Pneumonia and in more severe cases can lead to respiratory failure. Symptoms may include high fever, severe cough, wheezing, abnormally rapid breathing, difficulty breathing, and a bluish color of the lips or fingernails caused by lowered levels of oxygen in the blood. In infants with severe RSV infection, there may be abnormal retractions of the muscles between the ribs, as the child struggles to draw breath into infected breathing passages. Children who were born prematurely, or who have preexisting lung, heart, or immune problems, are at greatest risk to have serious complications from RSV infection.
Description
RSV is a virus that causes infection of the lungs and breathing passages. It can infect the same person several times during a lifetime, causing more severe illnesses (like pneumonia) in infancy, but only a common cold in adulthood. After each RSV infection, the body forms some immunity to the virus, but that immunity is never complete. Re-infections occur, but they usually are less severe than earlier RSV attacks. RSV passes from person to person through infected nasal and oral fluids. It can enter the body when the eyes or nose are touched.
RSV infections occur all over the world, most often in epidemics that can last up to 5 months, from late fall through early spring. Since 1990, epidemics have typically begun sometime between late October and mid-December, and peaked during January and February. Each year, RSV infections lead to more than 125,000 hospitalizations and about 2,500 deaths.
The highest rates of RSV illness occur in infants 2 to 6 months old, with a peak at age 2 to 3 months. RSV infection is often carried home by a school-age child and passed on to a younger one, especially an infant. When RSV infects a child-care center, it is not unusual to see 100% of the children come down with an RSV infection. RSV commonly spreads through hospitals, too, infecting both patients and staff.
Prevention
Because RSV spreads in fluids from the nose and throat of an infected person, it's best to wash your hands after touching anyone who has either a cold or a known RSV infection. Also, it's wise not to touch your nose or eyes after contact with someone with RSV as the virus could enter your body through either of these two areas. And keep your school-age child with a cold away from an infant brother or sister until the symptoms pass.
Treatments can be given to protect infants who are at highest risk for severe illnesses if they are infected with RSV, such as those who were born prematurely or those with chronic heart and lung disease. These treatments provide temporary immunity against RSV. One treatment, palivizumab, is given as monthly intramuscular injections during the autumn months and provides protection throughout the typical RSV season. Unlike a vaccine, its protection is short-lived and has to be repeated in following years, until the child is no longer at severe risk from RSV infection.
Incubation
Incubation period is 4 to 6 days.
Duration
RSV infection usually lasts 7 to 14 days, but some cases may last up to 3 weeks. Children who are hospitalized with lower respiratory tract illness usually spend 5 to 7 days in the hospital.
Contagiousness
RSV is highly contagious and can attack up to 50% of infants during an RSV epidemic. Yearly epidemics occur in the late fall, winter, and early spring - almost never in the summer. Children in child-care centers and preschools are at greatest risk for transmitting RSV. Infants are at special risk if they have an older brother or sister in school. RSV is an especially contagious virus because it can live on surfaces for hours, and is easily passed from person to person. Good, frequent hand washing is a must to prevent its spread.
Someone who has an RSV infection, even if it's "just a cold," can pass infectious RSV particles through oral and nasal fluids. Contagiousness is highest during the first 2 to 4 days of the illness, but RSV particles may continue to be spread for up to 2 weeks after the stuffy nose begins.
Home Treatment
In treating RSV infection, the goal is to make children more comfortable while their bodies fight the virus.
Using a cool-mist vaporizer to humidify the air may help soothe irritated breathing passages and relieve coughing.
Give your child plenty of fluids such as water and fruit juice - these help keep nasal secretions watery and easy to clear. Children younger than 6 months should not be given fruit juice or water. Instead, try breastfeeding or bottle-feeding smaller amounts more frequently.
If your baby is unable to feed or has symptoms of dehydration, your child's doctor may suggest other treatments.
If necessary to loosen mucus in the nose, you can use salt water (saline) nose drops. If the nostrils are irritated, place a little petroleum jelly under them.
If your child is uncomfortable and is too young to blow his or her own nose, use a nasal aspirator to remove sticky nasal fluids. Call your child's doctor if nasal discharge turns from clear to yellow, green, or gray.
Treat fever using a nonaspirin fever medicine like acetaminophen. Aspirin should NOT be used in children with viral illnesses since the use of aspirin in such cases has been associated with the development of Reye syndrome, a serious encephalitis-like illness.
Professional Treatment
RSV infection is not treated with antibiotics because these drugs do not work against viruses. An antiviral medicine called ribavirin may sometimes be given to very ill children who are hospitalized for severe pneumonia caused by RSV, but its use is controversial among doctors.
Younger children, especially infants, who have severe RSV pneumonia or bronchiolitis may need to be treated in a hospital. There they can receive specialized respiratory therapy, including humidified oxygen and medicines to open up their breathing passages.
When to Call Your Child's Doctor
Call your child's doctor if your child has any of the following symptoms: fever above 101 degrees Fahrenheit (38.3 degrees Celsius); thick nasal discharge that is yellow, green, or gray; cough that lasts more than 4 days; cough that produces yellow, green, or gray mucus; chest pain; difficulty breathing; very rapid breathing; bluish or gray color of the lips, skin or fingernails; or lethargy. Of course, call if you have any questions or concerns.
In infants, in addition to symptoms already mentioned, call your child's doctor if your child is unusually irritable or inactive, or refuses to breastfeed or bottle-feed.
Also, ask your child's doctor if your child is considered high risk for serious complications from RSV and would benefit from protective treatments such as palivizumab.
Here is some links that will help you learn more about RSV.
http://www.dhpe.org/infect/rsv.html
http://www.rsvprotection.com/
http://www.rsvinfo.com/
http://www.rsvinfo.com/diagnosing/diagnosing.html
