The ABCs of RSV

Common RSV symptoms

• Initial symptoms are similar to those seen with a cold: a runny nose, nasal congestion, mild cough and slight fever.

• Some children, particularly infants, may in a few days appear to have more frequent cough, wheezing, more difficulty with breathing and taking liquids and may appear more tired than usual.

At just 2 months old, Che Coleman found himself in the hospital struggling to breathe.

Just a few days before, his older brother Diata came home from preschool with a little cold. His mom, Kakuya Shakur, then caught it. Soon, Che started sneezing and his nose started running. Shakur, who was nursing him, says she knew Che was catching a cold.

What shocked her was how fast it took hold of her healthy baby. Just hours later, he started wheezing and breathing faster.

Shakur knew what symptoms she should watch for, yet Che never had a fever. But the wheezing worried her so much she called her doctor, who told her if she was really worried to take Che to the ER. Still, she thought her baby just had a cold.

“Before I got to the hospital, I figured they would just look at him and just send him home,” she says."But he really got worse pretty quickly.” At the ER, he started struggling to breathe and was simply overcome.

“It was definitely scary,” Shakur says.

Doctors immediately suspected RSV. A test proved it.

Common virus

The Respiratory Syncytial Virus, RSV, is the most common cause of lower respiratory tract infections, says Dr. Rupa Nimmagadda, a Chicago-based pediatrician and former director of the neonatal follow-up clinic at the University of Chicago Hospitals.

“RSV is an amazing virus because it’s so successful. It does its job as a virus very well, which is unfortunate for us.” The virus can live on hard surfaces for hours—some studies have shown it can live up to 24 hours—and up to a half hour on a person’s hands, she says.

By age 2, all children are infected, Nimmagadda says."It’s something to think about.”

In older, healthy children and adults, RSV mimics a common cold with a runny nose, maybe a mild cough and low fever."You don’t even know you had RSV,” Nimmagadda says.

But in babies under 2—especially those born prematurely with lung and heart problems—and children with medical conditions, RSV can be much more serious, even fatal.

What can be done?

A monthly injection during RSV season—November to April—is now available for at-risk kids. But for all the others, prevention is key.

Frequent hand washing helps prevent spread of the virus, Nimmagadda says.

Hand sanitizers have made it easier to wash your hands often, says Nimmagadda, a new mom herself."Homes with new babies in them or infants in them really should just have those all over the house.”

If you use hand sanitizers, make sure they actually kill viruses, too.

Also, keeping your baby away from people who might have a cold helps. The American Academy of Pediatrics recommends parents minimize exposure to child care settings for high-risk infants from November to April because spread of the virus is so hard to control.

“Being able to prevent the spread of (RSV) would actually help the group that actually gets it, gets ear infections, gets hospitalized,” she says.

There are no treatments for RSV. Antibiotics won’t help, but may be given for any ear infections that might be caused by the cold.

Nimmagadda says parents must be more aggressive when their kids have a cold. They can offer their babies supportive treatment that eases the cold symptoms, such as using humidifers and nasal aspiration with saline drops and keeping the babies upright to help with drainage.

Most importantly, she says, parents need to avoid dehydration. The respiratory symptoms and dehydration are the main reasons kids are hospitalized.

“It’s so much work for parents when kids gets these colds because they have to do so much. Their child is so miserable, doesn’t sleep and they’re exhausted but on top on it, you’re telling them to bulb suction them, keep them upright, keep them hydrated.”

Sometimes, the toughest decision for parents is when to call the doctor, especially if it just seems like a simple cold. So how do parents decide?

Nimmagadda says to call if it appears there’s any difficulty breathing and if your baby appears more lethargic than usual.

“It’s always worth speaking with someone,” she says.

Shakur says she is glad she did. Che, now 5, got better quickly and has no lingering effects.

Tamara L. O’Shaughnessy is editor of Chicago Parent. Two of her three children had RSV. Her oldest son, at 9 months old, was hospitalized for four days.

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