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RSV is on the rise: What you need to know

It’s hard to miss the headlines. Hospitals across the U.S. have reported a surge in cases of RSV, and the common respiratory illness has a lot of parents and vulnerable adults on high alert.

“RSV is a common virus that causes acute respiratory tract illness in all ages,” Dr. Justin Bowles, Medical Director for MultiCare Indigo Urgent Care explains. “Almost all children are infected by two years of age and reinfection can happen throughout life.”

While most healthy children and people who get RSV only experience mild symptoms, this seemingly harmful virus can be dangerous for some young babies and others at risk of developing severe symptoms.

 

What is RSV?

RSV, or respiratory syncytial virus, is a highly contagious viral illness that usually causes mild symptoms. It’s so common that almost all children will have RSV at least once by the time they turn 2, and anyone of any age can contract RSV multiple times throughout their lives.  

For most infants and young children, RSV shows up as nothing more than a cold. However, the infection can cause more serious – sometimes life-threatening – health issues, especially among the tiniest of kiddos.

According to the Centers for Disease Control and Prevention (CDC), RSV is the most common cause of bronchiolitis (inflammation of the airways) and pneumonia (infection of the lung) in children under the age of 1 in the U.S.

 

How do you get RSV?

Just like the common cold and other viruses, RSV spreads through direct contact with another person via saliva, mucus or nasal discharge. RSV can also survive on unwashed hands for 30 minutes or more and on unclean objects or surfaces for up to 6 hours.

Symptoms of the virus usually start 2 to 8 days after infection. According to the CDC, people who have the virus are usually contagious for 3 to 8 days. But infants and people with weakened immune systems can spread the virus for up to 4 weeks.

 

Who is at risk of getting RSV?

Anyone can get RSV multiple times throughout their lives, but symptoms of the virus can be severe for certain populations, including:

  • Premature infants.
  • Infants under 6 months of age.
  • Infants with congenital heart and lung disease.
  • Children and adults with weakened immune systems.
  • Children who have difficulty swallowing or clearing mucous.
  • Adults 65 and older.
  • Adults with heart and lung disease.

 

Why are cases of RSV on the rise?

It’s no surprise that RSV cases dropped dramatically during the COVID pandemic amid mask-wearing, social distancing and shutdowns of daycares, schools and businesses. As restrictions eased in 2021, RSV cases spiked, particularly among babies. In August of this year, the numbers began to climb again, far ahead of when the virus typically occurs in fall and winter.

Healthcare providers are bracing for what could be a triple threat as we head into winter. Flu season is also off to an early start, and another COVID surge is expected this winter.

 

What are the symptoms of RSV in young children?

RSV symptoms in young children typically develop in stages and may include:

  • Runny nose.
  • Coughing.
  • Sneezing.
  • Fever (above 100oF).
  • Decreased appetite.

Very young infants with RSV may develop only a few symptoms, including:

  • Fussiness or irritability.
  • Decreased activity level.
  • Decreased appetite.
  • Pauses in breathing.

Symptoms of severe RSV in infants may include:

  • Short, shallow and rapid breathing.
  • Blue tint to the skin, especially lips and fingernails (due to lack of oxygen).
  • Wheezing.
  • Dehydration (decrease in wet diapers).

 

What are the symptoms of RSV in older children and adults?

Often, older children and adults with RSV show no symptoms or very mild cold-like symptoms, including:

  • Runny nose.
  • Congestion.
  • Mild headache.
  • Sore throat.
  • Fever.
  • Cough.
  • Tiredness.

For children and adults at high risk of developing pneumonia or bronchiolitis because of RSV, more severe symptoms may develop, including:

  • Fever.
  • Severe cough.
  • Wheezing.
  • Rapid breathing or difficulty breathing.
  • Bluish tint to skin.

 

When is RSV considered serious?

RSV typically runs its course within a week or two, and most children and adults will recover from the virus on their own. However, you should see a health care provider if:

  • Symptoms worsen or don’t improve after 7 days.
  • Your child has difficulty breathing or decreased urinary output.
  • Your infant is younger than 3 months of age and has a rectal temperature of 100.4oF or higher.
  • Your child of any age has a fever higher than 104o

When symptoms are severe, hospitalization may be required. Treatment may include:

  • Intravenous (IV) fluids.
  • Humidified oxygen.
  • A breathing machine, or ventilator (in rare cases).

The CDC estimates that about 3 percent of children younger than 6 months with RSV require a hospital stay. Most go home after 2 or 3 days.

 

How are mild symptoms of RSV treated?

There is no specific treatment for RSV and, just like the common cold, there is no cure for the viral infection. If your child is experiencing mild symptoms, you can ease their discomfort with these standard remedies:

  • Pain and fever relievers. If your child is older than 6 months, over-the-counter pain and fever medication such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) should ease fever and discomfort. Always avoid aspirin, which has been linked to Reye’s syndrome in children. The rare but dangerous condition can cause brain swelling and liver damage.
  • Nasal saline. Non-medicated saline drops help keep tiny nasal passages clean and moisturized. After applying, use a bulb syringe to gently suction mucus.
  • Cool-mist humidifier. Adding some moisture into the air will soothe dry breathing passages and help break up mucus.
  • Loads of liquids. Make sure your child gets plenty of fluids and feedings to prevent dehydration.

CAUTION: Resist the urge to reach for nonprescription cold medications. Some are not recommended for young children. A healthcare provider can offer guidance.

 

How can I protect my child (and myself) from RSV?

We picked up some smart habits during COVID. Those same precautions will also help protect your child and others from RSV.

  • Cover coughs and sneezes with a tissue or your shirt sleeve – not your hand.
  • Wash hands often with soap and water, especially if you’ve come in contact with someone who has cold symptoms.
  • Avoid close contact with people who are sick.
  • Frequently clean and disinfect high-touch areas, including toys, door knobs and cell phones.
  • Don’t share bottles, cups, toys or other objects.
  • Avoid touching eyes, nose and mouth with unwashed hands.
  • Keep your child (and yourself) home when sick.
  • Limit time at large gatherings, especially if you’re prone to sickness or have a weakened immune system or condition that puts you at risk.

While there is no vaccine to prevent RVS, researchers are working on it. An international study has found that vaccinating moms-to-be is a highly effective way to prevent severe cases of RSV in young babies. Vaccines in development also provide protection for at-risk adults.

 

Concerned about RSV? Indigo Urgent Care can help

If your child (or a loved one) has worrying signs of RSV, Indigo Urgent Care is here to ease your mind and help relieve their uncomfortable symptoms.

One of our friendly health care providers will review your child’s history and symptoms, listen to their lungs and check oxygen levels with a simple fingertip pulse oximetry test. They may also order tests to check for signs of infection or take a nose swab to test for viruses. While it is possible to test specifically for RSV, the test is rarely necessary because results don’t typically impact the course of treatment.

If a more severe infection is detected, your provider may order additional imaging tests, including X-rays and a CT scan to check your child’s lungs.

At MultiCare Indigo Urgent Care, you and your little ones don’t have to wait for care. We’re here 8 am to 8 pm every day, including weekends and holidays. Simply walk in to one of our neighborhood locations across Washington state or book an appointment online.

And when a trip to a clinic isn’t comfortable or convenient, you can schedule an online care appointment and be seen by a provider from the comfort of your home, or wherever you are.

You should go to your nearest emergency department if your child – or anyone at risk of severe RSV infection –  has any of these symptoms:

  • Difficulty breathing
  • High fever
  • Blue tint to the skin (especially lips and fingernails)
  • Signs of dehydration (decrease in wet diapers)
  • Confusion

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