Why Is It On The Rise
RSV is common every winter. It spreads quickly through groups of people who spend time together indoors. But during the winter of 2020-2021, fewer people spent time together because of COVID-19. This resulted in a very low number of RSV infections, compared to other years.
The low number of RSV infections meant very few babies and toddlers were immune to RSV when the shutdowns ended. This allowed RSV to make a big comeback.;;
What Symptoms Should You Watch For In Your Child
Contact your childs doctor if common cold symptoms are complicated by any of the following:
- The child is younger than three months
- The child has ever been diagnosed with asthma or reactive airways disease
- The child has a fever
- above 100.4° in babies under 3 months old
- above 101° in babies 3-6 months
- above 102° in babies older than 6 months
or take your child to the emergency room for any of these symptoms:
- Signs of trouble breathing: nostrils widening with each breath; rapid breathing; skin above or below the ribs sucking in with each breath; skin, lips or nails turning blue
- A severe headache behind or around the eyes or the back of the neck; swelling or redness around the eyes
- Persistent vomiting or signs of dehydration: dry or sticky mouth; few or no tears; thirst; discolored or less urine than usual
When Should A Person With Rsv Go To The Hospital
Even RSV that starts out mild can become a bigger problem for some people. Anyone should go to the hospital right away if they:
- Cant eat or talk normally
- Have asthma and their inhalers arent working
- Seem too tired to breathe or cough
- Are dehydrated and not making urine
- Dont want to wake up;
- Have a high fever, or a fever and chest pain
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Does My Baby Have A Severe Rsv Infection
Apart from a history of possible exposure at a childcare center, school and a known outbreak, these signs and symptoms are indicative of a severe respiratory syncytial virus infection in infants that require emergency medical care :
- Short, shallow and rapid breathing
- Flaring of the nostrils with every breath
- Belly breathing
- Bluish coloring of the lips, mouth and fingernails
- Poor appetite
When To See A Pediatrician For Rsv
RSV cases can range from mild cold symptoms to those of severe bronchiolitis. But if you suspect your baby has RSV, its important to call your pediatrician or seek emergency medical care.
Symptoms to watch out for include:
- your baby appears dehydrated, such as sunken fontanels and no tear production when they cry
- coughing up thick mucus thats gray, green, or yellow in color making it hard to breathe
- fever greater than 100.4°F , rectally obtained, in babies younger than 3 months
- fever greater than 104.0°F in a child of any age
- thick nasal discharge that makes it tough for baby to breathe
Seek immediate medical care if your babys fingernails or mouth are blue in color. This indicates your baby isnt getting enough oxygen and is in severe distress.
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Respiratory Syncytial Virus And Subsequent Asthma: One Step Closer To Unravelling The Gordian Knot
Respiratory syncytial virus is the most common respiratory pathogen in infancy, infecting nearly all children within the first 2yrs of life . There is growing evidence that severe RSV lower respiratory infection early in life is an important risk factor for the development of recurrent wheezing and asthma in later childhood but the field abounds with apparent controversy . A recent paper from the Tucson Children’s Respiratory Study in Arizona, USA has demonstrated that mild-to-moderate RSV LRI in the first 3yrs of life is an important risk factor for subsequent wheezing , up to 11yrs of age, but this risk is no longer statistically significant by 13yrs of age . In this study, no relationship was found between the infection and development of atopy. In contrast, in Boras, Sweden, subsequent recurrent wheezing in later childhood was observed in children with a history of severe bronchiolitis requiring hospitalisation in infancy , and a significant association was found between RSV and atopic sensitisation, which was not explained by a family history of asthma or atopy. How does one reconcile these apparently discrepant observations? Clearly not all children with recurrent wheezing disease have been previously hospitalised with severe RSV bronchiolitis and not all children with RSV LRI go on to wheeze. The explanation for these observations is slowly unravelling.
- Received January 1, 1900.
Treatment For Rsv In Babies
In the most severe cases, RSV may require the help of a breathing machine known as a mechanical ventilator. This machine can help to inflate your babys lungs until the virus has had time to go away.
Doctors used to routinely treat most cases of RSV with bronchodilators. But this is no longer recommended.
Examples of bronchodilator medications include albuterol, which is under the brand names:
- ProAir HFA
- Ventolin HFA
These are medications used for people with asthma or COPD to help open up the airways and treat wheezing, but they dont help the wheezing that comes with RSV bronchiolitis.
If your little one is dehydrated, their doctor may also provide intravenous fluid .
Antibiotics wont help your babys RSV because antibiotics treat bacterial infections. RSV is a viral infection.
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What Should I Do If I Think I Have Rsv
Babies who could have RSV should see a healthcare provider. Very young babies might need to be watched closely in the hospital for a day or two.
Toddlers, older children, and adults who have RSV can usually recover at home. These people only need to see a healthcare provider if they have worrisome symptoms, such as:
- Difficulty breathing;
- Wheezing or noisy breathing, especially if you have asthma
- Trouble eating or drinking
- A cough that makes it hard to sleep
- Fever that lasts for more than 4 days, or a fever that comes and goes
Preventing Dehydration In Babies With Rsv
Providing fluids, such as breast milk or formula, can be important to preventing dehydration in your baby. You can also ask your doctor if you should give your baby an electrolyte-replacing solution.
Keep your baby in an upright position, which makes it easier for them to breathe. You can keep your baby more upright in a stable and secure car seat or baby seat while they are awake at times during the day.
At night, you can raise your childs mattress by about 3 inches. You can place an object underneath your babys mattress to keep it higher up. Always place your baby on their back to sleep.
Limiting your babys exposure to cigarette smoke is also vital to keeping them healthy. Cigarette smoke can make your babys symptoms worse.
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Rsv And New Coronavirus Strains
In June 2021, the CDC issued an official health advisory about a rise in RSV cases across the southern United States. It recommended that health care providers test for RSV in all people of any age who have signs and symptoms of respiratory illness, but test negative for the coronavirus.
The rise of RSV in summer is unusual because it typically takes off in the fall and winter. Doctors worry that if both viruses increase at the same time, it could put serious stress on the nation’s emergency care capacity.;
There is some evidence that the rise in RSV may be due in part to the relaxing of coronavirus prevention steps such as masks and social distancing. It may also be that because people have less exposure to RSV and other viruses due to these precautions, they have less immune protection.
Normally, mothers pass an immune response to their babies during pregnancy. Some doctors think this response is now compromised. This is because new mothers arent being exposed to as many viruses like RSV. This a cause for concern because infants and toddlers are especially at risk for RSV.
The RSV rise mirrors a rise in coronavirus infections due to the new Delta variant. Delta is more contagious than previous versions of the virus. It also seems to infect kids much more easily. This is of special concern for kids under 12: There was no vaccine approved for this age group as of August 2021.
Does Rsv Virus Lead To Asthma
Following RSV infection, a number of infants are known to develop recurrent wheezing and asthma symptoms. In fact, some epidemiological studies have shown that as many as 40% of infants who require hospitalization from RSV will develop these concerns.
Still, while infants who are hospitalized with RSV bronchiolitis are more likely to have asthma later on, most of us have had RSV infection at some time and do not have asthma. It remains unclear if RSV infection early on in life causes asthma or if infants who are genetically destined to have asthma are simply the ones to wheeze and get ill enough to be hospitalized if infected.
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Risk Factors For Post
Several possible hereditary, environmental and clinical factors for the development of recurrent wheezing and asthma were evaluated by using multiple logistic regression. Due to some blank cells, tobacco smoke and pet exposure and IgE levels were excluded in logistic regression and analyzed elsewhere, with a univariate test . As shown in Table 3, those delivered by cesarean section, or had an older age of onset also tend to experience wheezing repeatedly, OR equals 2.797 and 1.421, respectively. And the higher birth weight was associated with post-bronchiolitis asthma, OR equals 1.369. It is prudently to say that smoke exposure poses both risks, while pets only increase the likelihood of repeated wheezing since the intentional avoidance in children with asthma. Ultimately and pivotally, History of eczema is more directly relates to higher asthma risk than generally atopic condition, which is consistent with the serum IgE levels.
Table 3. Multinomial logistic regression of various risk factors for post-bronchiolitis recurrent wheezing and asthma.
Figure 1. Several risk factors for recurrent wheezing and asthma. Effect of smoke exposure; Effect of Pet exposure; Serum IgE level; Effect of elevated IgE. The data are expressed as the mean Â± SD or n . **P-value < 0.01, ****P-value < 0.0001.
Development Of Recurrent Wheezing And Asthma After Bronchiolitis
Long-term prospective studies have shown a link between bronchiolitis and asthma . In a study from the United Kingdom, Noble et al monitored a cohort of 101 hospitalized infants with acute bronchiolitis and 47 control infants. Abnormal pulmonary function still was found 9 to 10 years after hospitalization. Forced expiratory flow in 1 second and peak expiratory flow were 5% to 9% lower than in controls. Two to three times more episodes of wheeze and diagnosed asthma were reported in index children than in controls. The history of bronchiolitis was the only variable related to wheezing and diagnosis of asthma. Virus-specific analysis was not reported. No differences were found in histamine challenge and skin prick tests.
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Common Respiratory Syncytial Virus May Hide In The Lungs Lead To Asthma Researchers Report
- UT Southwestern Medical Center
- Conventional wisdom has been that respiratory syncytial virus — a common virus that causes infection in the lungs — comes and goes in children without any long lasting impact. A study conducted in mice, however, suggests that RSV may hide in the lungs even after other symptoms abate, ultimately resurfacing to cause recurrent wheezing and chronic airway disease.
Conventional wisdom has been that respiratory syncytial virus a common virus that causes infection in the lungs comes and goes in children without any long lasting impact.
A study conducted in mice by UT Southwestern Medical Center researchers, however, suggests that RSV may hide in the lungs even after other symptoms abate, ultimately resurfacing to cause recurrent wheezing and chronic airway disease.
“This research suggests that there’s a potential new mechanism for asthma related to viral infections in children that could be associated with RSV,” said Dr. Asuncion Mejias, assistant professor of pediatrics at UT Southwestern and senior author of a study available online and in the Nov. 15 issue of the Journal of Infectious Diseases. “These findings could aid in the development of preventive and therapeutic interventions for children with recurrent wheezing due to a virus such as RSV.”
Most children recover within a week, but RSV can cause repeated infections throughout life. There is currently no vaccine available.
What Are The Complications Of Rsv
Complications of respiratory syncytial virus include:
- Hospitalization. A severe respiratory syncytial virus infection may require a hospital stay so that doctors can monitor and treat breathing problems and give intravenous fluids.
- Pneumonia. RSV is the most common cause of inflammation of the lungs or the lungs airways in infants. These complications can occur when the virus spreads to the lower respiratory tract. Lung inflammation can be quite serious in infants, young children, older adults, immunocompromised individuals or people with chronic heart or lung disease.
- Middle ear infection. Germs that enter the space behind the eardrum can lead to otitis media . This happens most frequently in babies and young children.
- Asthma. A link may exist between severe RSV in children and the chance of developing asthma later in life.
- Repeated infections. There is also the chance of reinfection from the same virus after recovery, which is even possible during the same RSV season. Though symptoms usually arent as severe, typically in the form of a common cold, they can be serious in older adults or people with chronic heart or lung disease.
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Study: Rsv Is Not A Predictor For Pediatric Asthma
Virtually all deaths from RSV occur in developing countries, and long-term airway morbidity should be studied in those parts of the world.
Louis J. Bont, MD
Respiratory syncytial virus , a virus that infects the respiratory tract, does not cause current asthma or poor lung function by 6 years of age, according to a new study.
There are hundreds of clinical publications focusing on the relationship between RSV and asthma, noted study author Louis J. Bont, MD, Pediatric Infectious Disease Specialist at Wilhelmina Childrens Hospital, University Medical Center Utrecht, in the Netherlands.
That may be because RSV infection is one of the most common cause of disease during infancy, Bont said.
We provided the first conclusive evidence that RSV does not cause asthma symptoms and does not increase the risk of asthma, Bont said.
The six-year follow-up included 92% of the original participants. Parent-reported current asthma was reported in 28 of 199 children in the RSV prevention group and 47 of 196 children in the placebo group . The difference in current asthma was the result of infrequent wheeze .
Forced expiratory volume 0.5 percentage predicted values were similar between RSV prevention group and placebo group , with a mean difference of 1.0 . The number of children with current doctor-diagnosed asthma was similar between the RSV group and the placebo group ; ARR -0.4; 95% CI; -6.5 – 5.8).
Genetics Of Airway Hyperreactivity
A parental history of childhood respiratory problems is an important risk factor for infantile lower respiratory tract illnesses. In the Tucson Children’s Respiratory Study, the greatest risk was early onset of the parental illness . A parental history of asthma or bronchiolitis with onset before age 3 years was associated with wheezing illnesses in offspring. The continuation of wheezing from early life until age 6 years also has a clear association with a maternal history of asthma and atopy . Although these findings suggest a familial component in childhood wheezing, epidemiologic studies do not answer the question whether the risk is inherited genetically.
Since the 1990s, significant progress has been made in identifying the genes responsible for the development of asthma and atopy , , . There are probably many susceptibility genes that act either alone or in combination with other genes increasing the risk of the disease . Genetic studies are confounded by influences of genetic heterogeneity, heterogeneous phenotypes of asthma among the studied subjects, incomplete or low penetrance , and genotype-environment and gene-gene interactions , .
How Can I Help Prevent Rsv
The single best way to prevent RSV infection is good hand washing. Not only do you need to wash your hands, but you need to insist that anyone handling your baby does as well.
Additionally, keep your young infants away from people that have colds, respiratory tract infections, or fever. While you may want to show off your young baby and other young children will be very interested, RSV is very common in young children and is easily spread from child to child.
Finally, do not smoke or let others smoke around your child a good practice for many other reasons, too.
How Is Rsv Diagnosed
Testing for RSV is often not needed. If its required, there are several types of laboratory tests used for diagnosis. The most commonly used is the rapid diagnostic test. This test looks for RSV antigen in nasal secretions. A nasal swab can be taken in your doctors office and sent for testing. The results are usually available in less than an hour. If a rapid test is negative, your doctor may order a virus culture of the secretions. They may also choose a more sensitive test that uses genetic technology to detect the virus in the blood.
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