What RSV Means
RSV, or Respiratory Syncytial (sin-SISH-uhl) Virus, is a common and quite contagious disease. It is also known as human orthopneumovirus. And, as the name implies, Respiratory Syncytial Virus (RSV) attacks the respiratory tract (nose, throat, and lungs). It “usually causes mild, cold-like symptoms,” especially in older children and healthy adults. (Source: Centers for Disease Control - CDC)
As a pediatrician, I have commonly seen and treated RSV over the years. It has consistently presented, since my medical school training, as upper respiratory inflammation in older children, and upper and lower respiratory inflammation in infants and toddlers.
RSV is getting more attention from epidemiologists this year, because of a rise in the number of cases during unusual seasons.
Respiratory Syncytial Virus (RSV) is a common virus that enters the body through the nose, mouth, or eyes after contact with infected fluids or surfaces.
Why Is RSV On The Rise?
RSV (and other infectious diseases) cases have increased this year, and the rise is linked to the Covid-19 pandemic. In 2020, we saw a dramatic decrease in RSV cases, 97% fewer cases than average. This is attributed to less exposure due to social distancing and masking.
Young children that were not exposed in their infancy because of social distancing and masking in response to the pandemic, are now being exposed when they return to daycare, school, and resume sports and other normal social activities.
This has resulted in an unprecedented surge that began in late spring 2021 and has continued into 2022.
How RSV Spreads
RSV spreads easily and usually peaks in the winter season because people are indoors sharing germs in close quarters.
It is most commonly contracted by close contact (direct person-to-person contact) with saliva or nasal mucus which typically occurs when an infected person coughs or sneezes. But RSV can also be transmitted by touching infected surfaces and then the face.
RSV can survive on unwashed hands for 30 minutes or hard surfaces - such as toys, phones, and doorknobs - for 6 hours.
So activities like shaking hands, holding hands, sharing toys or phones, or touching chairs, desktops or counters, doorknobs, drawers and cabinet hardware, or lockers are ways that RSV spreads to children.
How Long Does RSV Last?
Symptoms of RSV infection are seen approximately 2-7 days after exposure and children remain contagious from the start of symptoms to approximately day 8 of illness.
How Threatening Is This Virus?
Almost everyone “gets” RSV at some point in their childhood. In fact, most adults have immunity and never realize they had the virus because RSV infections are usually just like a common cold. So, RSV is not a threat to the community at large.
The areas of concern are in children below 2 years of age, older adults, and individuals with chronic heart or lung diseases - such as those who have asthma, emphysema, or chronic obstructive pulmonary disease (COPD) - or compromised immune systems.
In these high-risk individuals, cold symptoms can quickly turn into lower respiratory symptoms such as wheezing and distressed breathing and lead to more serious diseases like bronchiolitis or pneumonia.
Some infants are at higher risk of RSV bronchiolitis than others such as premature infants, and those who:
- Are less than a year old at the start of the RSV season
- Have certain heart or lung diseases or weakened immunity
- Have smoke exposure
- Have low birth weight
Common RSV Symptoms
RSV Symptoms in Infants and Toddlers
In children aged two or younger, RSV symptoms can begin with:
- Fever (defined as a rectal temperature of 100.4 or higher)
- Wet or dry cough
- Runny nose
- Poor feeding
Symptoms may progress to lower respiratory involvement which is often characterized by fast breathing and wheezing.
Some infants develop very serious respiratory distress symptoms such as persistent rapid breathing, flaring of nostrils, belly breathing, and tugging in at the throat or between ribs.
RSV Symptoms in Older Children
In older children, RSV symptoms usually only include:
- Cough (dry or wet)
- Elevated temperature
- Reduced appetite
- Less energy
Some children at higher risk (see above), or with a history of wheezing, will progress to wheezing and chest tightness that do not respond to their prescribed inhaled medications.
How is RSV Treated? And When Does My Child Need Medical Attention?
Treatment for RSV when only upper respiratory symptoms are present is the same as treatment for other conventional upper respiratory infections: focus on keeping the child hydrated and keeping the nasal passage open with saline sprays and nasal aspirators.
In integrative medicine, we also use healing vitamins and herbs to boost the immune system, healing foods for the gut, and remedies to aid breathing. And, we take important measures to prevent secondary ear infections and eliminate the need for antibiotics.
Treatment for RSV with lower respiratory tract involvement requires the attention of a medical provider. If your child is showing signs of respiratory distress, it is important to see a healthcare provider on the same day. If the respiratory distress is moderate to severe, a trip to the ER is warranted.
Stay tuned for more on the integrative approach to RSV treatment and viral prevention.
About Dr. Nicole Craven
Dr. Nicole Craven is an integrative medicine pediatrician and a global holistic health educator treating patients at Robinhood Integrative Health in Winston-Salem, North Carolina. She has more than 18 years of experience helping patients achieve their best health through nourishment for improved cellular function, medical-grade supplementation, herbal medicine, and gut-immune-brain health.
Dr. Nicole received her MD from Tulane University and completed her pediatric residency at the Medical University of South Carolina, Charleston. Following her residency, she completed Dr. Andrew Weil’s Integrative Medicine Fellowship where she “became aware of the power of holistic medicine to find and treat the root cause of dysfunction, restore cellular function, and achieve wellness.” And she later became a certified health coach with the Institute for Integrative Nutrition (IIN) in New York.
She likes to spend her free time with her pup Liam, family, and close friends cooking, creating, moving, and being outdoors.