Respiratory syncytial virus (RSV), along with influenza and COVID, are circulating in our region at high levels and causing severe illness in all age groups.

At WVU Medicine Children’s Hospital, we have had very high numbers of hospitalized patients, both in our general ward and in our Pediatric Intensive Care Unit. Most of these patients have RSV infection.

The current surge started just before Christmas and is expected to continue for the next few weeks. The Centers for Disease Control and Prevention surveillance map is updated to Dec. 23 and still shows a steep upslope in virus detection.

Signs, Symptoms, and Progression

RSV causes both an upper respiratory tract infection (commonly referred to as a “cold”) and a lower respiratory tract infection (largely called “bronchiolitis” in infants and children).

In the first few days, mild symptoms, such as stuffy nose, sneezing, and cough, predominate.

During days three to five, symptoms can progress to lower airway involvement, which may include worsening cough, wheezing, and difficulty breathing. Fever can accompany the infection and can range from low grade to high.

Due to the nasal congestion, eating can be difficult for an infant, which can result in dehydration.

Observing your child’s breathing is an important skill to develop when deciding to seek medical care. Tachypnea (breathing too quickly) and retractions are signs of respiratory distress. Watch for indentations in your child’s chest as they breathe in to detect retractions. Common places to see retractions are at the base of the throat above the sternum, below the ribs, or in between the ribs. There are many videos on YouTube showing examples of respiratory distress.

If you observe these signs, please consult your child’s pediatrician.

Prevention and Care

RSV is primarily spread through direct contact.

Keeping your hands clean by washing for 20-seconds with soap and water or by using an alcohol-based hand sanitizer will help to lessen the spread.

RSV can survive for several hours on hands and surfaces, so sneezing into tissues and immediately throwing them away, then washing your hands will help protect you and your family.

If you or your family member is exposed to RSV, the incubation period, which is the amount of time between being exposed and developing symptoms, usually ranges between four-to-six days.

RSV symptoms typically last for seven to 14 days, with the last seven days having a lingering cough. The cough is a protective mechanism and helps to clear mucus. Using medication to stop the cough can be dangerous to your child and hinder their improvement.

Treatments

Most of the care for RSV is supportive, like controlling fever, ensuring adequate hydration, and providing oxygen and other respiratory support when needed.

Patients with asthma may benefit from bronchodilators (albuterol) and steroids. However, most patients without asthma get no benefit from these medications.

Nirsevimab, also known as Beyfortus®, was made available late last year and can help to protect your infant from severe RSV disease. Nirsevimab is an injection of antibodies directed against RSV. In a research study, it was found to greatly reduce severe RSV disease and decrease the need for hospitalization.

Please consider contacting your child’s pediatrician for availability.

We currently do have supply of this medication at WVU Medicine Children’s Pediatrics clinics, and we strongly recommend it to protect your infants.

Stay well!