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Childhood illnesses
Respiratory Syncytial Virus deserves parental attention

Families

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Europe Regional Medical Command
Public Affairs Office
CMR 442 APO AE 09042
U.S. Army Hospital – Nachrichten Kaserne
Postfach 103180 69021 Heidelberg, Germany
Contact Steve Davis 371-3317 Tel. 06221-17-3317
January 15, 2009

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    Childhood illnesses
    Respiratory Syncytial Virus deserves parental attention

HEIDELBERG, Germany

Respiratory Syncytial Virus (RSV) is a virus that usually causes respiratory illness in children under two years of age. It occurs primarily from November through April. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children under one year of age in the United States. Almost all children are infected with the virus by their second birthday, but only a small percentage develop severe disease. Symptoms are similar to the common cold, but RSV can progress to pneumonia, so it is important to monitor these symptoms in babies and young toddlers.

The illness typically begins four to six days after exposure with a runny nose and decreased appetite. Coughing, sneezing, and fever typically develop one to three days later. In very young infants, irritability, decreased activity, and breathing difficulties may be the only symptoms of infection. Most otherwise healthy infants infected with RSV do not require hospitalization, and in most cases, including among those who need to be hospitalized, full recovery occurs in about one to two weeks.

The virus is often brought into the home by school-aged children and can be rapidly transmitted to other members of the family. RSV can be spread from coughing or sneezing by an infected person. Droplets can linger briefly in the air, and if someone inhales the particles or the particles contact their nose, mouth, or eye, they can become infected.

Infection can also result from direct and indirect contact from infected persons, such as kissing the face of a child with RSV or if the virus gets on an environmental surface, such as a doorknob, that is then touched by other people. Direct and indirect transmissions of virus usually occur when people touch an infectious secretion and then rub their eyes or nose. RSV can survive on hard surfaces such as tables and crib rails for many hours. RSV typically lives on soft surfaces such as tissues and hands for shorter amounts of time.

People infected with RSV are usually contagious for three to eight days. However, some infants and people with weakened immune systems can be contagious for as long as four weeks. Premature infants, children less than two years of age with congenital heart or chronic lung disease, adults and children with compromised (weakened) immune systems due to a medical condition or medical treatment are at highest risk for severe disease.

Prevention is based in cleanliness. Cover all coughs and sneezes. Teach children to cough into their sleeve/elbow or into a tissue not into their hands. Wash hands frequently with soap and water for at 15-20 seconds. Because the virus can survive on surfaces it is important to keep things clean. Counters and door knobs and other surfaces should be cleaned with disinfectant or just hot soapy water. Avoid sharing cups and eating utensils.

It is wise to keep babies and people with poor immune systems away from crowds between November and April. If a school age child becomes ill with cold symptoms, you should explain how germs are spread by droplets and touch and encourage them to avoid holding and kissing any younger children or babies until they are better.

Drugs are available to prevent severe RSV illness in certain infants and children who are at high risk. The drug can help prevent development of serious RSV disease, but it cannot help cure or treat children already suffering from serious RSV disease and it cannot prevent infection with RSV. If your child is at high risk, talk to your healthcare provider to see if palivizumab or Synagis can be used as a preventive measure. Researchers are working to develop RSV vaccines, but none is available yet.

Visits to a healthcare provider for an RSV infection are very common. Contact your local health clinic if your child is displaying the following symptoms: wheezing, coughing that wakes up the child, pain when coughing, difficulty breathing (baby’s head moves with each breath), high persistent fever, ear pain, multiple episodes of vomiting, irritability, atypical behavior, excessive sleeping, decrease in wet diapers or intake of fluids.

There is no specific treatment other than the care of symptoms, but the physician will determine the best care plan for your child. Your doctor can give advice on how to make people with RSV infection more comfortable and assess whether hospitalization is needed.