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RSV: An Annual Virus That Demands Attention

Respiratory Syncytial Virus (RSV) typically occurs in New England during the fall and winter months when we spend more time indoors and schools and daycares are reopening. This common virus affects both children and adults, and in certain individuals can become a very serious health concern. In this article, we'll delve into what RSV is, who is at risk, how to treat it at home, and when to seek medical attention.


Understanding RSV

Commonly known as RSV, Respiratory Syncytial Virus is a highly contagious virus that primarily affects the respiratory system. It is a frequent cause of bronchiolitis and pneumonia in infants and young children, but it can affect individuals of all ages. RSV typically leads to symptoms like cough, runny nose, fever, and wheezing. In healthy individuals, RSV symptoms often resemble a mild cold, but in some cases, it can lead to severe respiratory distress, particularly in vulnerable populations.
 

Who Is at Risk for RSV?

1. Infants and Young Children: Infants under the age of one year are particularly susceptible to severe RSV infections. This vulnerability is due to their small airways and immature immune systems.

2. Elderly Adults: As we age, our immune system may weaken, making older adults more susceptible to RSV infections.

3. Individuals with Compromised Immune Systems: People with weakened immune systems, such as those with HIV/AIDS, undergoing chemotherapy, or taking immunosuppressant medications, are at increased risk.

4. People with Chronic Medical Conditions: Those with chronic lung diseases like asthma or chronic obstructive pulmonary disease (COPD) and heart disease have a higher risk of severe RSV infections.


Home Treatment for RSV

Mild RSV infections can often be managed at home if you follow some simple guidelines. First, ensure the affected person gets plenty of rest and stays well-hydrated with water, clear fluids, and oral rehydration solutions, especially in children. Air quality can be an important factor. Use a cool-mist humidifier to keep the air moist and alleviate congestion and minimize exposure to smoke and other irritants that can worsen respiratory symptoms. In addition, over-the-counter medications like acetaminophen or ibuprofen can help reduce fever and discomfort. However, always consult with a healthcare provider before giving any medication to young children.


When to Seek Medical Attention

While most cases of RSV can be managed at home, there are certain situations when it's crucial to seek medical attention:

1. Severe Breathing Difficulty: If the person, especially an infant, is struggling to breathe, with rapid, shallow breaths, it's an emergency. Seek immediate medical help.

2. High Fever: A persistent high fever (above 100.4°F or 38°C) may indicate a more severe infection, particularly in infants.

3. Dehydration: Signs of dehydration in a child include dry mouth, few or no tears, and reduced urine output. Seek medical attention if you suspect dehydration.

4. Worsening Symptoms: If the person's symptoms are getting worse or not improving after several days, consult a healthcare provider.

5. Blue Lips or Fingertips: Cyanosis, a bluish discoloration of the lips or fingertips, is a sign of insufficient oxygen in the blood. This is a medical emergency.

6. High-Risk Individuals: Infants, elderly individuals, and those with underlying health conditions should be evaluated by a healthcare provider if they exhibit symptoms of RSV.


Vaccination

RSV vaccination is a first line of defense for those most at risk. The CDC recommends adults 60 years of age and older get vaccinated, depending upon discussions with their health care provider. Infants under six months old are also at high risk and may benefit from the vaccine. In this case, there are two options for administration. A pregnant mother may receive a single dose between week 32 and 36 of pregnancy in order to transfer the antibodies. Alternatively, the CDC recommends that infants under eight months be treated with nirsevimab, a long-acting monoclonal antibody which is not a vaccine. Vaccine side effects are typically mild and may include fatigue, fever, headache, muscle or joint pain, nausea and diarrhea.

Respiratory Syncytial Virus is a common virus that affects people of all ages, but it can be particularly severe in infants, the elderly, and those with weakened immune systems. Understanding who is at risk and how to manage RSV at home is crucial. However, it's equally important to recognize when to seek medical attention. By staying informed and vigilant, we can help prevent the spread of RSV and ensure timely treatment when needed. If you suspect a severe RSV infection, do not hesitate to contact a healthcare professional for guidance and care.
 
Scheib,-Lisa.pngDr. Lisa Scheib is a board-certified internal medicine physician at Nashua West Adult Medicine for 15 years. Dr. Scheib sits on the board of trustees of Gateway Community Service and Family Promise. She is a graduate of Hahnemann University School of Medicine.
 

Posted: 10/31/2023 by Nancy Foti