The Pediatric Illness that Is Packing North Carolina Hospitals: Understanding RSV

Children get sick. That is something we can expect. We also expect children to recover. For the past 2 ½ years, we’ve learned to listen to specific cues of illness, fearing it may be COVID-19. But another illness is packing pediatric hospital beds throughout North Carolina. Its name is RSV or respiratory syncytial virus, and while most children get it by their second birthday, this year, it is far worse than usual. 

RSV is a common respiratory illness that resembles a cold in most children. You may not even know your child has RSV unless you have them tested. So many parents assume that when their child begins coughing, has congestion, and a runny nose, they have a cold and treat their symptoms accordingly. Colds are typically easy to manage and go away on their own. No big deal, right? Well, usually. But sometimes, symptoms worsen, and the child has difficulty breathing. And that’s where things get scary, and every second counts. 

Why is RSV Worse this Year?

Until recently, most adults and children have been wearing masks, which help protect against respiratory illnesses. In a typical (non-pandemic) year, the average child will get eight infections – most of them respiratory due to the ease of transmission. And while this helps build some immunity in the body, we’re coming out of mask mandates and limited exposure to illnesses. And our youngest children may not have even been exposed to bugs until recently, making them even more vulnerable to getting sick. 

What Does RSV Look Like?

RSV looks like the common cold for most healthy adults and older children – coughing, runny nose, congestion, and a low fever. But for infants – especially preemies born before 29 weeks gestation, RSV can be very dangerous. The reason is that RSV can turn into bronchiolitis resulting in the lungs’ small airways becoming inflamed and congested. In a small child with already small airways, any congestion can cause significant issues in their ability to breathe.

Who is Most at Risk for RSV? 

According to the American Academy of Pediatrics (AAP), those most susceptible to RSV are: 

• Children under 12 weeks at the onset of RSV season
• Babies with certain types of heart defects
• Those with a weakened immune system
• Those with chronic lung disease due to prematurity

The AAP also states that additional risk factors for RSV include children born with low birth weight, those with siblings, and those whose mothers smoked during pregnancy. Exposure to secondhand smoke in the home also puts children at a higher risk, as does a history of allergies and eczema, not being breastfed, and those who attend daycare. 

When Should Parents Get Help?

In children three months and younger, the AAP recommends that parents contact their child’s pediatric provider as soon as they show signs of illness, as they can rapidly decline. 

In older children, the AAP recommends parents seek medical help if the child: 

• Is having trouble breathing – ribs may suck in with each breath
• Has a gray or blue tinge to lips, tongue, nails, or skin
• Flaring nostrils, head bobbing, wheezing, or rhythmic grunting when breathing
• Has symptoms of dehydration (less than one wet diaper in 8 hours)
• Is significantly less alert or active than normal

In addition, RSV can cause a bacterial infection, such as an ear infection. Therefore, contact their doctor if you notice your child tugging at their ears, having trouble sleeping, being fussy, or if their symptoms do not improve over seven days. Keep track of their temperature. If older children get a fever over 104º or children younger than three months have a fever of 100.4º taken rectally, contact their pediatrician. 

As stated, RSV is a common and easily transmitted respiratory illness that typically does not have serious side effects. This season, however, it is crucial for parents and caregivers to remain diligent and watch for signs of any illness. Fast action is essential as RSV can quickly spiral into a more serious health condition. If you have any questions or suspect your child may have RSV, contact our office or schedule a walk-in visit. Call 911 or head to the nearest urgent care or hospital in any emergency situation.