Cold and flu season can often include a spike in that other respiratory illness that may bring concern, RSV. But this year, there will be extra protection for people at high risk.
In June, the Centers for Disease Control and Prevention (CDC) recommended a new RSV vaccine for those 60 and older. Then in July, the Food and Drug Administration approved another option, a monoclonal antibody injection to protect babies and toddlers up to 2 years old.
RSV, or respiratory syncytial virus, can include symptoms similar to a common cold. However, the virus can develop into something more serious. RSV can infect people of all ages but is most severe for older adults and young children. The CDC states RSV causes approximately 60,000–160,000 hospitalizations in older adults and an estimated 58,000-80,000 hospitalizations of children younger than 5. Given that there is not good antiviral treatment for a serious RSV infection, the best course is through prevention. This year we have that option with vaccines for adults and the monoclonal antibody for babies.
“Usually almost every child under the age of 2 has been exposed to RSV, but due to all the pandemic response over the last few years, kids have not been exposed as much to RSV,” said Dr. Ravi Johar, chief medical officer at UnitedHealthcare. “That is one of the reasons why we saw a spike last season.”
Symptoms
- Runny nose
- Low appetite
- Coughing
- Sneezing
- Fever
- Wheezing
For young infants with RSV, they might be irritable, sluggish or find it harder to breathe.
Your pediatrician will be able to figure out whether it’s a common cold, COVID-19 or RSV, if you have concerns about symptoms your child is showing. They might perform tests, like chest X-rays, to see if pneumonia has developed.
When should you call a doctor?
Most cases will go away on its own in a week or two. Symptoms are typically at their worst on days three to five of infection. Only 3% of children with RSV will require a hospital stay.
If symptoms become severe, contact your pediatrician right away. This may include:
- Symptoms of bronchiolitis (narrowing of small airways in the lung)
- Symptoms of dehydration (only one wet diaper in 8 hours or more)
- Difficulty breathing
- Gray or blue lips, tongue or skin
- A significant decrease in activity or alertness
Even though RSV is common, and it might seem difficult to figure out how severe it will become, there are some risk factors parents should be aware of.
- Children who are born premature or are 6 months old or younger are most at-risk for RSV complications
- Children with chronic heart or lung disease, or a weaker immune system, can also be susceptible to RSV
Treatment
Vaccines
The new vaccines, one each made by GSK and Pfizer, to help protect against RSV for those 60 and up are the first to be licensed in the U.S. and are expected to be available this fall. Both work by introducing an inactive RSV protein into the body, where it fuses to host cells and stimulates the immune system to recognize the actual RSV virus if the body encounters it. The goal is to prevent severe illness.
Monoclonal antibody
The CDC signed off on the monoclonal antibody, called nirsevimab, for all infants up to 8 months as they enter their first RSV season. The injection is recommended for a small group of children between the ages of 8 months and 19 months, if they’re at high risk for severe illness. The drug is given in a single injection in the child’s thigh.
The monoclonal antibody works differently than a vaccine. When you receive a vaccine, it causes your body to create antibodies to protect against the illness it’s intended for. With the monoclonal antibody, a single antibody is injected into the bloodstream, so if you’re infected, the antibody will bind to it and help your body fight the infection. Again, this treatment option isn’t expected to completely prevent RSV, but to lessen symptoms and prevent severe illness.
Most cases of RSV will resolve on their own. If you’re not eligible for the vaccines or monoclonal antibody treatment, there are a few things you can do to help relieve the symptoms:
- Manage pain and fever with over-the-counter medications (consult your pediatrician for guidance and never give aspirin to children)
- Drink plenty of fluids
- Nasal saline to help with breathing
- Cool-mist humidifier to help break up mucus
Talk to your health care provider before you give any over-the-counter cold medicine to your child.
How it spreads
RSV is typically spread through coughs and sneezes, but can spread when someone touches a surface that has the virus on it and then touches their face, before washing their hands.
The following tips may help reduce your family’s risk:
- Cover your coughs and sneezes with a tissue or your arm, not your hands
- Avoid close contact with others, especially those who are sick
- Wash your hands frequently
- Don’t touch your eyes, nose and mouth with unwashed hands
- Clean and disinfect frequently touched surfaces at home
- If you’re sick, stay home
“If you’re not eligible for the vaccines or monoclonal antibody, the best way to avoid transmission of RSV is what we have been doing very well over that last few years: Scrupulous hand hygiene with washing our hands frequently with soap and water, and cleaning the surfaces small hands get to, like doorknobs and handles,” Dr. Johar said. “Also, wear a mask if you have any respiratory symptoms.”
With the knowledge of what RSV may look like — and how it is different from other viruses — you’ll be able to take steps to keep your child as healthy as possible all year round.
For more information, visit the CDC website.
