A viral trifecta is sweeping the country this winter, with COVID-19, the flu and RSV (Respiratory Syncytial Virus) creating havoc in hospital emergency rooms, slamming all age groups but, in the case of RSV, hitting children especially hard. Here in Florida, the Department of Health has documented a higher number of pediatric emergency visits for RSV compared to previous years.
“This winter season has been pretty severe already with cases of children being hospitalized due to RSV,” said Dr. Julia Retureta, a board-certified pediatrician with HCA Florida Lawnwood Hospital in Fort Pierce.
In her capacity as assistant medical director of Lawnwood’s pediatric emergency department, Dr. Retureta, treats children with RSV from all over the Treasure Coast.
“We are the only dedicated pediatric facility on the Treasure Coast, so we get a lot of transfers in from other hospitals,” she said. “We have an entire staff of pediatric physicians on the pediatric floor and in the pediatric intensive care unit.”
RSV is the major cause of respiratory illness in children. Nearly all children will get an RSV infection by the time they are 2. Most of the time RSV causes only a common cold but sometimes it infects the lungs and breathing passages, leading to serious breathing problems for infants and young children. The Centers for Disease Control and Prevention estimates that as many as 80,000 children under the age of 5 are hospitalized annually due to the highly contagious virus.
RSV spreads through air droplets, mostly during the winter months. In older children it generally just causes a cold with upper respiratory symptoms, but it is more dangerous for children under the age of 2 – especially those less than 6 months of age and those born prematurely.
Early symptoms are generally the same as a common cold, including runny nose, decrease in appetite and a cough, but these symptoms can progress into bronchiolitis. Parents should be concerned if their child experiences shortness of breath, fast breathing, wheezing, abdominal breathing or nasal flaring – all signs of decreased air exchange in the lungs, which can progress into pneumonia.
Some children have apneic spells – basically holding their breath, which can lead to respiratory failure. Infants less than 6 months old may only show signs of RSV with irritability, decreased activity and appetite, and apnea.
“Unfortunately, there is no vaccine for RSV but there is a monoclonal antibody reserved for ex-preemies less than 28 weeks and congenital heart disease babies,” Dr. Retureta explained. “It’s a monthly intramuscular injection given for six months during the RSV season to prevent them getting the virus. Parents of these high-risk infants should talk to their pediatrician about this preventative measure.”
Mild cases of RSV typically clear up on their own after a week or two. To help relieve symptoms and make your child more comfortable, your doctor may recommend over-the-counter medications such as ibuprofen or acetaminophen. Some medications are not recommended for babies, however, so consult your pediatrician before using any nonprescription medicine.
You should take your baby to the ER immediately if there are signs of dehydration (decrease in wet diapers), labored breathing, high fever, lethargy, skin turning blue (especially lips and fingernails), or unresponsiveness.
If you are unsure whether your baby has severe RSV, err on the side of caution and seek medical treatment. If the RSV infection is severe enough for the child to be hospitalized, treatments may include intravenous fluids, humidified oxygen and, in rare cases, mechanical ventilation or a breathing machine.
“RSV is not at new virus. It’s been around for a long time,” Dr. Retureta said. “[Fortunately] there are some commonsense preventative measures parents can adopt to ward off the virus.
“Since RSV spreads by air droplet transmission, avoid close contact with sick people, wash your hands frequently, clean and disinfect surfaces, and cover your mouth when coughing. This year, RSV is more prevalent than ever so parents should be diligent in recognizing the symptoms and seeking medical help if the symptoms worsen.”
Dr. Julia Retureta graduated from the University Central Del Caribe School of Medicine and completed her pediatrics residency at UM/Jackson Memorial Hospital. She works exclusively in the Pediatric Emergency Room at HCA Florida Lawnwood Hospital. Should you suspect that your child needs emergency care for RSV, call the Consult-a-Nurse at 844-706-8773, also known as 844-70-NURSE.