THE FALL AND WINTER SEASONS BRING MANY CHANGES TO OUR LIVES. STUDENTS RETURN TO SCHOOL, THE WEATHER STARTS GETTING COLDER AND CHILDREN START CATCHING COLDS.
There is a misconception that colds are caused by being exposed to cold weather. The reality is that they are caused by contracting an infection caused by a virus. Transmission is usually by direct contact with infected secretions, such as by shaking hands with someone who is infected and has not washed his hands, then touching your eyes, nose or mouth. We can also catch the virus when somebody around us coughs or sneezes without covering his mouth and nose.
There are other viral illnesses in the winter that cause respiratory symptoms. They include, but are not limited to, the “flu,” or Influenza, and Respiratory Syncytial Virus (RSV), the topic of this article.
RSV is a very common virus that leads to mild, cold-like symptoms in adults and older healthy children. It can be more serious in young babies, especially to those in certain high-risk groups such as premature babies and babies with certain chronic lung conditions or congenital heart disease. RSV is the #1 cause of hospitalization in infants in the U.S.
RSV causes bronchiolitis in these babies and children under 2 years of age. It starts as a common cold with clear nasal secretions that become copious. Fever may be present. Later the baby develops cough, wheezing and shortness of breath. Respiratory distress is evidenced by increased work of breathing. The baby breathes deeper and faster and sometimes the belly looks like it is moving fast, and there may be sinking bellow the ribs and above the clavicles.
Respiratory distress is caused by nasal obstruction due to secretions and narrowing of the lower airways. The baby will feed less and can become dehydrated. Due to shortness of breath, the baby may need to be admitted to the hospital to receive intravenous fluids and sometimes oxygen. Some babies need to be intubated, requiring a respirator.
More severe RSV disease may occur in the following infants:
Infants with chronic lung disease
Infants whose immune systems do not work well
Infants with certain forms of heart disease
A simple way to help prevent RSV infection is to wash your hands often, especially before touching your baby. It is important to make certain that other people, especially caregivers, also take steps to avoid transmitting RSV to your baby. In the winter months do not allow people, other than caretakers, to get close to your baby and, particularly, kiss the baby.
For those babies who are at higher risk of more severe disease, additional protection can be obtained by giving RSV immune globulin during the RSV season. This globulin protects the baby against RSV. The protection is neither complete nor long lasting, so it is still important to make sure that only caretakers get close to the babies and that they wash their hands before handling them. Also it is necessary to repeat the injection every 4 weeks. Not all babies qualify for this vaccine. The pediatrician or pediatric specialist (pulmonologist) can evaluate the baby’s history and physical exam to determine if he/she qualifies. The insurance company will make the final determination.
Some babies that develop RSV will continue to wheeze on and off for a long time despite proper treatment. It is believed that some of them will develop asthma.
For this reason it is important to wash your hands before eating or drinking and before caring for your child and to cover your mouth and nose every time you cough or sneeze. Children should be taught from an early age to do the same. Let’s stop the spread of viral illnesses together.
By Roberto Ayres M.D.