RSV Virus
(from the RSV, RSVprotection.com)

Identifying Respiratory Syncytial Virus (RSV)
RSV is a labile paramyxovirus that produces a characteristic fusion of human cells in tissue culture--the syncytial effect. Two subtypes, A and B, have been identified.

Subtype B are characterized as the asymptomatic strains of the virus that the majority of the population experiences. The more severe clinical illnesses involve Subtype A strains, which tend to predominate in most outbreaks.

RSV affects the upper and lower respiratory tracts, but is most prevalent in lower respiratory illnesses such as pneumonia and bronchiolitis. RSV bronchiolitis is one of the severe illnesses caused by RSV and is associated with clinical signs and symptoms of small airway obstruction.

Bronchiolitis begins with mild symptoms of an upper respiratory tract infection and progresses to include cough, wheeze, onset of dyspnea, increased respiratory rate and retractions of the respiratory muscles, indicating lower respiratory tract involvement.

Airway obstruction can be extremely dangerous, especially in infants who have smaller peripheral airways than adults, so it is important to know the warning signs of bronchiolitis in order to manage the illness before it becomes life-threatening.

RSV is also one of the most common causes of pneumonia in young children. The incidence is greatest from birth to age three. Clues to a diagnosis of pneumonia may be the finding of crackles, respiratory distress and dullness to percussion.

Who is at risk for RSV infection?
The National Center for Infectious Diseases and the Centers for Disease Control recommend that during the RSV season, healthcare providers should consider RSV as a cause of acute respiratory disease in both children and adults.

Pneumonia and bronchiolitis, the most severe infections caused by RSV, are prevalent in infants aged 2 to 6 months, but children of any age with underlying cardiac or pulmonary disease or who are immunocompromised are at risk for serious complications from RSV infection.

In patients with pneumonia or bronchiolitis who also have an underlying condition including bone marrow or organ transplantation, and T-cell lymphoma, RSV must be considered in the diagnosis.

Other factors contributing to increased risk of developing serious RSV infection include:

• premature infants and infants less than 6 weeks of age
• infants with congenital heart disease
• infants with chronic lung conditions including bronchopulmonary dysplasia and cystic fibrosis
• immunodeficiency
• lower socioeconomic status; crowded living conditions
• exposure to passive cigarette smoke
• attendance in day care setting
• presence of older siblings in the home
• infants who were not breastfed

What will happen
Typically, RSV bronchiolitis presents with a two to three day "prodromal" phase, which resembles a common viral upper respiratory tract infection. Distinct symptoms of RSV bronchiolitis include:

• Rhinorrhea (runny nose)
• Wheezing and coughing (can persist for several months in severe infections)
• Irritability and restlessness (usually in those with impending respiratory failure)
• Low grade fever (102°F); but temperatures can be as high as 104°F when another illness, such as otitis media is present.
• Nasal flaring and retractions (intercostal, subcostal, and sternal) are indicative of airway obstruction. The chest may appear hyperexpanded and be hyperresonant to percussion. As a result of hyperexpansion of the lungs, the liver and spleen may be palpable several centimeters below the costal margins.
• X-ray findings are not pathognomonic, but often show air trapping and hyperinflation or appear normal.
• Apnea, usually as an initial presenting symptom in short episodes. It occurs in approximately 20% to 25% of young infants.
• Circumoral and nailbed cyanosis (severely affected infant)

Keeping your kids stay free of RSV:

• Always wash your hands with warm water and soap directly before touching your baby, and make certain that relatives and other care-givers do the same.
• Stay away from your baby if you have a cold or a fever.
• Try to keep older brothers and sisters away from the baby as much as possible, especially if they have a runny nose, cold or fever.
• Do not take the baby out to crowded areas such as shopping centers.
• Do not smoke around the baby.

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