Baby
RSV: WHEN COLDS BECOME SERIOUS
By Melodi B. Karakurum, MD, F.C.C.P
When your infant comes down with a cold, you need to be on the alert.
Baby colds can quickly turn into acute bronchiolitis, a serious lower
respiratory tract illness that causes swelling of the small airways in
the lungs. The Respiratory Syncytial Virus (RSV) is the most common
cause of acute bronchiolitis. While the infection can occur from birth
to two years of age, infants between ages two and six months are the
most susceptible.
The RSV lowdown:
- How is RSV transmitted?
Although RSV is a respiratory virus, it is transmitted mainly by direct hand contact from infected individuals.
- What are the signs and symptoms?
Typically, an
affected infant has cold-like symptoms such as nasal congestion, runny
nose, low-grade fever, decreased appetite and irritability. After
several days, symptoms progress to rapid breathing, rapid heart rate
and a hacking cough, suggesting the spread of the viral infection to
the lower respiratory tract. Increasing respiratory distress may cause
the skin around the mouth to turn a bluish color (cyanosis). Your
infant may also produce a wheezing sound when breathing while the
muscles between the ribs and below the rib cage retract. Your baby may
appear very sleepy, and dehydration may result from reduced feedings.
- How is it diagnosed?
A test can be performed in the
hospital to confirm the diagnosis of RSV bronchiolitis, but often a
history and physical exam are sufficient to make the diagnosis. A chest
x-ray may also be helpful.
- Can it be confused with other diseases?
Asthma is a
major consideration in children with bronchiolitis and is the more
likely diagnosis if there have been previous episodes of wheezing.
Gastric
reflux with aspiration of the stomach contents may also produce the
symptoms of bronchiolitis, but cold-like symptoms do not precede
respiratory distress in these cases.
- How is it treated?
Most children are treated at home
and improve within three to five days. Underlying conditions such as
prematurity, heart disease, and a weakened immune system puts a child
at high-risk for more serious complications from the disease. These
babies should be monitored more closely.
There are no specific
medications to treat RSV bronchiolitis. You'll need to monitor your
infant closely for signs of respiratory distress (outlined above) and
dehydration (signs include lethargy and dry diapers). If the fever
persists for more than four to five days and/or remains elevated
despite treatment with acetaminophen, your infant should be seen
immediately by a physician. Otherwise, adequate feeding of fluids by
and applying saline drops into the nose for nasal congestion are
sufficient until the infection resolves in three to five days.
- Can you prevent your baby from getting RSV?
Yes.
HAND WASHING is the most reliable way of protecting your infant. It is
especially important if there are older siblings in the house who are
exhibiting common cold-like signs. Having others hold your young infant
should be minimized to avoid transmission. Since RSV tends to peak
between October and April, you need to be extra mindful of taking
precautions with your infant during these months.
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About The Author
Dr. Karakurum is associate director of the division of pediatric pulmonology at Maimonides Medical Center in Brooklyn, New York.
