Bronchiolitis and Respiratory syncytial virus(RSV)- What a parent need to know?
A new virus ? Oh really? After coronavirus, influenza virus now a days RSV ( respiratory syncytial virus is making appearance in paediatric offices and news.
For some of you with children 2 years of age or younger, you may have come across this frustrating illness.
Bronchiolitis is a viral illness common to children younger than 2 years of age. It refers to inflammation of the bronchioles (smaller airways of the lungs). I like to think of it as a cold that you also get in your lungs. When a child has bronchiolitis, all that congestion and discharge and “goop” from his or her nose and sinuses is also present in the lungs.
What Should I Expect?
Children with bronchiolitis present very much like they have a cold. They start out with cold symptoms: cough, runny nose, congestion, fever. After a couple days, their symptoms may worsen — persistent fever, worsening cough, lethargic — prompting a visit to the office.
One of the biggest issues with bronchiolitis is breathing. Because all that “goop” is in the lungs, children with bronchiolitis sometimes have to work harder to breathe. They may breathe faster or show signs of working harder to breathe (ribs showing with breathing, chest sucking in while belly sticks out). Parents will often report noisy breathing, but this can sometimes be from sinus congestion as well (as with colds). Children with bronchiolitis may wake up frequently at night and have poor feedings.
Great. Now What?
The good news is that bronchiolitis is a viral illness — so antibiotics will not make a difference — and usually resolves within a week. It’s also similar to a cold in terms of being contagious. The treatments are similar to colds as well: humidifier at night, nasal saline for younger infants, encourage fluids, etc.
The most common complications are dehydration and breathing concerns. Hydration can often be maintained with slow and frequent sips of fluids appropriate for age. Breathing concerns require prompt evaluation in the office or ER.
What Should I Be Watching For?
Children should remain well hydrated — at least 3 wet diapers per day if younger, mouth and lips not persistently dry, making tears if crying. Fevers should not last more than 5 days, and should be controlled with medication. (When controlled, a fever should reduce, and the child should perk up, in-between fevers). Signs of lethargy — extremely tired at unusual times, difficulty waking up, not alert or making eye contact — or worsening symptoms typically require evaluation in the office or ER.
Since RSV is a virus, antibiotic medicines will not help. Here are some things you can do to make your baby more comfortable:
- For coughing and mucus build up (congestion), use a cool mist vaporizer. The moist air may make breathing easier and reduce coughing. Do not put medicine in the vaporizer. Change the water in it every day and clean it between uses.
- For a stuffy nose, use salt water (saline) nose drops to soften thick mucus. To get the mucus out, use a baby aspirator (suction device) like a bulb syringe .
- For a fever, give:
- Children over 2 months, acetaminophen.
- Children over 6 months, acetaminophen or ibuprofen
- Do not give aspirin or products that contain aspirin to any child (Picture 2).
- Do not give honey to children younger than one year.
- Give lots of fluids.
- Children younger than 12 months should not have fruit juice or water. Instead, breast-feed or bottle-feed small amounts more often.
- Children older than 12 months, give plenty of liquids like water or vegetable soup. Limit fruit juice or liquids high in sugar.
Preventing the Spread of RSV
Children can get RSV more than once. Adults can get it and pass it to their child. If you have a cold, be careful around your baby. Here are some tips to keep RSV from spreading:
- Wash your hands often, before touching your baby and before handling food. Wash your hands after sneezing, coughing, or changing diapers. Ask others to do the same.
- Sneeze or cough into a tissue or into your shirt sleeve, turned away from people.
- Do not share pacifiers, towels, washcloths, toothbrushes, drinking glasses, cups, forks, or spoons.
- Wash your baby’s toys and clothes often.
- Keep people who have colds away from your baby. This includes other family members.
- Do not smoke around your baby. Do not let others smoke around them either.
- Keep your child home from school or childcare when they are sick.
When to Call the Health Care Provider
Call your child’s health care provider if your child:
- seems sick, shows signs of RSV and is less than 6 months of age or at high risk.
- has a cough that lasts more than 4 days or has trouble breathing
- has thick mucus from the nose or mouth that is yellow, green or gray.
- has no energy – seems lazy and does not act like usual, will not eat or drink, does not urinate (pass water) or diapers are not wet for 6 or more hours
- has a fever
- age 3 months or younger, a temperature of 100.4º F (38º C) or higher.
- older than 3 months, a temperature over 102º F (38.9º C) that lasts more than 2 days.
RSV, the Flu and Covid
RSV, the flu and Covid are different viruses, but share some of the same symptoms. RSV and the flu can be very serious in children. However, their symptoms begin differently. RSV usually starts with cold symptoms and the flu usually starts with a high fever. Children with Covid often have mild symptoms or show none at all, but they can also have a fever and vomiting or diarrhea. RSV can get serious very quickly in some children.
What can we do at The child plus children’s hospital?
As we know that prevention is better than cure always be vigilant to prevent illness before they start. We are expert at diagnosis and treatment of paediatric and childhood illness. Feel free to contact us if any help regarding your child’s health. We are happy to help.