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RSV–The Bad Respiratory Virus

Each winter, one of the most troublesome respiratory viruses of childhood makes the rounds.  Most older children tolerate the respiratory syncitial virus (RSV) well and just suffer the symptoms of a cough, sore throat, runny nose and fever.

For some children, however, the virus can be very serious.  These are usually children who are between the ages of two and five months.  They are old enough that they have lost the immunity they received from their mothers and too young to tolerate such a harsh virus.  Children who have lung, heart or immune problems are also at greater risk of complications from RSV.  One of the other problems with this virus is that it may take two or three infections before a child develops good immunity to it.

The virus is spread by coughing and close contact, such as touching hands.  The virus is so common that most children have had the infection by three years of age.  After this age, RSV infections are seldom a problem.

The virus causes a great deal of irritation to the lining of the airways and lungs.  Increased mucus and sloughed cells cause the tiny airways to plug up.  This plugging slows the air that is leaving the lungs, so the lungs become over-expanded in a way similar to emphysema.  In the more severe cases, the airways become completely plugged up and the airways collapse.

Treatment is usually aimed at reducing the symptoms and making sure a child is getting adequate oxygen.  Infants often need to be hospitalized for RSV infections.  A steroid syrup or shot is commonly used and can decrease the symptoms.  In severe cases, an antiviral antibiotic can be used, but its usefulness is still being studied.

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