RSV in Infants and BronchiolitisAll about RSV in Infants and Bronchiolitis- the parent guide.A WINTER PROBLEMRespiratory Syncytial Virus (RSV) is a common virus and the burden of RSV in Infants is maximum during the winter months. In some areas RSV infections can occur throughout the year. As the name suggests it is mainly a respiratory bug (i.e. affecting the lungs and associates air spaces).HOW DOES THE VIRUS SPREAD?The virus mainly spreads from person to person (called the droplet spread from respiratory secretions). It can be via physical contact from an infected person (The virus is capable of surviving on an object's surface or tissue for up to 7 hours) You may not always find out how your baby picked up the bug as they spread quite easily from an infected person (some may not have a lot of symptoms themselves).A BABY PROBLEMRSV in infants primarily affects babies from the newborn period up to 12-18 months age. RSV can affect older children and adults too although it does not cause BRONCHIOLITIS(see below) and usually manifests merely with symptoms of cold.BRONCHIOLITIS
Many babies catch the bug but only some go on to develop the full symptoms of bronchiolitis (inflammation of the tiny air passages - the bronchioles- within the lung).The smallest/youngest babies are at the highest risk of severe symptoms and signs. The risk of being infected with RSV in infants is higher in the following babies† Premature babies (preterm babies have immature lungs and also have insufficient antibodies for protection-Read about Synagis below) † Babies with heart disease † Babies with lung disease † Smokers in close contact † Family history of Asthma Your little one may start with mild symptoms like runny nose and minor cold. This may be followed by coughing, wheezing, chestiness, breathing difficulties and also fever (usually mild to moderate). The symptoms can be wide and varied in individual babies but the IMPORTANT ISSUE is the baby's general well-being (general demeanor, feeding, sleeping). Many babies, even in the presence of obvious chestiness and wheeze, will continue to be happy and feed reasonably.
RED FLAGS TO WATCH FOR (ANY RED FLAG WARRANTS AN ASSESSMENT BY A DOCTOR)⇛ Excessive Lethargy (can't be bothered/drowsy) or Irritability (persistent or inconsolable crying)⇛ High Fever (unusual in Bronchiolitis- may indicate another illness) ⇛ Difficulty (breathing faster than usual, chest in drawing, making frequent moaning/grunting noises- these may happen in the presence or absence of chestiness/wheeziness) ⇛ Looking pale or blue ⇛ Poor feeding -by far the MOST CONSISTENT and IMPORTANT Symptom (As a yardstick I tell parents that babies/children should take at least HALF their usual volumes of fluids during a course of illness)
SO, HOW CAN YOU MINIMISE THE RISKS OF YOUR BABY GETTING RSV INFECTION?• Hand washing regularly before contact with your baby especially before feeding.• Keep away from crowded areas. • Look out for people with colds and stay well away from them. Please ensure that your baby's toys, clothes and bedding are clean. • Do not let anyone smoke near the baby
THE TREATMENTThere is no specific cure for RSV infection (Antibiotics will be of no use with viruses). If babies have significant symptoms of Bronchiolitis they will need hospital admission.The broad aims of hospital management are as follows ↪ clinically and rule out other serious diagnosis ↪ inhaled oxygen if needed ↪ suctioning of secretions from nostrils and mouth (this is a major problem for many small babies) ↪ feeding- may need gastric tube feeding or intravenous fluids in some cases ↪ observation and general supportive management Occasionally, a baby may need artificial ventilation if breathing difficulty is significant. Such babies will be admitted to an intensive care unit where most will recover from the illness.
WHAT ABOUT A VACCINE?Over the past few years there is an increasing usage of PALIVIZUMAB(RSV immunoglobulin- Trade name is SYNAGIS) to reduce the risks of small babies getting the infection. In most places this is particularly reserved for babies in the 'high-risk group' (as noted above). Please ask your doctor if your baby needs/qualifies for SYNAGIS prophylaxis during the winter months.Return to homepage- Baby-Health-Care-Tips
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