Respiratory syncytial virus (RSV)

DON’T PANIC – here is all you need to know about RSV infection

Patient education:

Respiratory syncytial virus (RSV) is a small virus with single-stranded RNA and belong in the family of Pneumoviridae family.  

There two types of RSV:

Type A&B:  present in most outbreaks and cause more severe disease and Type B milder disease.

Transmission: the virus is transmitted by direct contact with virus containing secretions or formites (running nose, coughing and saliva) but also it can be spread by droplets aerosols too. The virus can survive for up to approximately 4-6 hours on the hand.  Hand washing and contact precautions are important.

When does RSV season start?

Before the COVID-19 pandemic, the RSV season in  South  Africa  usually  preceded  the influenza  season  with  the  usual  average  onset  at  the  end  of  February  (range  early February  –  mid-March)  over  the  last  10  years.  However, since the start of COVID-19 pandemic, with non-pharmaceutical interventions to prevent SARS-CoV-2 transmission in place, RSV circulation has been disrupted, with fewer cases and out of season outbreaks reported

What are the risk factors for severe RSV-associated disease? Children born prematurity, congenital heart disease, chronic lung disease  of  prematurity,  neurological  disease,  infants  aged  <6  months, immunodeficiency and lack of breast feeding. Environmental factors that are risk factors for severe RSV-associated disease include overcrowding, poverty, and day care centre attendance

Common disease caused by RSV:

Mild upper respiratory tract infections: such as cough, running nose, block nose and fever but self-limited by some children and adults can developed Bronchiolitis:

Bronchiolitis is an infection that affects a part of the lungs called the “bronchioles.” The bronchioles are the small, branching tubes that carry air in and out of the lungs. When these tubes are infected, they get swollen and full of mucus. That makes it hard to breathe.

Bronchiolitis usually affects children younger than 2 years of age. In most children, bronchiolitis goes away on its own. But some children with bronchiolitis need to be seen by a doctor.

What are the symptoms of bronchiolitis?

  • A stuffy or runny nose
  • A mild cough
  • A fever (temperature higher than 100.4ºF or 38ºC)
  • A decreased appetite

As bronchiolitis progresses, other symptoms can start, including:

  • Breathing faster than normal
  • Pauses between breaths – Sometimes, a pause in breathing can last more than 15 or 20 seconds
  • Wheezing – This is a whistling sound when breathing. It usually lasts about 7 days.
  • A severe cough – The cough can last for 14 days or longer.
  • Trouble eating and drinking – Other symptoms can make a child less interested in food. In babies, a stuffy nose or fast breathing can make it harder to breastfeed or drink from a bottle.
  • Stops breathing
  • Has blue-looking lips, gums, or fingernails
  • Has a very hard time breathing
  • Starts grunting
  • Looks like they are getting tired from working so hard to breathe

Treatment:

Most cases of the RSV are mild, and it does not need treatment at all.

But patients with bronchiolitis might need following treatment:

  • The main treatments for bronchiolitis are aimed at making sure that your child is getting enough oxygen. To do that, the doctor or nurse might need to suction the mucus from your child’s nose or give your child moist air or oxygen to breathe.
  • The doctor will probably not offer antibiotics. That’s because bronchiolitis is caused by viruses, and antibiotics do not work on viruses.
  • Is there anything I can do on my own to help my child feel better?

Yes. Here are some things you can do:

  • Make sure your child gets enough fluids. Call the doctor or nurse if your baby has fewer wet diapers than normal.
  • Use a humidifier in the room where your child sleeps.
  • If your child is uncomfortable because of fever, you can give over-the-counter medicines, such as acetaminophen. Be sure to read instructions carefully. Never give aspirin to a child younger than 18 years old.
  • Remove the mucus from your child’s nose with a suction bulb
  • If your child is older than 1 year, feed them warm, clear liquids to soothe the throat and to help loosen mucus.
  • Prop your child’s head up on pillows, if they are over a year old. (Do not use pillows for a child younger than 1 year.)
  • Sleep in the same room as your child, so that you know right away they start having trouble breathing.
  • Do not smoke or allow anyone else to smoke near your child.

Can bronchiolitis be prevented?

  • Washing your hands and your child’s hands often with soap and water, or using alcohol-based hand sanitizer
  • Staying away from other adults and children who are sick
  • Getting a flu shot every year for you and your child

Referrence:

  • UpToDate
  • NICD
  • Images from Shutterstock.com

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