By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

RESPIRATORY SYNCYTIAL VIRUS IS COMMON CHILDHOOD INFECTION

Question: I am expecting my second child soon. My first child, who is 4 now, was very ill as an infant with RSV and had to be hospitalized. Will I have to go through the same thing with this next baby? Can I do anything to prevent RSV? Is there a vaccine to prevent it?

Answer: RSV stands for infection caused by the Respiratory Syncytial Virus. RSV is the primary cause of pneumonia and bronchiolitis in infants under 1 year of age. Over 125,000 babies and children are hospitalized annually with this viral infection. It is estimated, however, that this is just the tip of the iceberg and represents only about 2 percent of the children who actually get RSV. Though very common in infants and children, RSV is, fortunately, usually relatively mild in nature.

This viral infection is spread from person to person through direct contact with respiratory secretions or from RSV contaminated surfaces and objects. RSV usually occurs in the winter and spreads rapidly among children. By age 2, most children will show evidence of past RSV infections when given the appropriate blood test.

There are several risk factors for infants getting an RSV infection. Prematurity, low birth weight, congenital heart disease, chronic lung conditions, secondhand cigarette smoke exposure, older brothers and sisters in the home, day care and bottle feeding all increase the likelihood of a child developing a serious RSV infection.

RSV usually starts off like a typical cold. Fever, runny nose, cough and irritability may sometimes be followed by wheezing. In some cases the child may experience difficulty in breathing. Most children with RSV infections are better in about a week with supportive care such as acetaminophen for fever and fluids. Many doctors’ offices can perform a rapid RSV test, which can confirm the diagnosis and aid in the treatment of the RSV. The test is done by taking a swab of the child’s nasal secretions.

As of yet there is no long-term vaccine to prevent this common, viral infection in all children. There are some short-acting vaccines that can be given to at-risk infants during outbreaks of RSV, but these shots need to be given monthly and are not recommended for all children.

Other preventive efforts such as routine hand washing are always good, but RSV can be spread for several days before a child has any symptoms and for a couple of weeks after the child has recovered. This makes it difficult to control this infection in the community setting.

So, will you have to experience an RSV infection with your soon-to-be-born child? Though my crystal ball is a little hazy, I’d say that the odds are that your second child will come down with RSV at some point. However, it is somewhat unlikely that he or she will experience the severe form that required hospitalization of your first child.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.