RSV infections are seasonal, and in the United States, most infections begin in November or December and continue until March to May. So, the RSV season extends from November to May.
RSV infections are so common that about two-thirds of children are infected during their first year of life and almost all children have had an RSV infection by the time they are two years old. Most of these are mild infections, but RSV leads to about 125,000 Pediatric hospitalizations each year and 1-2% of these hospitalized children die.
Children usually develop symptoms about 2-8 days after being exposed to someone with an RSV infection (the incubation period). These symptoms initially include just a clear runny nose, but as the virus spreads, symptoms may worsen, and may include coughing, vomiting, fever (which can range from low grade to very high), rapid breathing with retractions and nasal flaring, wheezing, and poor feeding. In severe cases, children may have apnea and respiratory failure.
Like most viral infections, treatment of RSV infections are usually symptomatic. In children with wheezing and difficulty breathing, nebulized treatments with albuterol may be helpful. In general, though, breathing treatments only help about 25% of children with bronchiolitis, so if your child doesn't have a good response to a breathing treatment, your doctor will likely not continue them.
Other treatments may include supplemental oxygen and intravenous fluids if your child is not able to eat and drink well. Treatment of bronchiolitis with steroids is controversial, and is generally not thought to be helpful.
Since it is a virus, treatment with antibiotics is also not usually helpful, unless your child develops a secondary bacterial infection.
Although most children with RSV infections can be safely treated at home, about 1% of children, especially younger infants or those with a chronic medical condition, need to be hospitalized and closely monitored. Occasionally, children with severe difficulty breathing and/or apnea need to be placed on ventilator to help them breath. RSV can also be fatal in some children.
Children most at risk for serious complications of an RSV infection include premature infants with or without chronic lung disease and term infants with chronic lung disease. Fortunately, medications are available to prevent RSV infections in these high risk patients.
RespiGam (RSV-IVIG) was licensed in 1996 to prevent RSV infections in high risk patients. It is available as a monthly intravenous infusion and provides children with antibodies against RSV and some other respiratory viruses to give protection against getting infected.
A newer medication, Synagis (palivizumab), is a monoclonal antibody against RSV. Although it is also given monthly, Synagis is available as an intramuscular injection. And unlike RespiGam, Synagis is not a blood product and won't interfere with your child's immunizations (children can't receive the MMR or Chickenpox vaccine until after 9 months of finishing their RespiGam infusions).
