Respiratory Syncytial Virus (RSV) Concerns in Kids

Respiratory Syncytial Virus (RSV) Concerns in Kids

Cases of respiratory syncytial virus infection, or RSV, are surging throughout the country, including in our local area. We see on the news stories about hospitals being overwhelmed with cases of RSV, and parents fearing for their children’s well-being.

In the vast majority of cases, however, RSV does not lead to complications and hospitalizations. Yet parents should still be aware of the symptoms of this viral infection, and ensure their children get the treatment they need.

Here is information to help parents and caregivers navigate RSV and help their little ones feel better soon.

What is RSV and What are the Symptoms?

RSV is a common viral illness. It’s so common, in fact, that according to the U.S. Centers for Disease Control and Prevention, nearly all children get an RSV infection by the time they are 2 years old.

RSV can spread in a variety of ways, including touching a surface that has the virus on it or having direct contact with someone who has RSV. RSV also can spread through respiratory droplets: If someone with RSV coughs or sneezes near your child, your child can get sick.

RSV causes mild symptoms in most cases; some children may have no symptoms at all!

RSV symptoms are akin to those of a cold and may include:

  • Coughing and sneezing
  • Stuffy or runny nose
  • Sore throat
  • Earache
  • Fever

Symptoms usually last one to two weeks. Symptoms tend to worsen around day 4 or 5, and then gradually improve. If fever lasts longer than four days, or if cough and congestion last longer than two weeks, seek medical care.

Some children are at greater risk of severe illness, including premature infants; infants 6 months or younger; children with neuromuscular disorders; children with weakened immune systems; and children with certain chronic medical conditions.

Severe RSV can cause bronchiolitis – a lower respiratory tract inflammation of the small air passages in the lungs – and pneumonia. Both bronchiolitis and pneumonia can be serious illnesses. Symptoms of severe RSV include worsening fever; labored or rapid breathing; flared nostrils; severe cough; wheezing; and dehydration. Parents may notice their child’s belly going in and out, or their muscles contracting between the ribs when breathing. These are signs that the child is working too hard to breathe. Other red flags include grunting sounds and skin that turns blue.

Infants may refuse to drink or eat. They may be irritable and lethargic.

Call your pediatrician if your child has any symptoms of worsening RSV, breathing difficulty, signs of dehydration or blue skin. Some children do need to be hospitalized where they can get outstanding treatment to improve their symptoms. Though this can be a very scary experience for parents and children alike, nearly all children make a full recovery.

Treating RSV

There is no one medicine or cure for RSV. Instead, we focus on treating the symptoms. Most children with RSV can be treated at home.

Parents can try:

  • Using saline nose drops or spray to clear up congestion. Bulb suction is recommended for infants.
  • Ensuring their child is drinking fluids. Breastfed infants may need to feed more frequently for shorter amounts of time. Infants on formula may take smaller bottles, but can be offered the formula more frequently. For children over 6 months, I recommend small sips of water and Pedialyte. Popsicles can also help older children stay hydrated. Don’t worry if your child doesn’t have an appetite and doesn’t eat much. Instead, focus on hydration. Children should have at least three wet diapers a day.
  • Setting up a humidifier. A humidifier can help your child breathe easier.
  • Using over-the-counter fever relievers. Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) can bring down a fever. Ibuprofen is meant for children ages 6 months and up. Make sure the medication isn’t expired and to read the label carefully to ensure the proper dose. Know your child’s weight since the dosage of these medications is weight based. Do not give aspirin to children.
  • Giving your child honey. Honey can help thin out mucous. Important note: Do not give honey to children younger than 12 months old.

Connecting with Your Child’s Physician

Medical offices offer different ways to connect with a pediatrician. At Kaiser Permanente, parents can send a secure message to the child’s doctor with non-urgent concerns, such as when to send the child back to school and questions about medications. We encourage calling the call center for more urgent concerns and immediate medical advice. In-office visits are recommended for persistent fevers, worsening symptoms, concerns about dehydration or respiratory difficulties.

Preventing RSV

With RSV cases rampant, it may be difficult to completely prevent your child from getting infected with RSV. However, there are steps that you can take to lower the risk. Adults should practice good hand hygiene and teach children who are old enough how to properly wash their hands with soap and water. Parents also should teach children to keep their hands away from their eyes, nose and mouth to help stop spreading germs. And teach children how to blow their nose and cover their coughs and sneezes – and to throw away their tissues and wash their hands afterward.

Try to keep your children away from people who may be sick – and do not send sick children to day care or school. Particularly if your child is high risk, try to limit the number of people they are exposed to.

Though there is currently no vaccine for RSV, ensure children are up to date on other vaccines, including the flu vaccine, COVID-19 vaccine and other childhood immunizations.

I encourage parents to talk to their child’s doctor about any concerns surrounding RSV, and to take measures to keep their children as healthy as possible. These same measures can keep your children protected against the flu, COVID-19 and other viral illnesses. Though not all illnesses can be prevented, taking precautions may help your child have a milder illness.


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