Respiratory virus is making a comeback, can be deadly
Respiratory syncytial virus, or RSV, isn’t new to doctors, but recently the respiratory illness is making a comeback and in some cases the virulent strain can kill.
The Mayo Clinic says anyone who lives in the United States and is older than 2 has probably had it, even if they didn’t realize it.
Locally physicians, especially pediatricians are seeing “a lot, a lot,” said Baylor Scott & White Hillcrest Medical Center pediatrician Dr. Brian Barkley.
In fact, Barkley, who has three children of his own, said, two young patients have been admitted to the hospital this week alone.
Dr. Jill Clay, a Waco physician, said she hasn’t seen any cases of RSV this year, “but last year we had it in some nursing homes and it was a problem.”
That divergence is not unusual as the U.S. Centers for Disease Control says the timing and severity of RSV season in any given community can vary widely from year to year.
But this year, at least for youngsters, is a bad one.
The virus, first identified in 1956, usually causes symptoms very similar to the common cold and in most cases clears up in a week or two, the CDC, says.
“Respiratory syncytial virus (RSV) causes infections of the lungs and respiratory tract and is so common that most children have been infected with the virus by age 2, but RSV also can infect adults,” according to a document published at the Mayo Clinic.
In infants and young children and in the elderly it can progress into a fatal outcome.
“Each year in the United States, an estimated 57,000 children younger than 5 years old are hospitalized due to RSV infection,” a CDC publication on the virus says.
By very far, Barkley says, most of them survive, but if a young child is compromised because of mucous or other issues, that fluid can fill tiny lungs quickly and the child can die, basically, from drowning in the fluids that gather in the lungs.
Those at greatest risk for severe illness from RSV include premature infants, very young infants (especially those 6 months and younger), children younger than 2 years old with chronic lung disease or chronic heart disease, children with weakened immune systems or children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions.
“RSV is the most routine cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children younger than 1 year of age in the United States and is also a significant cause of respiratory illness in older adults,” Mayo Clinic doctors say.
The Mayo Clinic report says symptoms of RSV in both children and adults include congested or runny nose, dry cough, low-grade fever, sore throat, and mild headache.
In severe cases it can spread to the lower respiratory tract, causing pneumonia or bronchiolitis--inflammation of the small airway passages entering the lungs—and the symptoms, including fever, severe cough, wheezing, rapid breathing or difficulty breathing and a bluish color of the skin due to lack of oxygen, can worsen.
A drop in oxygen levels, signaled by the bluing of the skin and the labored breathing, Barkley said, should be immediate signals that the child is struggling and should be taken for medical attention.
Parents may notice their child's chest muscles and skin pull inward with each breath, a sign the child is struggling to breathe.
In infants symptoms also include short, shallow and rapid breathing, cough, poor feeding, unusual tiredness or irritability
“Think about watching an athlete run a 100-yard dash,” Barkley said.
“When he gets to the finish line he’s taking very deep, filling breaths and that what it can look like in small children, just struggling to breathe.
Others at risk include “older adults (especially those 65 years and older), adults with chronic heart or lung disease and those with weakened immune systems,” the CDC report says.
“Each year, it is estimated that more than 177,000 older adults are hospitalized and 14,000 of them die in the United States due to RSV infection.”
Mayo Clinic says “Seek immediate medical attention if your child — or anyone at risk of severe RSV infection — has difficulty breathing, a high fever, or a blue color to the skin, particularly on the lips and in the nail beds.”
Those at risk of severe or sometimes life-threatening RSV infections include premature infants young children who have congenital heart or lung disease, children with weakened immune systems such as those undergoing chemotherapy or transplantation, infants in crowded child care settings, older adults, adults with asthma, congestive heart failure or chronic obstructive pulmonary disease, people with immunodeficiency, including those with certain transplanted organs and those who have leukemia or HIV/AIDS.
Complications those with severe issues might encounter include hospitalization, pneumonia, middle ear infection, asthma and repeated infections, CDC says.
CDC says RSV virus enters the body through the eyes, nose or mouth and it spreads easily through the air on infected respiratory droplets emitted when someone nearby sneezes or coughs, but the virus can migrate through direct contact, such as shaking hands.
RSV can live for hours on hard objects such as countertops, crib rails and toys so touching such an item can leave it infected or can infect you.
An infected person is most contagious in the first few days after infection, however, the virus can continue to spread for up to a few weeks.
Children who attend daycares or school are at highest risk among children who contract the virus, especially in the early fall and springtime, CDC says, and currently there is no vaccine.
“Just think about it,” Barkley said, “just holding or kissing a baby if you’re infected, or a younger child playing with an older one who’s been exposed, can easily pass the condition on to others.”
“Researchers are working to develop RSV vaccines, but none are available yet,” the Mayo Clinic website says, but a medication called palivizumab is available to prevent severe RSV illness in certain infants and children who are at high risk for severe disease”
Prevention of exposure comes down to the basics, like wash your hands, limit contact with people who are ill, keep surfaces and other things clean and disinfected, don’t share drinking glasses or other utensils with others, don’t smoke and wash items your child uses regularly, like toys.
“RSV season occurs each year in most regions of the U.S. during fall, winter, and spring,” the CDC website says.
“If you are at high risk for severe RSV infection, or if you interact with an older adult, you should take extra care to keep them healthy and some tips include: wash your hands often with soap and water for 20 seconds and if soap and water are not available, use an alcohol-based hand sanitizer.
Also keep your hands off your face, avoid close contact with sick people, cover your coughs and sneezes, clean and disinfect surfaces and stay home when you are sick.
Scientists are developing several vaccines, monoclonal antibodies, and antiviral therapies to help, but those could be years away.
“It comes down to common sense, just be careful,” Barkley said.