The rain brings many diseases. One of them is Respiratory Syncytial Virus (RSV), a common, contagious virus that causes infections of the respiratory tract. Parents should be on their guard against RSV because it spreads easily. Although people of any age can get infected, it is most common – and most dangerous – among children. Here we’re going to pass on some valuable information about it, including the warning signs, so parents and others can be prepared to deal with it.
What is RSV?
RSV infects the upper and lower respiratory tract. It causes the body to produce secretions such as sputum. Highly contagious, it spreads through coughing and sneezing. Parents are often all too familiar with it as RSV-related illnesses are common. It is most common among children under five years old and most severe in children under two years old.
The virus travels down the bronchi or lung tissue causing pneumonia or bronchiolitis. If children less than three months old are infected, it can cause apnea. Children born prematurely or with congenital diseases such as congenital heart disease, immunodeficiency, or malnutrition, are also at higher risk.
RSV transmission
RSV is transmitted by an infected person’s mucus or saliva when they cough or sneeze. The virus is transmitted through the nose, mouth, and the eyes’ conjunctiva. Infection is also possible through contact with objects such as toys, utensils or furniture contaminated with an infected person’s mucus or saliva. Without cleaning, RSV can remain contagious on the surface of objects for several days, it can remain contagious on hands for 30 minutes or more, and an infected person can spread the virus for three to eight days.
Symptoms and differences between RSV and the common cold
Although RSV symptoms are similar to the common cold, it's much more intense and longer lasting. The incubation period is about five days. Patients show symptoms four-to-six days after exposure to the virus. Initial symptoms are similar to a cold such as fever, coughing, sneezing, blocked nose, runny nose, dry cough, sore throat and headache.
If the symptoms become more severe, the lower respiratory tract starts to have problems and complications such as pneumonia and bronchiolitis ensue. The symptoms are all the worse for patients with heart problems or chronic lung disease. If their child gets infected, parents should observe the symptoms closely, looking for:
- Fever higher than 39-40 degrees for several days.
- Strong cough.
- Breathing faster than usual or gasping for breath until a dimple appears in the ribcage or chest.
- Sticky mucus causing difficulty breathing.
- Having a lot of sputum which is gray, green, or yellow.
- Wheezing.
- Anorexia.
- Being easily irritable or lethargic.
- The mouth or nails turn dark green from lack of oxygen.
- Rashes.
- Dehydration (no tears when they cry).
If you observe any of the severe symptoms in your child, seek immediate medical attention.
Diagnosis
The doctor will begin by examining the overall physical condition of the patient using a hearing aid to detect any wheezing in the respiratory system and listen to lung function and for any abnormal sounds coming from other places. Next will come some tests such as:
- Pulse oximetry to gauge oxygen levels.
- White blood cell count and detection of viruses, bacteria, and any other foreign matter.
- Chest x-ray to check for pneumonia.
- Check nasal secretions for viruses.
Treatment
So far, there is no vaccine that protects against RSV, Doctors can only treat symptoms to help patients breathe better. Patients can treat symptoms at home as follows:
- Using a steamer to increase humidity in the air where they are. The humidity level should not exceed 50%, so choose a steamer that can measure the humidity in the room and keep it at the right level for the respiratory system to work as well as possible and prevent growth of mold and harmful air-borne bacteria. This is because fungi and bacteria thrive in high humidity, especially fungi which generally have air-borne mold spores that are so small they are invisible to the naked eye. However, when mold spores settle in a moist location, they tend to develop into a black patina.
- Put the child in a posture in which they can breathe comfortably such as sitting up straight. Use a pillow that is neither too soft nor too hard and don’t wrap them up too much in clothes and blankets.
- Have the child drink plenty of water as this will help reduce the sticky viscosity of the phlegm or mucus or other secretions, thus preventing clogging, obstructing, and inhibiting functioning of the respiratory system.
- Use nasal drops to reduce swelling of the nose. Rinse the nose with a saline solution to make breathing through it easier.
- Take Acetaminophen medication to reduce fever.
If your child starts showing signs of severe symptoms, immediate hospitalization is required, especially if they’re young. They will then be treated something like this:
- Antibiotics will be prescribed in case the patient has bacterial complications such as bacterial pneumonia.
- If there’s a lot of sticky sputum, a nebulizer will be used to reduce wheezing and suck out phlegm to make their breathing more comfortable.
- Epinephrine will be administered to dilate the bronchi and reduce airway swelling.
- Oxygen or a ventilator will be used in the event of hypoxia or respiratory failure.
Complications
The mortality rate for children infected with RSV is low and RSV is generally not considered a life-threatening disease. Most cases of death result from complications, especially in preterm infants, the youngest children, those with immune system problems, and those with lung and heart problems. Any of these conditions may result in the following complications:
- Pneumonia or bronchiolitis: The virus travels from the upper respiratory tract, including nose, throat and mouth, down to the lower respiratory tract, causing inflammation in the lungs or airways. Patients at risk due to having the above-mentioned conditions are more likely to develop the most severe symptoms of RSV.
- Middle ear infection: The infection enters the area behind the eardrum causing otitis media. This is most common in infants and the youngest children.
- Asthma: Over the long term, RSV can cause asthma attacks.
- Re-infection: There is a possibility that once infected, a patients may relapse. However, symptoms the second time around are generally not as severe as the first time, except in the case of those with lung or heart problems when the symptoms can still be severe.
Protections
- Maintain hygiene: Teach your child to cover their mouth and nose with a handkerchief or hand when coughing and sneezing. Teach them to wash their hands often and thoroughly before eating or after going to the bathroom and so on.
- Practice wearing a mask to prevent the spread of infection.
- Avoid exposing preterm babies and infants for one-two months after contact with infected people such as those who have a fever or a cold.
- Always keep the house clean. Clean toys and launder bedding frequently to reduce the spread of infection. Used tissues should be discarded in a covered bin.
- Maintain cleanliness by having everyone who wants to touch the child wash their hands with soap or alcohol gel as adults may carry the disease with them from outside the home.
- Do not let your child share drinks from the same vessel as others. Children should have their own glass.
- Avoid taking your child to crowded places. They should only be taken to open places with good ventilation. Avoid letting your child touch public items or have them wash their hands immediately if they do touch anything.
- During an outbreak, avoid places that are easily infected such as nurseries or places where there are a large number of children such as ball houses and playgrounds.
- Have your child eat nutritious foods and get enough exercise and rest.
- If your child gets sick, they should stop attending school.
We hear about RSV outbreaks every year. Many parents are worried that one day their child will get infected. Understanding the nature of the disease and knowing how to prevent it will help relieve them of their stress and give them the tools to cope if their child does get sick. When children are happy, parents are happy too!
Krungthai-AXA Life Insurance customers with mild symptoms who want to consult an online doctor can use the Krungthai-AXA Telehealth service by downloading the Emma by AXA application, pressing “TeleHealth” and confirming your policy number the first time you use it. For more details, please visit: https://www.krungthai-axa.co.th/th/health-services/telehealth
References
· Corporate Communication, Faculty of Medicine, Ramathibodi Hospital
https://bit.ly/3l5hSK1
· Bangkok Hospital
https://www.bangkokhospital.com/content/respiratory-syncytial-virus
· Siriraj Piyamaharajkarun Hospital
https://www.siphhospital.com/th/news/article/share/rsv
· MedPark Hospital
https://www.medparkhospital.com/content/rsv
· Vichaivej Hospital
https://bit.ly/3KPW1ka
· Pobpad website
https://bit.ly/3OY0k05
· Faculty of Pharmacy, Mahidol University
https://bit.ly/3a9FT0c
