, but happens more often in children younger than 2 years. An RSV infection usually lasts 5 to 15 days. Most RSV infections go away on their own.

How does the virus spread?

RSV is highly contagious. An infected person may spread germs to others through coughing, sneezing, or close contact. He may leave germs on objects such as beds, tables, cribs, and toys. Your child may get infected by breathing in the virus. He can also get infected by putting objects that carry the virus into his mouth or by touching the object and then rubbing his eyes. Your child may get RSV from a school-aged brother or sister or at a daycare center. RSV infections usually occur in outbreaks (clusters of infected people), where 2 or more children are infected.

What increases my child's risk for a severe RSV infection?

  • Being born prematurely (less than 37 weeks) or at a low weight (less than 5 pounds)
  • Age younger than 6 months
  • A medical condition, such as a heart problem or cystic fibrosis
  • A weak immune system caused by certain conditions, such as HIV or a bone marrow transplant
  • Exposure to high levels of secondhand cigarette smoke

What are the early signs and symptoms of an RSV infection?

RSV infection begins like a common cold. Your child may have any of the following:

  • Breathing faster than usual
  • Cough or wheezing
  • Fever
  • Not eating or sleeping as well as usual
  • Runny or stuffy nose

What are the signs and symptoms of a severe RSV infection?

  • Very fast breathing (60 to 70 breaths or more in 1 minute), or pauses in breathing of at least 15 seconds
  • Grunting and increased wheezing or noisy breathing
  • Nostrils become wider when breathing in
  • Pale or bluish skin, lips, fingernails, or toenails
  • Pulling in of the skin between the ribs and around the neck with each breath
  • A fast heartbeat
  • Loss of appetite or poor feeding, or being fussier or more irritable than before
  • More sleepy than usual, trouble staying awake, or not responding to you
  • Urinating little or not at all
  • Increased coughing, or coughing that causes vomiting

How is an RSV infection diagnosed?

Your child's healthcare provider will examine your child and ask about his signs and symptoms. He will ask about how your child has been eating, drinking, sleeping, and acting. Tell him about your child's activities and if he has been around any sick people. Tell him if your child has other medical problems. Your child's healthcare provider will watch how he is breathing. Your child may also need any of the following tests:

  • Blood tests may be used to check for the respiratory syncytial virus.
  • X-ray pictures of your child's lungs and heart may be used to check for infection.
  • A culture is a test to grow and identify the germ that is causing your child's condition. A culture may be done from swab samples taken from your child's throat or nose.
  • A nasal wash is used to test a sample of mucus from your child's nose for the germ causing his symptoms.

Which medicines are used to manage an RSV infection?

Antibiotics only treat a bacterial infection and will not treat an RSV infection. Do not give over-the-counter cough and cold medicine to a child younger than 6 months. The following can help you manage your child's symptoms until the infection is gone:

  • Acetaminophen may help decrease your child's pain and fever. This medicine is available without a doctor's order. Ask how much medicine is safe to give your child, and how often to give it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
  • Bronchodilators may be given to help open narrowed airways. Your child will use a nebulizer to take this medicine. His healthcare provider will show you and your child how to use the nebulizer.
  • Ask about medicine that protects against severe RSV. Your child may need to receive antiviral medicine to help protect him from severe illness. The medicine may be given if your child was born prematurely or has a chronic lung disease. When needed, your child will receive 1 dose every month for 5 months. The first dose is usually given in early November. Ask your child's healthcare provider if this medicine is right for your child.

What else can I do to help manage my child's symptoms?

  • Have your child rest. Rest can help your child's body fight the infection.
  • Prevent dehydration. Encourage your child to drink liquids often. Ask your child's healthcare provider how much liquid your child should drink each day and which liquids are best for him.
  • Mucus removal is a procedure used to suck mucus from your child's nose with a bulb syringe. Do this before you feed him so it is easier for him to drink and eat. Ask your child's healthcare provider how to use a bulb syringe. Ask for information about nose drops that help thin your child's mucus.
    Proper Use of Bulb Syringe

What can I do to help prevent an RSV infection?

  • Wash your and your child's hands often. Use soap and water. Use gel hand cleaner when soap and water are not available. Wash your hands after you use the bathroom, change a child's diapers, or sneeze. Wash your hands before you prepare or eat food.
  • Keep your child away from others while he is sick. This will help prevent spreading the virus to others.
  • Clean toys and surfaces. Clean toys that are shared with other children. Use a disinfectant solution to clean common surfaces.
  • Do not smoke around your child or expose your child to smoke. Smoke can make your child's symptoms worse. Nicotine and other chemicals in cigarettes and cigars can cause lung damage.
  • Ask about medicine that protects against severe RSV. Your child may need to receive antiviral medicine to help protect him from severe illness. This may be given if your child has a high risk of becoming severely ill from RSV. When needed, your child will receive 1 dose every month for 5 months. The first dose is usually given in early November. Ask your child's healthcare provider if this medicine is right for your child.

When should I seek immediate care?

  • Your child has a hard time breathing, is breathing faster than usual, or has pauses in his breathing.
  • Your child has signs of dehydration:
    • Crying without tears
    • Dry mouth or cracked lips
    • More irritable or sleepy than normal
    • Sunken soft spot on the top of the head, if he is younger than 1 year
    • Urinating less than usual, or not at all
  • Your child's lips or nails turn blue.
  • Your child's symptoms do not get better, or they get worse.

When should I contact my child's healthcare provider?

  • Your child has a fever and is wheezing.
  • Your child is not eating, has nausea, or is vomiting.
  • Your child is very tired or weak, or he is sleeping more than usual.
  • Your child is breathing fast:
    • More than 50 breaths in 1 minute if he is 6 months or younger
    • More than 40 breaths in 1 minute if he is 6 to 11 months old
    • More than 30 breaths in 1 minute if he is 1 year or older
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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