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Ask the doctors 11/22

By Eve Glazier, M.D., and Elizabeth Ko, M.D. Andrews McMeel Syndication

Dear Doctors: What can I do to protect my baby from RSV? What are the symptoms? People are talking about a “tripledemic,” and it has my husband and me worried. We’re both vaccinated for the flu and COVID-19, and we are being super careful when we’re out and about. What else can we do?

Dear Reader: RSV is short for respiratory syncytial virus. It’s a common winter virus that can affect people of any age. In most cases, RSV infection causes mild symptoms similar to the common cold. However, infants and children younger than 2, whose immune systems are still developing, are at increased risk of serious illness.

RSV is the most common cause of pneumonia in infants and young children in the United States. It is also the leading cause of bronchiolitis in that age group. That’s a lung infection in which the smallest airways become inflamed and swollen, and an increase in mucus production impedes air flow into and out of the lungs.

This year, as with the flu, RSV season has arrived early. Hospitals throughout the U.S. are reporting a surge of serious infections among infants and younger children.

The virus enters the body through the airways and the mucous membranes. It can remain viable on hard surfaces – such as a doorknob, night table or dinnerware – for several hours. It can also persist on softer surfaces, such as a tissue or the skin. Someone can become infected by breathing in the viral particles that remain airborne following a cough or a sneeze, or by touching their mouth, nose or eyes after direct contact with contaminated droplets.

Someone who is sick with RSV typically remains contagious for between four and eight days. However, due to their still-developing immune systems, it’s possible for infants to continue to spread the virus for several weeks, even after symptoms of the disease have abated. There is no vaccine for this virus, and no targeted treatments. Prevention relies on the same precautions you use to avoid any respiratory illness. That is, keep your baby away from people who are ill, avoid close contact with people outside your home and be vigilant about hand hygiene.

Symptoms of RSV arise between three and six days after infection. They can include a runny nose, sneezing and coughing, fever, a decrease in appetite and lung congestion that can cause wheezing. These symptoms tend to be progressive, arriving in stages as the body mounts its attack against the virus. But in very young patients, the first, and sometimes only noticeable, symptoms of RSV can be increased fussiness, a decrease in activity and difficulty breathing.

Treatment for RSV consists of managing symptoms. The specific avenue of care depends on a child’s age, general health and symptoms. In infants, treating RSV includes a focus on adequate hydration and remaining alert for any signs of problems with breathing. The majority of RSV infections run their course in a week to 10 days. Parents of younger infants should check with their pediatricians for guidance on treatment, particularly medications. If your child has difficulty breathing, isn’t drinking enough fluids or has worsening symptoms, call your health care provider right away.

Send your questions to askthedoctors@mednet.ucla.edu.

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