Managing respiratory illness in youths

Respiratory Syncytial Virus (RSV) is a common virus and causes respiratory illness in children. RSV infection can range from asymptomatic or cold-like symptoms to severe infection requiring admission to the Pediatric Intensive Care Unit (PICU). RSV is the most common cause of bronchiolitis in children, inflammation of the airways in the lungs.

RSV circulation in children begins in the fall and increases in intensity during winter. This seasonal variation increases pediatric emergency room visits and hospitalizations for children during fall and winter. This year we are encountering an increase in the number of children with RSV infections. The exact cause of such an increase is being studied.

Symptoms and Transmission of RSV infection

Children start showing symptoms within four to six days of being infected. Symptoms consist of running nose, fever, cough, sneezing, decreased appetite and change in activity. Most children with RSV infection will have cold-like symptoms, though children with underlying medical conditions are at higher risk for developing severe symptoms that may require hospitalization.

Children will be contagious for three to eight days and can be contagious even when they don’t show signs of infection. RSV can spread when an infected child sneezes or coughs near others through direct contact, like kissing a child’s face, sharing toys with children infected with RSV and touching commonly shared surfaces. RSV can survive for hours on hard surfaces, making the virus susceptible to spreading.

During fall and winter, we also see a rise in other viral infections like influenza, rhinovirus and other viruses. Cough, fever, sneezing, decreased appetite and such symptoms can all be due to viruses. While it can be difficult to differentiate between the types of viral infections based on symptoms, urgent cares, emergency rooms, pediatrician offices and hospitals can run tests to determine the type of virus causing the symptoms.

Care of child infected with RSV

Care of children with RSV infection begins with fever control and hydration. Commonly used fever control medications like acetaminophen (Tylenol) and/or ibuprofen (Motrin) can be used for fever. Emphasis should be placed on adequate hydration as children will be at risk for dehydration due to decreased oral intake. Children with asthma will need their asthma medications more frequently.

Parents should call their pediatrician if symptoms cannot be managed at home; for example, if fever is not controlled with fever medications or children refuse to take anything by mouth and appear dehydrated. In addition to respiratory symptoms, children can have vomiting and diarrhea, leading to dehydration.

Any child with breathing difficulty should seek immediate medical care, such as urgent care or the emergency room.

Prevention of RSV infection

Prevention consists of regular and frequent hand washing with soap and water, like any respiratory infection. Children and adults should use their elbows or tissue while sneezing or coughing to prevent the spread of the virus. Frequently touched surfaces should be disinfected with common household disinfectants. Children at high risk of hospitalization if infected with RSV, such as premature or young babies, and children with asthma, congenital heart disease, compromised immune systems or cancer, should be diligent to avoid potential exposure to infected children.

Dayanand Bagdure, MD, MPH, FAAP, is associate professor and vice chair of pediatrics at LSU Health Shreveport.