You may have heard that RSV (Respiratory Syncytial Virus) cases are higher than ever this year in young children.  Pediatric Hospitals are actually seeing a surge in cases about two months earlier than normal. This is largely due to the fact that with eased COVID precautions, many infants and young children are now getting exposed to RSV for the first time in their life.  With a lack of immune protection from prior infection, more kids are becoming sick much earlier than we normally see.  More sick kids overall have led to more severe cases of RSV and an increase in hospitalizations.  
 
So what is RSV anyway?  What can you do at home? And, when should parents seek further care? We asked pediatric hospitalist, Dr. Chase Parsons, the expert that leads our Ultimate Safety Class, to fill us in on all things RSV. See his answers below: 
 
What is RSV?  RSV is a common virus that most children contract at least once prior to the age of three.  RSV most commonly causes a disease called bronchiolitis which can cause viral respiratory symptoms and inflammation of the airways.  A child’s first infection with RSV is usually the most severe.  
 
Who is at risk?  While both school-age and younger children are becoming infected with RSV more than we normally see this year, younger toddlers and infants are at increased risk of severe infection.  This is because their airways are smaller which makes it more difficult for them to clear the thick secretions caused by this virus.  Premature infants or those with underlying medical issues (like heart or lung problems) are also at increased risk. 
 
What should you look out for when your child has RSV?  RSV infections begin with signs of the common cold: nasal congestion, nasal discharge, and cough.  These symptoms may then progress to more severe respiratory or airway symptoms we call bronchiolitis, like more frequent coughing, wheezing, and difficulty breathing.  The worst of these airway symptoms typically occur on the third day of symptoms.  Fever may be present as well.  Of note: while other viruses may cause bronchiolitis, RSV is one of the most common causes. 
 
What can I do as a parent to care for my child?  I always tell parents to do their best to make sure their child is “eating, drinking, pooping, and peeing,” especially when their child is sick. With an RSV infection, this means supporting them through the illness.  With all that congestion and their nasal passages blocked, they’ll be less interested in feeding. In my Respiratory Illnesses Class, one of the classes within TInyhood’s Ultimate Safety Class, I demonstrate how to correctly use a bulb suction and a NoseFrida.  Use one of these suction methods with nasal saline prior to feeding and sleep to give your child the upper hand.  Also offer them smaller, more frequent feeds.
 
When should I seek further care?  

If your child exhibits any of the following, take them to Emergency Department or call emergency services:

  • Grunting to breathe
  • Stops breathing
  • Overly tired from working to breathe
  • Severe depression of the skin around the ribs when breathing
  • Blue-tinged skin

 
If your child exhibits any of the following, take them to or call their medical provider:

  • Decreased oral intake
  • Signs of dehydration like more dry diapers, less peeing than normal, dry tongue, lips, or mouth. You can also do the Nail Bed Test I demonstrate in my Vomiting, Diarrhea, and Dehydration class. 
  • Under 4 months of age and have a temperature of > 100.4F or higher

 
How can I prevent RSV?  RSV is very contagious and can live on surfaces for hours. So make sure you’re washing your hands and cleaning common surfaces at home frequently to prevent the spread of RSV during the viral season.  
 
Do I need a test for RSV?  Because there is no specific treatment targeted at RSV a test to identify the virus is not necessary.  RSV infection is typically diagnosed with symptoms and physical examination along with knowledge of what viruses are most common in the community at a certain time.
 
Who is at the highest risk?  Young infants (<6 months of age) or those born prematurely are at the highest risk of severe symptoms.  Children with underlying medical issues (like heart or lung problems) are also at increased risk. 
 
For more on RSV along with treating other upcoming seasonal illnesses like fevers, the common cold, the flu, and croup, check out our Ultimate Safety Class, led by Dr. Parsons.