The start of school and the cooler weather typically starts a wave of illness in our kids. People gathering in groups indoors allows germs to spread and our youngest patients are particularly good at sharing germs: they drool, can’t wipe their nose and put everything in their mouths.
This year, we are seeing a higher level of illness than we typically see. The Covid-19 pandemic has caused our usual patterns of illness to shift. In the past, viruses have followed a predictable pattern of when they cause infections. However, all the things we did to prevent the spread of Covid-19 also prevented other viruses to circulate at their usual times. One virus whose pattern is off and is circulating at a high level right now is RSV, or Respiratory Syncytial Virus.
RSV typically circulates and causes infection in the winter months, peaking in January and February. However, for the last two years we have seen RSV start to cause infections as early as August.
RSV is a virus that causes a respiratory infection that causes cough, nasal congestion and a runny nose. This virus causes our bodies to make A LOT of mucous. Kids can run a high fever and have a very frequent cough. Infants and toddlers tend to have the hardest time with this illness. The mucous can settle in their chest and causes inflammation in their lungs. This can cause kids to wheeze, and they may have trouble breathing or maintaining their oxygen levels. When this occurs, we call this bronchiolitis. School aged kids and adults don’t typically get the chest congestion and wheezing that infants get; RSV can cause a bad cold or upper respiratory infection in older kids.
RSV bronchiolitis is one of the leading causes of hospitalizations in infants and young children. About 3% of children with bronchiolitis require hospitalization to give support breathing or to maintain their oxygen levels. Signs that your child is having trouble with this virus are fast or heavy breathing, retractions, which is when their skin pulls in at their ribs or throat when breathing, and difficulty feeding.
There are no medicines that can be used to get rid of bronchiolitis any faster. This is a viral infection that needs to run its course. The treatments we use are to relieve the symptoms. Nasal saline drops and suctioning can help to clear the mucous from the nose. A humidifier can help to keep the mucous moist. Infants usually need to eat more often because they can get tired more easily. It’s important for kids to get enough fluids when they are sick. Over the counter cough and cold medicines are not proven to be effective and are not recommended in kids less than 6 years of age.
Most healthy children begin to recover from RSV in a few days. The cough, wheezing and congestion may linger for a week or two. No one knows how long this wave will last or if RSV will be back again this winter but if it is we will be prepared to see your sick child.