CNN — In September, an eight-month-old baby at Dr. Juanita Mora’s office in Chicago contracted RSV, an infection that doctors didn’t expect to see for two months. Like her colleagues across the country, the allergist and immunologist has been treating young children with this cold-like virus long before the season usually begins. “We’re seeing RSV infections across the country,” Mora said. Nearly all children become infected with RSV at some point before the age of two, according to the Centers for Disease Control and Prevention (CDC). Most adults who catch it have a mild illness. It can be dangerous for the elderly, people with chronic heart or lung disease, or a weakened immune system. However, RSV can be particularly tricky with infants and children. Mora, a volunteer medical spokesperson for the American Lung Association, says it’s important for parents, caregivers and caregivers to know what to watch out for with RSV, which stands for respiratory syncytial virus. That way, the sick child will know if she can get treatment at home or if she needs to go to the hospital. “The emergency room is full of all these sick kids, so I want parents to know they can go to the pediatrician and get tested for RSV, influenza and Covid-19,” Mora said. Amid the surge in respiratory disease, there are other things parents need to know. For many people, RSV causes a mild illness that can be managed at home. On average, the infection lasts five days to two weeks and will often go away on its own, the CDC says. Sometimes a cough can last up to 4 weeks, pediatricians say. Symptoms may look like the common cold: runny nose, decreased appetite, coughing, sneezing, fever and wheezing. Young infants may appear irritable or lethargic and may have difficulty breathing. Not all children will have all potential RSV symptoms. Assistant Professor of Pediatric Infectious Diseases at Cedars Sinai Medical Center, Dr. “Fever, especially in young infants, is often caused by RSV infection,” said Priya Soni. She said parents should watch for changes in behavior, including eating longer or not paying any attention to food at all. A child may also have a severe cough and some wheezing. It’s also important for her to watch for signs that your child is having trouble breathing or is breathing through her ribs or belly. “These symptoms could overlap with many other viruses we’re seeing again,” Soni added. Because it’s difficult for parents to differentiate between RSV and respiratory conditions like the flu, it’s a good idea to take your sick child to a pediatrician for testing to pinpoint the cause. She said Soni “may need to pick up the baby soon for an evaluation,” she said. When it comes to RSV, parents should be especially careful if their children are premature, newborns, children with weakened immune systems or neuromuscular disorders, and younger than 2 years of age with chronic lung and heart disease, the CDC says. “Parents need to be really alert to all changes like activity and appetite and pay particular attention to signs of shortness of breath,” Soni said. Treatments like flu and Covid-19 can be different, so testing is important. There is no antiviral or specific treatment for RSV like the flu, and there is no vaccine. But if your child is sick, there are things you can do to help. Fever and pain can be managed with a non-aspirin pain reliever such as acetaminophen or ibuprofen. Also, make sure your child is getting enough fluids. “RSV can make you very dehydrated, especially when kids aren’t eating or drinking, especially when we’re talking to infants,” Mora said. “Once you stop eating or urinate, you don’t have many wet diapers. This is a sign that you may need to go to the pediatrician or the emergency room,” she said. Talk to your pediatrician before giving you over-the-counter cold medicine. This medicine may sometimes contain ingredients that are not good for children. The pediatrician will check the child’s breathing rate (how fast they breathe) and oxygen levels. If your child is seriously ill or at high risk of becoming seriously ill, your doctor may want your child to go to the hospital. “RSV can be very dangerous for some young children, especially children under the age of two,” said Soni. Mora said hard breathing is a sign that a child has a problem with the virus. RSV can develop into more serious illnesses, such as bronchiolitis or pneumonia, which can lead to respiratory failure. If you see your child’s chest move up and down as they breathe, or if they can’t sleep with a cough, or if their symptoms get worse, “this could be a sign that you need to see a pediatrician or take him to the hospital. You need to go to the emergency room. Because then you may need additional oxygen or you may need nebulization therapy.” CNN medical analyst Dr. Leana Wen says this shortness of breath, which includes tilting your head, sneezing and grunting, is one of the two main problematic signs of any respiratory infection. The other is dehydration. “Especially for babies with stuffy noses. They may not be fed.” Most of the treatment provided by hospital staff will help you breathe. “We provide supportive measures for RSV and these children with respiratory therapy including oxygen, IV fluids and inhalation,” said Soni. A thin tube may need to be inserted into the lungs to remove the mucus. Children can get additional oxygen through a mask or a tube attached to their nose. Some children may need to use an oxygen tent. Those who are very difficult may need a ventilator. Some babies may need to be fed by tube. Doctors say the best way to prevent RSV infection is to teach children to cough and sneeze into a tissue or elbow rather than their hands. Also, keep frequently touched surfaces clean. Mora says that when a caregiver or her older brother is sick, she should wear a mask with others and wash her hands frequently. And best of all, if a child or adult is sick, stay home to avoid spreading the disease. There are monoclonal antibody treatments available for children who are at the highest risk for serious illness. Not everyone can use it, but it can help protect the most vulnerable. It comes in the form of an injection that children can get monthly during the typical RSV season. Talk to your doctor about whether your child is eligible.
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