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Offered by: Ellen McCormick,MD – Premier Pediatrics

Just as influenza season returns every fall, other cold viruses also follow this seasonal pattern of attack. Trying to identify the virus causing a cold is possible but rarely helpful because we have so few options for specific treatment of viruses. Yes, you got it: “There is no cure for the common cold.” Or even for colds that are uncommonly severe.

As December approaches we move again into RSV season. RSV stands for Respiratory Syncitial Virus, a cold virus with a particular affinity for attacking the small airways of young children and babies.

RSV infection is hard, almost impossible, to avoid. 90% of kids will contract RSV at least once by the age two, as proven by antibody studies. Over 60% of them will develop only upper airway infection, in other words, a typical cold. Like so many infections, a RSV infection can vary from very mild to quite severe. First time infections are the most likely to be severe, and most serious illnesses occur in very young babies. Premature babies with lung disease are at major risk, and special treatment is available for them during RSV season. Grade school kids, teens, and adults can get RSV too, but will likely experience just cold symptoms. Older adults with emphysema however, can experience significant respiratory complications from RSV including pneumonia, bronchospasm and a need for hospitalization.

Many parents first learned about RSV n the pediatrician’s office when they brought their unhappy wheezing baby in with a harsh cough. RSV is the most common virus to cause the classic symptoms of bronchiolitis, although it is by no means the only one. Other viral bugs, including influenza, adenovirus, parainfluenza, and others, can do the same thing. A nasal swab test can look for RSV, but isn’t required to verify the diagnosis of bronchiolitis. Checking the child’s oxygen level is very important however, as many will require oxygen for a few days while the illness runs its course. Low oxygen levels in infants can lead to apnea, long pauses in breathing, and can be treated with oxygen at home or in the hospital. Sometimes a chest x-ray is helpful, but many times the illness can be managed without the additional imaging.

RSV season typically runs from December to March, and during these months it’s best to avoid taking small babies out into public more than absolutely necessary. The grocery store or mall are great places to catch respiratory viruses! Older adults with lung problems should avoid their grandchildren when they have bad colds.

RSV and bronchiolitis are problems that come around every winter. They are nothing new, and are not a reason for panic. But if your little one develops signs of a cold, accompanied by fast breathing and wheezing, call your doctor’s office promptly to see if this might be a case of bronchiolitis. There are still no antiviral drugs to cure RSV, but monitoring and supportive care are especially important for our smallest patients, and can prevent serious problems in the future.

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