Respiratory Syncytial Virus (RSV) is a virus that causes infections of the lungs and respiratory tract. It's so common that by the age of two, most children have been infected with it. Dr Dion Alexandrou, Consultant Paediatrician at The Portland Hospital, explains what the virus is and how you can manage your child’s symptoms.
What is RSV?
RSV is an airborne virus causing infections of the lungs and respiratory tract. It can be contracted in different ways and can be a result of both direct and indirect contact. Direct contact can occur by kissing a child with RSV and an indirect contact occurs if the virus gets onto an environmental surface, such as a toy. The virus can survive on surfaces for many hours so it is important that parents clean surfaces, toys and their hands regularly to minimise spreading the infection.
How likely is it for a child to encounter RSV in infancy?
By age two, most children will have been infected with RSV. Children attending childcare or with siblings at school are at higher risk of exposure, with susceptibility greater during the peak RSV season, usually starting in autumn and ending in spring.
Are some children more vulnerable to the virus?
Infants are more vulnerable than healthier older children and adults. It can be particularly severe in infants younger than six months, premature babies under a year and those with an underlying health condition, such as congenital heart disease or a compromised immune system. Infants exposed to tobacco smoke have a higher risk of contracting RSV.
What are the symptoms?
RSV usually causes mild signs and symptoms similar to a cold, such as a congested or runny nose or a cough and low-grade fever. Symptoms usually appear four to six days after exposure to the virus and may last a few days.
In higher risk cases, infants can develop feeding problems, irritability and breathing difficulties. Some may experience apnoea, which is when they stop breathing for a few seconds. Children with severe RSV symptoms may require hospitalisation to help with feeding and regulating their breathing.
How should parents manage these symptoms?
Managing symptoms depends on the child’s age. Children and toddlers with mild, cold-like symptoms need to have their high temperature and cough managed, usually with a child-analgesic such as Calpol. Infants with worsening symptoms should see a doctor and may require hospitalisation for a few days.
What complications might a child develop if infected with RSV?
In infants less than a year, RSV can cause lower respiratory tract illnesses such as pneumonia (chest infection) or bronchiolitis (inflammation of the small airway passages). Symptoms may include fever, a severe cough and wheeze, fast or difficulty in breathing, apnoea and feeding difficulties. 25 - 40% of infants infected with RSV will show signs of pneumonia or bronchiolitis.
What action can parents take to protect their child from RSV?
Regular day-to-day precautions can help prevent RSV from spreading. Parents should wash their hands frequently, particularly before touching their baby, and teach older children the importance of hand-washing. When possible, limiting the time high-risk children spend in childcare or other potentially contagious settings may prevent infection and spread of the virus during the peak RSV season. To further avoid exposure to the virus, especially for premature babies and all infants up to two months old, parents can limit their infant's contact with people who have fevers or colds.
Is there an RSV vaccine?
There is no specific treatment for RSV infection and no vaccine available. However, a drug called palivizumab is available to high-risk patients. This can prevent severe RSV disease but cannot help children already suffering from serious RSV or prevent general infection with RSV.
Will developing RSV have any longstanding implications on a child’s respiratory health?
Once a child has been infected with the virus, an occasional recurrence is common, usually in the form of a cold, but subsequent infections are typically not as bad as the first one. There is also a small link between severe RSV infection and the chance of developing asthma later in life.
For more information about RSV or to make an appointment to discuss your child’s respiratory health with Dr Alexandrou, please contact our children’s services enquiry line on 020 3642 7501 or alternatively email Dr Alexandrou on firstname.lastname@example.org