RESPIRATORY SYNCYTIAL VIRUS

General Information

DEFINITION--A contagious, viral infection that occurs in epidemics, usually in the fall, winter and early spring. In healthy adults and older children, the symptoms are usually mild, but in infants and young children, they can be serious.

BODY PARTS INVOLVED--Upper and lower respiratory tracts.

SEX OR AGE MOST AFFECTED--Both sexes; all ages; most common in infants and children (it is the major cause of respiratory tract infections in this age group).

SIGNS & SYMPTOMS

Early symptoms:

• Runny nose.
• Low grade fever.
• Decrease in appetite.
• Cough, sometimes with wheezing.
• Lethargy.

Later symptoms (may occur early in infant with underlying cardiac or respiratory disease):

• Infant or child refuses to eat.
• Ear ache.
• Cough and wheezing increases.
• Difficulty breathing.
• Listlessness.
• Excessive sleeping.
• Spells of apnea (in premature infants or those under 6 weeks).

CAUSES--The virus is transmitted from person-to-person by respiratory secretions (exhaled, coughed or sneezed). Reinfection is common, but the symptoms are milder.

RISK INCREASES WITH

• Infants and young children.
• School or day care. Adults who are caring for small children are often infected.
• Medical personnel.

HOW TO PREVENT

> Studies show that few children under 4 have escaped contracting some form of RSV, even if it is mild. As with any situation involving a viral epidemic: careful attention to hand washing, proper disposal of any paper tissues used for nasal or throat

secretions, and covering your mouth when coughing or sneezing.

• A vaccine is being researched.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor. The symptoms are similar to many other disorders (common cold and flu), but knowing there is an RSV epidemic in the community helps makes the diagnosis more likely.
• Laboratory studies of blood and respiratory secretions from the nose or throat.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for severe symptoms with close observation for respiratory problems. May require respiratory support.

POSSIBLE COMPLICATIONS

• Pneumonia.
• Bronchiolitis.

PROBABLE OUTCOME--Mild cases usually resolve in 7-12 days (5 days for adults with reinfections) without any special treatment. More severe cases are curable with hospitalization and treatment for complications.

How To Treat

GENERAL MEASURES--

• Hospitalization of an infant or young child is traumatic for parents and children. Stay in close communication with the doctor. Provide reassurance to the child, cuddle an infant, provide diversion activities suitable to the child's condition.
• For home care: provide supportive measures, including rest, extra fluids to drink, humidify the air with a cool-mist, ultrasonic humidifier. Clean humidifier daily.

MEDICATION--Your doctor may prescribe:

• Ribavarin (an antiviral drug) for severe symptoms.
• Oxygen for hospitalized patient.
• Theophylline or adrenergic drugs for wheezing.

ACTIVITY--In mild cases treated at home, have the infant or child get extra rest.

DIET--No special diet. Drink plenty of fluids.

Call Your Doctor If

• You or your child has symptoms of respiratory syncytial virus.
• Any of the following occur during treatment: Temperature rises. Cough or wheezing worsens. Increased difficulty in breathing. Unusual tiredness or weakness. Infant refuses any foods or liquids. Excessive sleeping or periods of sleep apnea (breathing stops for a period of time).