RSV in Children: Symptoms, Treatment, and What Parents Should Know


September, 8 month old baby Walked in Dr. Juanita Mora’s office in Chicago contracted an infection that doctors wouldn’t see until two months later: RSV.

Like her peers across the country, allergists and immunologists have been treating young children with the cold-like virus before the usual season begins.

“We’re seeing RSV infections rampant across the country,” Mora said.

The Centers for Disease Control and Prevention says nearly all children will be infected with RSV by age 2. Most adults who contract it have mild illness; it can be dangerous for older adults or those with chronic heart or lung disease or weakened immune systems. But RSV is especially tricky for babies and children.

Maura, a volunteer medicine spokeswoman for the American Lung Association, said it’s important for parents, caregivers and daycares RSV stands for Respiratory Syncytial Virus and workers know what to look out for. That way, they know if a sick child can be treated at home or needs to go to the hospital.

“The emergency room is full of all these sick kids, so we want parents to know that they can go to the pediatrician and get tested for RSV, flu and even Covid-19,” Mora said.

Here’s what parents also need to know amid the surge in respiratory illnesses.

For many people, RSV causes mild illness that can be treated at home.

On average, the infection lasts from five days to a few weeks and usually goes away It will go away on its own, the CDC says. Sometimes the cough can last up to four weeks, pediatricians say.

Symptoms may look like the common cold: runny nose, decreased appetite, coughing, sneezing, fever, and wheezing. Young babies may just appear irritable or lethargic, and have trouble breathing.

Not every child will develop all potential RSV symptoms.

“RSV infection does cause fever, especially in young infants,” Dr. Dr. said. Priya Soni, assistant professor of pediatric infectious diseases at Cedars Sinai Medical Center.

Parents should be aware of any changes in behavior, including eating longer or not being interested in food at all, she said. The child may also have a severe cough and some wheezing.

It’s also important to watch your child for signs of difficulty breathing or breathing through the ribs or abdomen — “these symptoms may overlap with many of the other viruses we’ve seen,” Soni added.

Because it’s not easy for parents to differentiate between respiratory illnesses such as RSV and the flu, it’s best to take a sick child to a pediatrician who can do tests to determine the cause.

“You may need to take your baby for an evaluation as soon as possible,” Soni said.

For RSV, parents should be especially careful with RSV if their children are premature, newborns, children with weakened immune systems or neuromuscular disorders, and children younger than 2 years old with chronic lung and heart disease, the CDC said.

“Parents should be very sensitive to any changes, such as their activity and appetite, and then pay special attention to any signs of respiratory distress,” Soni said.

Testing is important because treatment for conditions like the flu and Covid-19 can vary.

There is no antiviral or specific treatment for RSV like influenza, and there is no vaccine. However, if your child is sick, there are things you can do to help.

Fever and pain can be controlled with non-aspirin pain relievers such as acetaminophen or ibuprofen. Also make sure your child is drinking enough fluids.

“RSV can seriously dehydrate kids, especially when they’re not eating or drinking, especially when we’re talking about babies,” Mora said. “Once they stopped eating or urinating less, they didn’t have as many wet diapers, which suggests they may have to see a pediatrician or emergency department.”

Check with your pediatrician before giving your child any over-the-counter cold medicines, which can sometimes contain ingredients that are not good for your child.

Your pediatrician will check your child’s breathing rate — the rate at which they breathe — and their oxygen levels. If your child is very sick or is at high risk of becoming seriously ill, the doctor may ask them to go to the hospital.

“RSV can be super dangerous for some young infants and young children, especially those younger than 2 years old,” Soni said.

Mora said difficulty breathing indicates the child has the virus. RSV can turn into more serious diseases, such as bronchiolitis or pneumonia, and can lead to respiratory failure.

If you notice your child’s chest moving up and down when breathing, if their cough doesn’t put them to sleep or if it gets worse,” this could be a sign that they need to seek help from a pediatrician or take them to the emergency department, because then they may need supplemental oxygen , or they may need nebulization therapy.”

CNN medical analyst Dr. Leana Wen said this difficulty breathing — including shaking your head, opening your nose, or grunting — is one of the two main problems with any respiratory infection. Another is dehydration. “This is especially true for babies with stuffy noses. They may not be feeding.”

Much of the care provided by hospital staff will help with breathing.

“We provide support measures for RSV and these children with oxygen, IV fluids and respiratory therapy, including suction,” Soni said.

A thin tube may need to be inserted into their lungs to remove the mucus. Children can get extra oxygen through a mask or a tube attached to their nose. Some children may need to use an oxygen tent. Those who are struggling may need ventilators.

Some babies may also need to be tube-fed.

Doctors say the best way to prevent RSV infection is to teach children to cough and sneeze into a tissue or elbow instead of their hands. Also try to keep frequently touched surfaces clean.

If a caregiver or older sibling is sick, they should wear a mask around others and wash their hands frequently, Mora said.

Most importantly, if someone is sick – a child or an adult – they should stay home to avoid spreading the disease.

There is a monoclonal antibody therapy for children at highest risk for serious disease. It’s not for everyone, but it can protect those who are most vulnerable. It comes in a form that children can get every month during a typical RSV season. Discuss with your doctor whether your child is eligible.

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