Respiratory Syncytial Virus (RSV) - Part II

Last week, we talked about RSV, which is one of the most common causes of childhood illness. It can be dangerous and even life-threatening for some children. This year it is causing record high emergency department visits and hospitalizations. Today, we will continue our discussion, focusing more on how RSV is diagnosed and treated and how you might decrease the spread of the disease.

How is the diagnosis of RSV made?

Your child's doctor may suspect RSV based on the symptoms your child is having, watching your child's breathing pattern, hearing abnormal lung sounds when listening with a stethoscope, along with knowing whether RSV is circulating in your community.

Other tests may not be necessary, but sometimes they can be helpful to diagnose RSV or to rule out other conditions that may cause similar symptoms. These tests may include:

• A swab of the nose to test for RSV and for COVID
• Chest X-ray to look for inflammation in the lungs
• Blood tests - such as a complete blood count
• Pulse oximetry – the skin monitor that can detect the level of oxygen in the blood

How is RSV treated?

Because RSV is a virus, antibiotics do not work to treat it. There is currently no antiviral drug that works for RSV. Most RSV infections go away on their own in a week or two. Treatment for RSV generally includes supportive measures to make your child more comfortable. These include:

• Manage fever and discomfort with medications such as acetaminophen. (Never give aspirin to a child.)
• Nasal saline drops used with nasal suctioning to help clear a stuffy nose
• Offer plenty of fluids and watch for signs of dehydration (dry mouth, little to no urine output, sunken eyes, and extreme fussiness or sleepiness)
• Talk to your child's doctor before giving any cold medications. Some medicines contain ingredients that are not good for children.

If your child has severe disease, an emergency room visit or hospital stay may be needed. Hospitalization usually only lasts a few days. Treatment at the hospital might include:

• Intravenous (IV) fluids
• Humidified oxygen
• Intubation with mechanical ventilation (a breathing tube hooked to a ventilator) is only needed in rare cases.

How does COVID-19 impact RSV?

Because Covid-19 and RSV are both respiratory viruses, some of the symptoms are very similar. Having RSV may lower immunity and increase the risk of getting COVID-19, for both kids and adults. It is also possible to have both of these infections together, which can significantly worsen the severity of illness.

Can RSV be prevented?

Just like other viruses, the spread of RSV can be decreased by using some basic lifestyle habits, including:

• Wash your hands frequently and teach your kids the importance of handwashing.
• Limit your baby's contact with people who have fevers or colds, especially in the first 6 months.
• Cover your mouth and nose when you cough or sneeze. Discard used tissues right away.
• Don't share drinking glasses with others.
• Don't smoke – Babies exposed to tobacco smoke have a higher risk of getting RSV and having more severe symptoms. If you do smoke, do not smoke inside the house or car or around the children.
• Wash toys regularly, especially when your child is sick.

Is there a vaccine or protective medication to protect against RSV?

There is currently no vaccine for RSV, but research is being done to try to develop a vaccine.

There is a medication called palivizumab (Synagis), which can help protect certain infants and children 2 years old and younger who are at high risk of serious complications from RSV. This includes:

• Premature infants
• Children with chronic lung disease
• Children with certain heart defects
• Children with a weakened immune system

The medication is given as a shot. The first shot is given at the start of the RSV season, and monthly injections are continued through the RSV season. It helps to prevent RSV infection. It does not help treat RSV once symptoms develop. Talk with your child's doctor to find out if your child might benefit from this medication. It is not recommended for healthy children or for adults.

If you have any questions about RSV, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Respiratory Syncytial Virus (RSV)

Respiratory syncytial virus (RSV) is a common respiratory virus that can be dangerous for some infants and young children. It is highly contagious and most common during the winter months in the US. Emergency department visits and hospitalizations due to RSV are at record highs this season. Let's talk more about it.

What is RSV?

RSV is an RNA virus that affects the respiratory system. It was first discovered in 1956. It has since been recognized as one of the most common causes of childhood illness. It typically causes yearly outbreaks of respiratory illnesses in all age groups. It usually causes symptoms like a common cold. But in some cases, it can cause pneumonia and bronchiolitis (infection in the smallest bronchial tubes) that can be dangerous and even life threatening.

How common is RSV?

It is so common that most children have had an RSV infection by age 2. It is the single most common cause of respiratory hospitalization in infants and has been for many years. Natural immunity after an RSV infection is relatively short-lived, so reinfection rate is high. However, having the infection more than once increases your immunity and there is some protection against severe disease that remains after an infection. Due to the pandemic, with masking and social distancing, the last 2 cold weather seasons saw very low rates of RSV infections. This has contributed to both a very early start to the RSV season this year, as well as high infection rates and high rates of severe disease.

What are the symptoms of RSV?

Symptoms usually start about 4-6 days after exposure to the virus. A typical case of RSV will cause symptoms such as nasal congestion, runny nose, dry cough, low-grade fever, sneezing, sore throat, and headache. Just like any other cold. In severe cases, the virus spreads into the lower respiratory tract. Signs and symptoms of severe disease may include:

• Fever
• Severe cough
• Wheezing - a high-pitched noise heard when breathing out
• Rapid breathing - often with short and shallow breaths
• Difficulty breathing or struggling to breathe - You may see chest muscles and skin pulling inward with each breath.
• Bluish color of the skin - due to low oxygen levels
• Poor feeding - in infants
• Irritability
• Unusual tiredness or listlessness

Who is at most risk for severe disease?

Here are the children most at risk for severe RSV disease:

• Premature infants
• Infants 6 months old and younger
• Children younger than 2 years with chronic lung disease or congenital heart disease
• Children with suppressed immune systems
• Children with certain medical conditions that cause difficulty swallowing or clearing mucus secretions

What about adults?

Adults who get RSV usually have symptoms of a mild cold that lasts around 5 days. However, some adults are at high risk of severe illness from RSV. This includes:

• Older adults, particularly 65 years and older
• Adults with chronic heart or lung disease
• Adults with weakened immune systems

Next week, we will talk more about RSV, including how the diagnosis is made and how it is treated.

If you have any questions about RSV, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Domestic Violence Prevention

We recently talked about domestic violence, also called intimate partner violence, and the significant costs associated with it. Today we'll talk about some things you can do to help prevent domestic violence.

Intimate partner violence (IPV) is preventable!

One of the important ways you can help to stop IPV is to recognize it. To recognize it, you need to know the signs. Sometimes violence begins early in a relationship but other times it develops over months or even years. It is important for women to be taught to recognize the early warning signs in a relationship. It is also important for a bystander to recognize it in order to help friends or loved ones.

What are the warning signs of IPV?

Be wary if your partner exhibits any of these signs at any point in a relationship:

• Being jealous of your friends or time spent away from your partner
• Discouraging you from spending time with your friends or family
• Embarrassing you or shaming you
• Controlling your financial decisions or your access to money
• Blaming you for all the problems in the relationship
• Blaming you or others for their problems
• Preventing you from working
• Intentionally damaging your property
• Intimidating you physically, especially with weapons
• Threatening violence against you, a loved one, or a pet to gain compliance
• Pressuring you to have sex when you don't want to

What are some ways that you can prevent or stop IPV locally?

• Don't ignore it - If you hear or see a violent or potentially violent situation, call the police. You could save a life!
• Listen - If someone ever confides in you about domestic violence, listen without judgement. Ask how you can help.
• Be available - Be ready to help if someone you know is thinking about leaving or is in fear that the violence will escalate. Keep your phone with you. Discuss an escape plan or meeting place ahead of time.
• Know the number to a nearby shelter - You never know who might need refuge in a hurry.
• Check in with friends and loved ones regularly - Especially if you know they are in danger.
• Be a resource - Those experiencing IPV may not be able to research shelters, buy a cell phone, or do other critical planning while living with their abuser. Offer to help them do these tasks and keep things confidential!
• Write it down - If you witness any violence, you should document every episode, including all details such as date, time, location, injuries, circumstances, etc. This information could be critical in later court cases.
• Raise awareness – Assist local organizations in their efforts to raise awareness in your community. Organize talks at your local church, community groups, wellness fairs, etc.
• Use the power of the purse – Refuse to support music, television programs, games, etc., that glorify violence, especially violence against women.
• Support charitable organizations that focus on preventing violence.

For more information on preventing IPV, use this link Fast Facts: Preventing Intimate Partner Violence |Violence Prevention|Injury Center|CDC

If you have any questions about domestic violence prevention, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor