RSV in my child: should I be concerned?

I have heard that a new virus called RSV is spreading among children. As a parent, should I be concerned?

Respiratory syncytial virus, better known as RSV, is a disease of the upper respiratory tract that is very common in children. By the age of 2, almost all children have had it. In most cases, the virus causes mild symptoms, similar to colds and flu, such as a runny nose, congestion, or fever.

But in some children, especially infants, it can lead to more serious complications like pneumonia and bronchiolitis, a condition in which the small airways in the lungs become inflamed. Some 58,000 children under the age of 5 are hospitalized with RSV each year in the United States. For those under a year old, it’s the number one cause of hospitalization, said Dr. Ethan Wiener, chief of pediatric emergency medicine at NYU Langone Health.

The virus typically circulates during the fall and winter months, with a peak in February. But the pandemic has disrupted the usual RSV patterns: Last winter, many hospitals saw almost no cases of RSV, as people wore masks and were physically away from each other during shutdowns, and the Centers for Disease Control and Prevention have reported that positive test results for RSV (as well as influenza and other seasonal infections) have reached historically low levels. Once states began to reopen and people relaxed masking and social distancing in early summer, cases of RSV in infants and toddlers skyrocketed across the country.

At the Children’s Hospital in Philadelphia, doctors began to see an increase in the number of cases in May, which has accelerated over the past eight weeks, said Dr Audrey John, head of the infectious disease division. pediatric patients from the hospital. “To put that into perspective, none of the children who tested for RSV during the winter were positive,” she said. “But in the past two weeks, up to one in four children who get tested are positive for RSV. That’s a lot of viruses. ”

The spread of RSV appears to have started in the northeast and then spread to other parts of the country, where children’s hospitals in states like Texas, Florida and Louisiana reported peaks in June. The virus is quite contagious and can survive on hard surfaces for several hours. Experts say it is much more likely to be transmitted through infected surfaces than SARS-CoV-2, the virus that causes Covid-19.

But experts say parents of school-aged children shouldn’t be too worried. While older children can be infected, severe cases of RSV are primarily of concern for children under 2, said Dr Jennifer Lighter, pediatric infectious disease specialist and hospital epidemiologist at Hassenfeld Children’s Hospital. by NYU Langone Health. Infants are most at risk, she said, especially those who are born prematurely or have heart, lung or neuromuscular disease.

One way for doctors to prevent severe cases of RSV is to give children at high risk a medicine called Palivizumab, which is given as five monthly injections during the winter season. But due to the unusual increase in cases this summer, the American Academy of Pediatrics released a statement this month calling on pediatricians to consider administering the drug immediately to infants who may be eligible.

Older children are less likely to become seriously ill, but they can still pass the virus to more vulnerable children. In general, doctors recommend common sense precautions like washing or disinfecting your hands frequently, avoiding crowded indoor areas, and – for children over 2 years old – wearing masks. Children and adults with cold or flu symptoms should avoid close contact with babies. And parents should keep their children home, away from school or daycare if they are sick and have symptoms like a cough, runny nose or sore throat, said Dr. Philadelphia Children’s Hospital.

“A child who has two of these three symptoms would be the kind of thing that triggers my worry,” she said. “But if a child runs outside and comes in with a runny nose and quickly leaves, that wouldn’t be worrying.”

Dr John said keeping a sick child at home is in part a matter of social responsibility, since a sick child can be a nuisance to many other families. “If your child goes to daycare and five other children are infected, the parents of those five children should stay home when their child becomes ill,” she said.

There is a nasal swab test that doctors can do to look for RSV. But the American Academy of Pediatrics generally does not recommend routine testing in children over 6 weeks of age. Parents who are concerned about whether their child has RSV or Covid-19, however, can ask their pediatrician if it makes sense to get tested.

RSV in infants and children at high risk requires immediate medical attention. In rare cases, otherwise healthy older children with RSV can become dehydrated and develop breathing problems, which can be a sign of pneumonia. In these cases, you should consult a doctor. But in general, experts say, most children make a full recovery from RSV within one to two weeks at home.

“The vast majority of children who get RSV will not get seriously ill – they will catch a cold,” said Dr Wiener. “In the vast majority of cases, it’s really about keeping the child comfortable, like you would with a cold, and monitoring any progression of symptoms.”