What sounds like a cold, looks like a cold and acts like a cold – but sends more babies to the hospital than any other condition?
Respiratory syncytial virus, or RSV: the common disease with the uncommon name.
RSV tends to pop up in the winter and early spring. It starts as an upper respiratory infection, with familiar cold symptoms – runny nose, mild cough, low fever. And for most people, that’s where it ends.
By the time children are 2 or 3 years old, most have likely been infected by RSV at least once, with few problems. However, for premature babies and infants, children with asthma, and patients of all ages with underlying lung, heart or immune system problems, the virus can be life-threatening.
What makes RSV so dangerous is its ability to quickly spread down from the nose and throat into the lower respiratory tract, where it infects and causes inflammation in the tissues of the lungs (causing pneumonia) and the tiny bronchial air tubes (causing bronchiolitis). Inflammation is the body’s natural process for fighting infection, but in tiny infant airways or those already inflamed by asthma, it can cause increased airway obstruction and difficulty in breathing.
Another danger of RSV is that a serious RSV infection in young children often leads to later development of asthma and allergies. Researchers do not know exactly why this happens. It may be a cause-and-effect reaction, where the RSV infection damages the lung, which leads to asthma; or it may just be an association, where a child who is at risk for asthma may also be at risk for a more serious RSV infection.
Over the past 10 years, researchers have realized that RSV is also quite common among adults, especially senior citizens living in group settings. People most at risk of exposure to RSV are those in close contact with large numbers of people. The highly contagious virus spreads quickly through human contact, often before the infected person shows any obvious signs of the disease. To make things worse, the RSV virus can live on surfaces such as doorknobs and tabletops for days.
The key to controlling RSV is preventing infection and identifying early symptoms. Prevention centers on strict hygiene:
- wash hands frequently, especially before eating or before handling babies
- wash toys, tabletops and other shared surfaces
- avoid sharing cups, eating utensils or food
- stay away from people with obvious cold symptoms
- stay away from cigarette smoke, which can increase the risk of infection and severity of symptoms
Identifying RSV depends on recognizing the danger signs. Call your physician if cold symptoms last longer than a week, or if they evolve into any of these complications:
- high fever (above 100.4° in babies under 3 months old; above 101° in babies 3-6 months; above 103° in babies older than 6 months)
- fast breathing or other breathing problems
- worsening cough
- blueness around the mouth (indicating lack of oxygen)
There is no medical cure for RSV. Physicians focus instead on treatments that reduce congestion and open the airways so the patient can breathe. Serious cases require hospital care, intravenous fluids, nebulizer medications and oxygen treatments. Some high-risk babies may qualify to receive a preventive medicine called palivizumab, given by injection every month during RSV season (fall and winter).
Parents and caregivers of children with asthma, premature babies and infants – as well as elderly people – need to take extra precautions during the RSV season, learn to recognize the warning signs and seek medical treatment as soon as possible.
First published: The MA Report
Reviewed: March 2011