Watch closely if your kids appear to have a common cold this fall or winter. It could instead be respiratory syncytial virus, known as RSV, and that makes it more likely to progress to a serious lower lung infection.
RSV is back in force this year after a reprieve while many stayed home last year because of the COVID-19 pandemic, according to experts at Penn State Health.
“The symptoms are virtually synonymous with the common cold – runny nose, congestion, maybe a little cough – but RSV is associated with a much higher risk of progression from an upper respiratory cold to a lower lung infection,” said Dr. Patrick Gavigan. He is a pediatric infectious disease physician at Penn State Health Children’s Hospital, in Hershey, Penn. “This includes viral pneumonia or bronchiolitis, which involves inflammation of the small airways in the lung.”
Hospitalizations of children with RSV are up at Penn State hospitals, Gavigan said. RSV cases started earlier than usual this year – in July. RSV season is typically from October through March.
About 10% of viral tests are positive for RSV now, when 3% is the average, according to a news release from Penn State. In some locations, such as Pennsylvania’s Hershey Medical Center, rates are at 13% to 16% for the past three weeks, said Wallace Greene, director of the medical center’s diagnostic virology laboratory.
Parents who aren’t sure if their child has a cold or RSV should look for signs of trouble feeding or difficulty breathing. A doctor can confirm a diagnosis with a nasal swab.
“Are they breathing faster or do you see them sucking in their belly a lot to breathe? Apnea – a pause in breathing – is common in premature babies or infants under 1 month of age who have RSV,” Gavigan said. “Are they feeding enough to stay hydrated? We often see loss of appetite, or they’re working really hard to breathe while they’re feeding.”
Children at high risk of complications from RSV are often prescribed monthly injections of palivizumab (Synagis). This monoclonal antibody helps prevent serious lung infections and hospitalizations, Gavigan said.
Who’s most at risk?
Premature infants born at 29 weeks’ gestation or less and infants younger than 6 months are among those most at risk from the virus.
Children younger than 2 years old who have chronic lung disease or congenital heart disease are also at higher risk, as are kids with a weakened immune system or neuromuscular disorders.
Yet all infants and toddlers might be more at risk this year. In a June health advisory, the U.S. Centers for Disease Control and Prevention warned medical professionals that older infants and toddlers might be at greater than usual risk of severe RSV-associated illness because it was unlikely that they had typical levels of exposure to RSV during the previous 15 months.
“By age 2, most children have had RSV, and symptoms usually peak around five to seven days before resolving on its own,” Gavigan said. “However, 1% to 3% of children will be hospitalized with it.”
Taking steps to prevent RSV looks similar to what you might do to avoid other respiratory viruses.
RSV is spread through respiratory droplets and can live on surfaces. Penn State Health advises disinfecting high-touch areas like doorknobs and countertops.
“Wash your hands frequently, wear a mask, stay at home if you are sick and get a flu shot,” Gavigan said.
Children over the age of 6 months can safely get a flu shot, and should do so, according to the CDC.
More information
The U.S. Centers for Disease Control and Prevention has more on respiratory syncytial virus (RSV).
SOURCE: Penn State Health, news release, Oct. 14, 2021
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