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Posted by Dr. Monica Wonnacott | March 5, 2016

5 Worry Signs During Rsv Season

In Utah, this time of year is what pediatricians refer to as RSV season. It’s the time of year when most sick slots in the day are filled with the same problem, RSV. The season starts in December and runs through March, with January and February being the worst of it. The season hits earlier the further east you go across the nation.

RSV is Respiratory Syncytial Virus. It is a very common respiratory illness. In fact, most kids get exposed to it in the first few years of life. So why is it such a big deal? In general, the younger you are when you get the virus, the worse off you are. RSV infection can range in severity from life threatening (I’ve had many kids during my career end up on ventilators) to a no-big-deal little cold. Newborns end up in the hospital, while adults get a runny nose (and maybe a slight cough). RSV typically causes inflammation of the small airways or bronchioles leading to bronchiolitis (not to be confused with bronchitis which involves the larger airways).

RSV initially starts in the nose and may sound like a little congestion and occasional cough. After a few days, the infection settles into the lungs, where it then just hangs out, causing a wretched cough (and often wheezing). The cough is a frequent, wet, junky, raspy cough. When you’re holding your child who has RSV, she may sound like she’s are purring or rattling. RSV has no cure. The treatment is completely supportive (e.g., suctioning out the airways, giving oxygen, IV fluids if dehydrated, treat fevers with Tylenol or Motrin).

Young children (especially sub 6 months) who have suspected RSV should be seen by their doctor. They should have a careful lung examination and oxygen saturation levels checked (to see how much oxygen is getting to the rest of the body).

Worry signs include:

  1. Increased respiratory rate (greater than 60 breaths per minute, which is a breath a second)
  2. Increased work of breathing or retractions (you can see the muscles around your child’s ribs sucking in and out when she breathes)
  3. Signs of dehydration (e.g., not peeing at least every 6 to 8 hours, no tears when she cries, dry mouth)
  4. Unable to eat
  5. Continuous coughing

Prevent spread by washing hands, staying away from sick people, etc. Don’t take new babies in public (e.g., day-care, church), especially this time of year. RSV is a virus that parents should have a healthy respect for. When my one-month-old got RSV last season, I was reawakened to how awful the virus really can be. My bedroom looked like a hospital room (she would have been in the hospital if otherwise) — oxygen tanks, saturation monitors, suctioning tubes. My poor baby was miserable. I nearly cry for new parents when I break the news that their baby has RSV. Because I truly empathize with what is to come.