Health Guide: RSV

Written By Katie Livingstone
 

RSV (Respiratory Syncytial Virus) is a virus that affects the lungs and breathing passages. It’s the most common cause of respiratory and breathing infections in children and is often the culprit for ‘the common cold’. RSV is usually mild for adults and older kids, but for preschoolers and infants it can cause more serious infections. For babies under the age of one we need to be particularly careful as RSV is the leading cause of bronchiolitis and pneumonia for this age group.

How’s it spread:

Kids with RSV are infectious for roughly eight days from the beginning of their symptoms. It’s one of those tricky viruses because it’s highly infectious, it can live on surfaces (including hands) for a good few hours. It’s spread through droplets - so coughing, sneezing or anything that’s been in contact with an infected child's mouth, nose or eyes. If you’ve ever met a toddler, you’ll know their interest in infection control is minimal! Most preschoolers have had the virus at least once by the age of two.

Prevention:

Unfortunately it’s a virus that kids can catch more than once, but taking these steps can help prevent the spread:

  • Clean surfaces, toys and high touch areas regularly

  • Don’t share eating utensils or water bottles

  • Wash hands for at least 20 seconds using friction - make some bubbles!

  • Encourage your child to cough or sneeze into a tissue then throw it in the trash

Signs & symptoms:

Usually the symptoms will start five days after exposure. The first 3-4 days are the worst and then symptoms should start to improve. 

  • Irritability 

  • Lethargy

  • Fever

  • Runny nose

  • Sore throat

  • Headache

  • Cough and/or wheeze

Home care:

RSV can be managed at home as long as your little one is feeding well and breathing normally, most cases are mild. Helpful management tips include:

  • Smaller more frequent feeds

  • Rest and comfort

  • Keeping nasal passages clear - you can use a nose spray or saline drops to help with this

  • Honey to relieve the cough in children over the age of one year

  • Hydration - fever, dripping nose and cough all mean an increase in fluid loss so it’s important to really stay on top of this (especially with younger kids who have less fluid reserves than adults)

  • Monitor for any deterioration in symptoms

Triaging and choosing the best healthcare pathway:

Triaging means completing an initial health assessment to determine the urgency of your child's need for treatment and also what treatment they might require. In the home setting, this would start with a quick head to toe assessment to note the symptoms your little one might be experiencing. We want to place a special focus on the respiratory system with our assessment as with RSV, this is the system that will most likely be impacted.

Respiratory assessment:

Knowing how to do a respiratory assessment is really important, as mentioned in the last blog, kids are not mini versions of adults - physiologically they’re different which means they’re more prone to respiratory distress than adults. Our sessions can teach you how to do an in depth respiratory assessment so you feel comfortable assessing the needs of your child the next time they have a respiratory infection. To summarise briefly, we want to be looking at four key areas:

  • Sound - does your child have a wheeze, stridor or grunt?

  • Work of breath - how difficult is it for your child to take a breath? Are they breathing faster than usual? Are they using accessory muscles - do they have indrawing around the ribs or throat? Is their head bobbing up and down?

  • Appearance - has your child changed colour? Are they blue, pale or grey around the lips and fingertips? This could be a sign they’re not getting enough oxygen

  • Level of consciousness -is your child confused or drowsy? This is another sign that could mean your child’s not getting enough oxygen

When to call an ambulance:

Infants are at risk of getting unwell very quickly with RSV. If your child is having a hard time taking a breath or is experiencing any of the symptoms highlighted in the respiratory assessment (noisy, fast breathing etc.), it’s considered an emergency and it’s time to call an ambulance.

When to visit the doctor (or an after hours medical clinic the same day):

  • Your infant is under the age of 3 months and has a fever

  • Is refusing food or drink (they’re feeding less than half of their usual)

  • There’s been no wet nappies (or trips to the bathroom if your child is toilet trained) for 6 hours

  • Your worried or something doesn’t feel right

If you’ve already visited the doctor but since you’ve returned home you feel your child's symptoms have become worse, it’s always okay to take them back to be reassessed. This is never a waste of time, you know your child the best and you know when things look different. 

What’s the treatment for RSV:

RSV is a virus so it doesn’t need antibiotics. Most kids will get better on their own without treatment, however supportive home care can help make your little ones feel more comfortable. 

We share a lot of tips and tricks for supportive care for viral illnesses in our Petite Triage sessions as well as how to do an in depth respiratory assessment. We’ll teach you what to do, how to do it and why. Flick us a message or enrol in one of our sessions to start worrying less and caring more!

References:

  • Kids Health (2021, June 9). Respiratory Syncytial Virus (RSV) Infection. https://www.kidshealth.org.nz/respiratory-syncytial-virus-rsv-infection

  • The Royal Children's Hospital Melbourne (2018, May 1). Respiratory Syncytial Virus (RSV). https://www.rch.org.au/kidsinfo/fact_sheets/respiratory_syncytial_virus_rsv/

Katie Livingstone
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