Respiratory virus tough on toddlers

By Sharna Johnson: CNJ staff writer

Around this time every year the majority of Plains Regional Medical Center’s 12-bed pediatric ward is full with babies and young toddlers and often there’s a single culprit to blame — Respiratory syncytial (sin-SISH-uhl) virus or RSV.

“When a child has RSV, they’re pretty sick little kids,” said Janna Flores, director of women and children’s services at PRMC.

There were six children being treated for RSV on Monday at the hospital.

Oxygen, breathing treatments and steroids are the norm for the children, who are kept anywhere from overnight to several days, she said, explaining hospital staff are working to combat the dehydration and difficulty breathing that accompanies the common childhood virus.

Complications from the virus can include pneumonia and bronchitis.

From October through March, RSV is the predominant condition treated on the pediatric floor at PRMC.

According to the Centers for Disease Control and Prevention, RSV strikes approximately 75,000 to 125,000 children under the age of one per year.

In perhaps three or four cases a season, Flores said children need to be sent to larger hospitals because a ventilator is needed.

RSV is not only common, it is also easily transmitted, said Flores, who has been with PRMC for nine years.

Exposure can come from visiting busy places like churches, shopping centers and even from older siblings or adults, she said.

And RSV is one of the reasons parents with new babies are cautioned to keep them at home.

Thought of as almost an exclusively childhood illness, generally only children under age 2 fall seriously ill and develop the severe respiratory issues associated with RSV. Though older adults and those with compromised immune systems can be susceptible, Flores said.

There is a vaccine, she said, but it is typically reserved for the most susceptible of children — such as severely immune compromised or premature babies — because it is a fragile vaccine that must be administered monthly to be effective.

Not every child with RSV requires hospitalization, Flores said.

“Several of the kiddos can go home. They’ll usually go home with a nebeulizer machine,” to help them breathe, she said.

With flu-like symptoms such as irritability, fussiness, lack of appetite, coughing and sometimes even vomiting, RSV often distinguishes itself to parents when they find their child struggling to breath in the night or discover a raspy, wheezing, rattling sound and racing heart rate in their ill child.

Doctors are extremely well versed in the symptoms and, with the aid of a nasal swab, can usually pin it down quickly.

The illness can be quite daunting to new parents, she said.

“It’s very scary initially because they’ve never had to deal with anything like this,” she said. “(But those fears lessen) once they’re here and they realize that there is a plan.”

The best course for prevention, Flores said, is to limit a child under 2 from exposure to large crowds or groups of people, practice good hand washing and hygiene, avoid exposure to second-hand cigarette smoke and wash toys and other items with soap and water or disinfectants.

What is RSV? — Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a respiratory virus that infects the lungs and breathing passages. Infection can be severe in some people, such as certain infants, young children, and older adults.

RSV is the most common cause of bronchiolitis and pneumonia in children under 1 year of age in the United States.

Symptoms — Coughing, sneezing, runny nose, fever and a decrease in appetite. Wheezing may also occur. In very young infants, irritability, decreased activity and breathing difficulties may be the only symptoms of infection.

Treatment — There is no specific treatment for RSV infection.

In the most severe cases, infants may require supplemental oxygen, suctioning of mucus from the airways, or intubation (have breathing tubes inserted) with mechanical ventilation. In most cases, full recovery from illness occurs in about one to two weeks.

How it’s spread — RSV can be spread when an infected person coughs or sneezes into the air. Coughing and sneezing send virus-containing droplets into the air, where they can infect a person if they inhale these droplets or these droplets come in contact with their mouth, nose, or eye.

Prevention — people who have cold-like symptoms should:

• Cover their coughs and sneezes

• Wash their hands frequently and correctly (with soap and water for 15–20 seconds)

• Avoid sharing their cups and eating utensils with others

• Refrain from kissing others

In addition, cleaning contaminated surfaces (such as doorknobs) may help stop the spread of RSV.

Source: Centers for Disease Control,