This is a column in a series from Dr. Scott Hamilton, director of the pediatric emergency department at Ochsner Lafayette General Medical Center, offering practical guidance on preventing and treating illnesses and injuries so kids can stay healthy and out of the emergency department.
RSV is back again. If babies could talk, they would recount the miseries of the winter virus and how it's similar to influenza.
Humorist Dave Barry described how, when he and his wife got the flu, they spent days in bed achy, congested and feverish. “There has been a mound of blankets on my wife's side of the bed,” he wrote long ago. “I think it might be my wife ... the only way to tell for sure would be to prod it, which I wouldn't do” for fear that poking her could be fatal. Dave, espousing a more active lifestyle, attempted to crawl to the bathroom.
In addition to cough and congestion, babies with RSV get fevers and aches like the flu. Adults can get RSV, too, but infants are more often severely affected. Sometimes congestion happens deep in their lungs and they struggle to breathe and get enough oxygen. Also, with noses clogged with mucus, they can't breathe and feed at the same time, which can lead to dehydration. Dehydration dries out the mucus, which becomes stickier and harder to hack out of their throats and lungs.
The other bugaboo about RSV is that, again like flu, it's highly contagious. Maybe your child's daycare is great about hand-washing, but RSV flies around the room with every cough, to be inhaled by other nearby infants and picked up from contaminated surfaces. Parents and grandparents may carry it home from work or shopping, while older siblings bring it home from school. If babies aren't the only child at home with obsessive hand-washing parents who stop every visitor at the door to inspect for sniffles and grubby paws, they're at risk.
RSV is difficult to treat. Babies' lungs wheeze like kids with asthma, but breathing treatments and steroids we use for asthma don't work for RSV. Infants and toddlers who become seriously ill need hospitalization for oxygen supplementation and IV fluids to keep them hydrated. Sometimes they need more intensive care, and some infants die.
Of course, the best medicine is prevention: don't let your baby get it! Fortunately, there's now a shot that's effective at preventing RSV. Babies can receive it on their first office visit after birth, or pregnant moms can get it before delivery, passing immunity to baby through the placenta.
We hope RSV will become like measles or polio: one more deadly virus tossed to the scrap heap of history. Maybe ten years ago this would have been true. However, misinformation on social media and now in government have sowed doubt about preventive shots, and some parents are confused trying to decide what's best for their children.
Listen to your kid's doctor: RSV shots are safe. Getting RSV is not.