Worried about RSV for Thanksgiving? What parents need to know

The holiday season is a time to get together closely with loved ones and people you haven’t seen in a while, but with these close gatherings comes an increased risk of spreading contagious diseases, like respiratory syncytial virus, or RSV, to people who are more vulnerable to getting really sick.

A surge of RSV cases in children occurred earlier this year and is causing an unusually high number of hospitalizations, according to data from the US Centers for Disease Control and Prevention.

“It appears that the circulation of (RSV) has occurred earlier than usual, and the number of cases is higher than normal,” said Dr. Mary T. Caserta, member of the committee on infectious diseases of the American Academy of Pediatrics. a November 17 report from the AAP. “There has been a dramatic increase in the number of cases and the number of hospitalizations.”

Contributing to the alarm over higher than normal RSV rates and a difficult respiratory virus season are other factors affecting pediatric health care, such as an understaffed health care industry, disparities in payment for hospital beds and mental health crisis in older childrenwrote Dr. Moira Szilagyi, president of the American Academy of Pediatrics, in an opinion piece for CNN.

A CDC graph showing an early and steep spike in RSV infections across all age groups. RSV was the leading cause of hospitalizations in babies under the age of one from 2009 to 2019, according to a study published in the Journal of Infectious Diseases.

US Centers for Disease Control and Prevention

We have already been warned that we will probably have a tough flu season this year, as public health measures like mask-wearing are being phased out after a few years of COVID-19 precautions. But RSV has become an additional concern as waves of infection have started earlier than normal and familiar reports of overburdened hospitals flood the media.

RSV is a common virus — most children will get it before their second birthday. And although anyone can catch it, babies, children under 5, the elderly and immunocompromised people are particularly vulnerable to serious illnesses, which can cause pneumonia or bronchitis and require hospitalization.

Although almost all children have at least one RSV infection before their second birthday and most recover at home, it is important to know the signs of a more serious infection in order to get the care you need. need. It may also be necessary (although sometimes embarrassing) to take some simple preventative measures when it comes to other people holding or being around your child.

Is it a “COVID cough” or RSV?

Cough is a common symptom of many respiratory viruses, including RSV, COVID-19 and influenza. So how do you know what’s causing your child’s cough?

“From a clinical perspective, it’s difficult to determine how the cough might be different,” New Jersey-based pediatrician Dr. Syeda Amna Husain said in an email. RSV, COVID-19 and the flu all have the potential to cause bronchiolitis-like symptoms (lung infection) in children, which can prevent them from moving their lungs to let in air, Husain says.

Testing is the only sure way to know which virus is responsible, according to Husain, and it may also narrow some treatment options.

What is RSV? How does it spread?

Respiratory syncytial virus is a common respiratory virus, which means it spreads to others through tiny droplets from the nose or throat of an infected person. You get it when these droplets get into your eyes, nose or throat, either through contact with a sick person or by touching a contaminated surface then touching your eyes, nose or mouth.

According to the Centers for Disease Control and Prevention, the virus lives on hard surfaces (like cribs) for hours. RSV does not live as long on soft surfaces, such as skin or tissue. According to the CDC, it is the most common cause of bronchiolitis and pneumonia in babies under 1 year old.

Can adults catch RSV from children?

Yes. Children usually contract RSV at school or daycare and bring it home to other family members. Most adults, however, will have mild or no symptoms of RSV.

Some adults, including the elderly, people with weakened immune systems, or adults with lung or heart problems may have more serious disease or complications.

What are the symptoms in children and babies?

Symptoms usually appear about four to six days after being infected or exposed, according to the CDC. Common signs include:

  • Runny nose
  • To sneeze
  • Decreased appetite
  • Cough or wheeze
  • Fever

In very young infants or babies, however, the only symptoms may be fussiness and fussiness; decreased activity or more tired than normal behavior; or breathing difficulties, including pauses in breathing.

A three-year-old coughs while his mother takes his temperature

Filadendron/Getty Images

How to Avoid RSV

Since RSV is a respiratory virus, many of the same health precautions we take for other viruses will reduce the risk of you or your child getting it. This includes avoiding contact with people who are sick or showing symptoms, avoiding crowded indoor places, and washing your hands before eating or touching your face.

For babies and young children, prevention could extend to not allowing other people to kiss, hold or touch your baby if you are concerned about contracting the virus. (You can also ask them to wash their hands and wear a mask when they hold your baby.) Ideally, the CDC says people with cold symptoms should avoid being around children at higher risk for RSV.

How about minimizing the risk of RSV in a child who is active and tends to have his hands and toys everywhere?

“Try to keep your child’s hands away from their face, especially their nose and mouth,” Husain said, as this is a quick way for common infectious particles to spread. You can also disinfect frequently touched surfaces, such as toys, counters and doorknobs.

Signs you should take your child to the hospital

Signs that you should call your doctor or get medical attention right away, according to the CDC and the American Academy of Pediatrics, include:

  • Rapid breathing or wheezing
  • Breathe with flared nostrils or by “shaking your head” with each breath
  • Pulling or abdominal breathing, as shown in a video on the AAP page (the ribcage may appear to be collapsing)
  • Your child cannot drink or has symptoms of dehydration (less than one wet diaper every eight hours)
  • Your child’s lips, skin or tongue are grayish or blue in color

Very young infants (under six months), babies born prematurely, and children who have weakened immune systems, neuromuscular disorders (difficulty swallowing or clearing mucus) and other health conditions are at greater risk. risk of serious disease due to RSV. If your child has only mild symptoms, further treatment will probably not be necessary outside of your home. But according to the Cleveland Clinic, your child may need to be given intravenous fluids (have an IV) if their rapid breathing makes it difficult for them to drink and stay hydrated. According to the clinic, about 3% of children with RSV will need hospitalization and most will be able to go home within two to three days.

If you are elderly, immunocompromised, or have an underlying medical condition, you may also be at higher risk of serious illness from RSV. In fact, the elderly have a higher burden of death from RSV. According to CDC surveillance, RSV is expected to cause at least 6,000 to 10,000 deaths in adults 65 and older, compared to 100 to 300 deaths in children under age 5, each year in the United States.

If you or someone around you is having trouble breathing, always seek emergency care or medical attention immediately.

RSV treatments

RSV is a viral infection, which means antibiotics will not work. RSV treatment is usually supportive, and over-the-counter medications (but never aspirin for children) can help relieve common symptoms like cough or congestion. You should consult your doctor before giving your child any medication, even without a prescription, because not all medication ingredients are safe for children and their growing little bodies.

High-risk children who are seriously ill are sometimes treated with an antiviral ribavirin and intravenous immunoglobulin. Treatment may also be considered for seriously ill immunocompromised adults. The vast majority of patients do not require these interventions.

For infants and children at high risk, preventive strategies are available; there is a monoclonal antibody called palivizumab. It is given as monthly injections during RSV season and is intended for children who are at higher risk of hospitalization. Some eligible children would be babies born very premature (before 29 weeks) and young children who are immunocompromised or have other health conditions, such as heart disease or neuromuscular disease. In November, the AAP updated its guidelines and suggested doctors consider giving high-risk patients more than five consecutive doses of palivizumab.

If you think your child is at high risk and might be eligible for treatment, contact your doctor.

Is there a vaccine?

There is no vaccine against RSV yet, but scientists are working on it. Pfizer this week announced promising results from its global trial which found that its RSV vaccine, when given to a pregnant person, was around 82% effective in preventing serious illness in their babies after birth. during the first three months of life. It was about 69% effective in the first six months of a child’s life.

Johnson & Johnson also began international trials of its vaccine in the elderly.

The information in this article is for educational and informational purposes only and is not intended to constitute medical or health advice. Always consult a physician or other qualified health care provider with any questions you may have about a medical condition or health goals.

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