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Update on RSV in the Community

December 13, 2023  

Hello NAP Families,   We have seen a significant number of kids coming in with RSV-like symptoms and wanted to send a quick update and reminder of how to best manage this illness. RSV stands for Respiratory Syncytial Virus and is one cause of the common cold. Typical symptoms include prolonged cough (3-6 weeks), severe nasal congestion, runny nose, sinus pressure, and occasionally fever. This particular virus tends to affect the small airways in the lungs more than other viruses which can lead to more serious breathing issues in young or high-risk children. The high risk groups are all children under 1 year of age and children under 2 years who were born very prematurely, have serious lung or heart issues, or are severely immunocompromised. In these children, the inflammation of the small airways in the lungs could make those airways so narrow that it is difficult to get air in and out. This causes children to have to use extra muscles in their stomach and rib cage to force the air through these small passages and, in severe cases, the muscles can become tired and not be able to keep up that extra effort. If your child is in a high risk group and they have signs of RSV or breathing difficulties, please call our office for an appointment.   The other main challenge that RSV poses to children is the amount of mucous it creates! Infants with stuffy noses have to use their mouths to breathe and can struggle to nurse or take a bottle as a result. Monitoring your infant’s hydration is important – if the number of wet diapers goes down significantly it might be a sign that they are not getting enough fluid. One way to address this is by offering smaller amounts of milk more frequently through the day while they are sick. You can also try to suction your child’s nose to remove as much mucous as possible before eating or sleeping so they can breathe more comfortably. Doing a “steam bath” – going into the bathroom, turning the shower on to the hottest setting, and standing/playing with your child in the steam for 5-10 minutes – can help loosen the mucous and make nasal suctioning more effective. The best treatment for RSV is consistently clearing out the mucous any way you can!   A note on RSV testing: every child with RSV-like symptoms does not need a test. These tests are limited and are often billed to families as part of insurance deductible so the providers at NAP are very thoughtful about when a test is needed. Typically, high risk children may need a test to determine how closely they need to be monitored. Older kids do not need testing because the result of the test will not change how we care for them. If your child attends daycare and their daycare provider is requiring an RSV test to return to class, please let us know and our office will reach out to them directly to ask that they revisit this policy.   If you believe your child has RSV, take standard precautions including staying away from high risk people (young children and elderly), washing hands frequently, and wearing a mask when out of the home if your child is able. If you believe your child has been exposed to RSV, monitor for the development of symptoms and call our office for an appointment if they are high risk (infants or toddlers with specific health conditions, see above) or if they are looking unwell (having trouble breathing or staying hydrated, prolonged high fevers, ear pain that could be an infection).   Unfortunately, the RSV preventive treatment (Beyfortus) which was supposed to be available this fall and winter season for infants has had serious supply issues and is not expected to be available to the greater community until fall 2024. Beyfortus is an injectable monoclonal antibody that offers very good protection against serious RSV disease in newborns and young infants. Studies showed a 75% reduction in office visits, hospitalizations, and ICU stays! Some newborn nurseries and NICUs have a small supply and are able to give it to babies shortly after delivery. There is also a similar treatment available to pregnant mothers in the end of their third trimester that offers protection to the newborn for up to 6 months. If you are pregnant currently, please consider receiving this RSV treatment or, if offered during your newborn’s hospital stay, consider accepting the treatment for your child. You will likely not be able to access it after discharge home from the hospital if you decline.   Please stay well, take care, and have a wonderful holiday season!  

Northampton Area Pediatrics