RSV: Those Three Dreaded Letters

By now, everyone is probably well aware that “RSV season” is here. In case you aren’t aware of the signs of RSV, allow me to explain briefly what it is.

RSV stands for Respiratory Syncytial Virus, which is why we just refer to it as RSV. It is a virus that makes the rounds every winter and makes a lot of babies and toddlers sick. Typical symptoms are the same as a common cold: cough, runny nose, fever, congestion, etc. However, RSV has earned a reputation as a much nastier virus because some kids do end up hospitalized with it.

What You May Not Know

Virtually all children have been infected with RSV at least once (yes, they can get it multiple times) by the time they turn 3.

How can that be? The answer is that for most kids, RSV will look like a common cold, with maybe some wheezing. (YouTube video of a wheezy baby). Very few children infected will be hospitalized.

What To Do About It

The only thing gained from testing is the knowledge that your child has RSV. There is no specific treatment for RSV, and antibiotics will not help because it is a virus, not a bacterial infection. However, if your child is wheezing, we can prescribe medication to help.

Use these methods to make your child more comfortable:

Time is really the best medicine for RSV. Although symptoms may worsen in the first 4-5 days, they should start to improve and completely resolve after 1-2 weeks.

 When To Come In

If your child is having difficulty breathing, it is very important to get them evaluated ASAP.

Look for these signs of respiratory distress:

  • Being able to see their ribcage when they breathe in
  • Nostrils flaring when they breathe
  • Seeing their skin “cave in” around the neck

Another way children with RSV get into trouble is by having low oxygen levels. You can’t check levels at home, but you should see or hear signs that let you know you might want to consider taking them to the doctor, such as the respiratory distress signs listed above or the wheezing. Another sign of low oxygen levels is simply having no energy.

 Signs of Healing

Look for these signs to know your child is on the path to healing:

  • Your child is alert
  • Your child has 3-4 wet diapers per day
  • Your child has tears when he/she cries
  • Your child’s mouth looks wet

If you aren’t sure of any of those things, take them in.

 What About Daycare?

I wish there was a good answer to this, but there isn’t. Once infected, a child can spread the virus for as little as 3 days to as long as 8 days. Some children have been found to spread the virus for weeks afterward. My rule of thumb is they need to be fever-free for 24 hours, without having to give Tylenol or ibuprofen, and they should be drinking and breathing well enough that you are comfortable with a daycare provider caring for them.

 How To Prevent RSV

For the most part, it is inevitable that your child will have RSV at some point in their first 3 years. However, you can minimize the risk. Of course, hand-washing is the best way, and not allowing your child to share things like pacifiers and sippy cups with other kids is important. Cleaning toys and other items that are frequently touched is also a good idea.

Hopefully, after reading this, those three dreaded letters are not as frightening. Remember, the vast majority of parents will never even know their child had RSV.

By Dr. Shari Eich

Pediatrician at Avera Medical Group McGreevy Clinic, Sioux Falls

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One Response to RSV: Those Three Dreaded Letters

  1. Chris Prendergast March 6, 2012 at 3:54 pm #

    Very useful info– thanks, Dr. Eich!