Respiratory Syncytial Virus/Bronchiolitis

– by Christina Connelly, RN, MSN, CPNP

Respiratory Syncytial Virus or “RSV” is a common respiratory virus that spreads seasonally starting in late fall through early spring, peaking in the months of December and January. The virus causes only mild cold symptoms in adults and healthy, older children. In infants younger than age 1 and in those children with special health care needs, RSV can lead to “bronchiolitis”. Bronchiolitis causes lower respiratory tract symptoms such as cough, wheezing, rapid or labored breathing, and cyanosis (blue color to skin).

How is RSV spread?

RSV is spread through tiny droplets that are released into the air when someone infected with RSV coughs, sneezes, or blows their nose. Those children that attend daycare, have older siblings in school, or live in crowded conditions are more likely to catch RSV. Exposure to second hand smoke also increases the risk of catching RSV.

How do I prevent my infant from getting RSV bronchiolitis?

  • Handwashing is key! Make sure all adults taking care of your infant wash their hands first, especially during winter months. Portable hand sanitizers make washing hands on the go more convenient.
  • Don’t smoke or allow adults to smoke in your home or around your infant.
  • Don’t be shy about asking adults and older children who have obvious cold symptoms to avoid handling your infant. Avoid passing your infant around in crowds at holiday get-togethers or children’s birthday parties.
  • Provide proper nutrition and rest to all family members as this has been shown to decrease the overall amount of colds and viruses.
  • Premature infants and infants born with special health care needs may receive Synagis, a monthly injection given during RSV season to help prevent RSV bronchiolitis.

How is RSV bronchiolitis treated?

RSV is a virus and therefore not treated with antibiotics. RSV in older children and adults causes cold symptoms and is treated like any other cold. Please refer to our Acute Illness Guide for instructions on dealing with cold symptoms. RSV bronchiolitis in infants is treated with close monitoring, humidified air and occasionally home nebulizer treatments. Some infants with bronchiolitis need to be admitted to the hospital for oxygen and further observation.

What do I do if I think my infant has RSV?

Symptoms of RSV bronchiolitis usually develop within 7 days of being exposed to the virus. RSV can start mildly, with a runny nose and slight cough. Within 2-5days, infants can develop increased coughing, rapid breathing, nasal flaring, caving in or “sucking in” of the chest, or blue color to lips or face. Other signs of bronchiolitis in infants are poor sleep, poor feeding or vomiting after feeding, coughing, general restlessness or lethargy. The illness peaks at 7-10 days then improves, but can linger with mild symptoms for up to 6 weeks.

If you are concerned that your infant may have RSV bronchiolitis, please call our office or bring your infant in for an appointment. Our providers are available by telephone 24hrs/day 7days a week at (978)-975-3355 and are happy to assist you for urgent concerns after hours.