Jyoti Kinghorn 
If your infant or young child is sneezing, irritable, and having trouble breathing, these could be symptoms of an RSV infection. Respiratory Syncytial Virus, or RSV, is a virus that causes cold-like symptoms. The virus generally circulates in the U.S. during the fall and peaks during the winter months. The virus is very contagious, and it is also very common. Almost all children get an RSV infection at least once before their 2nd birthday. While most full-term babies and healthy children will be able to fight off RSV on their own, the disease can lead to more serious health problems in some infants and small children. Therefore, it is important to keep an eye on the child’s symptoms and seek medical counsel if symptoms worsen. If your child or baby is sick, here are some things to watch for.
RSV symptoms in infants
Babies younger than 6 months old who are sick from RSV almost always show symptoms.
According to the CDC, symptoms from an RSV in babies can include:
1. Increased irritability
2. Lower levels of physical activities such as kicking or rolling
3. Drinking less breast milk or formula than normal
4. Difficulty in breathing
5. Apnea (when the baby stops breathing for more than 10 seconds). Babies under the age of 2 months are at the most risk of RSV-associated apnea
6. Fever
A baby suffering from RSV may not show all of these symptoms, and most will get better within one to two weeks. However, children born prematurely or those with congenital heart disease are more at risk for complications.
RSV symptoms in young children
According to the CDC, RSV symptoms in young children include:
1. A runny nose
2. Loss of appetite
3. Drinking less fluids
4. Difficulty in breathing
5. A cough that may progress to wheezing.
6. Fever
School-age children can get one or two RSV infections a year. They may not show all or any of these symptoms.
At-home care and recovery
Some breathing-related symptoms in children may be alleviated by using saline nasal drops and sprays. You can ease nasal congestion by using a humidifier to moisten the air. While the child may not want to eat or drink, offer them plenty of fluids regularly to avoid dehydration.
Dr. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital informs that during an RSV infection, children are working so hard at breathing that they may fall behind on their fluid consumption. Continue offering comforting fluids to young children with RSV, and breast milk or formula to the babies. With care and rest, most kids get better within 7-10 days. However, sometimes the cough resulting from the RSV infection can linger on and take up to 6 weeks to clear out. Talk to your pediatrician if the symptoms start worsening.
RSV complications in infants and young children
A few days into the illness, RSV symptoms can start getting worse. In infants under 6 months of age, apnea due to RSV is a well-known complication. In babies as well as children, RSV can cause bronchiolitis, which can get severe and can lead to hospitalization. RSV can also cause pneumonia. While preemies and children who have heart or lung disease or other immunity-compromising conditions are more at risk for complications from RSV, previously healthy children can develop complications as well. According to the National Foundation for Infectious
Diseases (NFID), 80% of children under the age of 2 are hospitalized for
RSV-related complications do not have any other comorbidities.
When to seek medical attention
While it is always a good idea to talk to your pediatrician about your child’s RSV-related symptoms, depending on the severity of the symptoms you may need to take them to the ER. Medical experts advise that if a child has difficulty breathing, their mouth, lips, or nails turn blue, or their ribs are sticking out, they should be taken to the ER. They could need supportive care to help them get enough oxygen, and breathe better, followed by careful monitoring until they get better.
When can my child go back to school or daycare
As a general guideline, someone with RSV is typically contagious for 3-8 days, and generally for no longer than 10 days. But some people can stay contagious for longer. Always check with your child’s pediatrician and discuss when it may be safe to send them back to school or daycare.
RSV Vaccines
The CDC recommends RSV vaccines Nirsevimab (Beyfortus), and Palivizumab (Synagis) for children. Nirsevimab is recommended for infants under 8 months of age, and some at-risk infants 8-19 months of age. Palivizumab is recommended for at-risk infants under 24 months of age.
Talk to your healthcare provider to see if your baby could benefit from RSV vaccination.
