Respiratory Syncytial Virus Infection

Am Fam Physician. 2011;83(2):149-150

See related article on respiratory syncytial virus infection

What is respiratory syncytial virus?

Respiratory syncytial virus (RESS-per-uh-TORee sin-SISH-uhl VIE-russ), or RSV, causes lung infections in children, especially those younger than two years. Children younger than one year may get a cough and runny nose, and may wheeze when they breathe. Older children may have only a runny nose and mild cough.

How is it diagnosed?

Your doctor can usually diagnose an RSV infection based on your child's symptoms and a physical exam during RSV season (November through April). There is also a nasal swab test for RSV, but it's not usually needed.

How is it treated?

Treatment is mainly aimed at relieving symptoms. Be sure your child drinks plenty of fluids. The hospital or doctor's office may give your child oxygen to help him or her breathe easier. Gently suctioning your infant's nose may help him or her eat and drink better. Because RSV is caused by a virus, antibiotics usually don't help. Steroids and cool mist aren't helpful either. Wheezing can be treated with an inhaler medicine to open airways.

How does it spread?

RSV can be spread by contact with body fluids like saliva and mucus from the sick child's nose or mouth, or by objects that the child has touched. Having your child wash his or her hands often can lower the risk of spreading the infection. Children may return to day care when they have no fever and can eat and drink without problems.

When should I take my child back to the doctor?

If your child has trouble eating or drinking, tires easily during feeding, or becomes sluggish, see a doctor. You should also see a doctor if your child is younger than 60 days and has a fever, or if your child is having trouble breathing (is taking 60 breaths or more per minute). See a doctor if your child seems to be getting worse.

What else can I do to prevent RSV?

Talk with your doctor about preventive therapy if your child was born more than five weeks early or if he or she is younger than two years and has chronic lung or heart disease. A medicine called palivizumab can be given once a month for five months during the peak RSV season. This medicine can help your child's body fight infection.

What if RSV goes untreated?

For most healthy infants without a heart or lung condition, RSV is similar to the common cold. In children with a weaker immune system, untreated RSV can cause pneumonia or bronchiolitis (swelling of the smaller airways in the lungs). Sometimes these children have to stay in the hospital.