It's RSV season again

I know I've touched this topic before, but since the season has started again and we're in a different format, I'll touch it again. There may even be new information in here. RSV stands for Respiratory Syncytial Virus. The key word here is "virus." It predominantly infects infants and toddlers, but can cause illness at any age. In older children and adolescents, the illness shows up primarily as a cold with cough and congestion lasting one to two weeks. In infants and toddlers, however, there is frequently a severe cough and likely some wheeze. In very small infants, an infection with RSV can actually cause the children to stop breathing all together (called apnea) for short periods.
It's this wheezing and apnea that causes so much trouble with RSV. The wheeze comes because the airways have become inflamed and swollen. These swollen airways have a much smaller air passage than normal and causes the infants to have difficulty breathing (imagine breathing through a straw). This combination causes the respiratory rate to go up and causes the children to have to work much harder than normal to catch their breath. Eventually, some infants tire to the point that they quit working so hard. This is when the trouble begins and their little bodies need help with extra oxygen and maybe even breathing support.
The apnea appears to be unassociated with the swollen airways and can occur without warning in very small infants and is potentially life-threatening.
The biggest trouble is that there are no proven therapies for this infection. Much like the common cold, nothing specifically treats RSV. There is an immunization, Synagis, that can provide some protection for those that are most likely to suffer a severe infection (premies and infants with chronic lung conditions). It is very expensive and does not offer long term protection. Therapies for asthma like breathing treatments and steroids only prove to be helpful in a limited number of patients. There is some suggestion that those who do respond may actually have underlying asthma. Antibiotics don't help at all since it is a viral infection. That leaves physicians with very little to do except watch very carefully for the infants at risk of tiring out and needing extra help. We do that with supplemental oxygen and in severe cases, actually breathing for the infant with a ventilator.
Much like the cold, the best management is to try to prevent this infection. Good handwashing is the cornerstone of prevention. If you know your child has RSV, they are contagious with the start of the runny nose and for several days after that. If your child is wheezing, and especially if he or she seems to be short of breath, then he or she needs to be seen. Give your doctor a call!