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Respiratory cyncytial virus (RSV)


Mum looking at incubator
RSV is a very common virus that causes cold-like symptoms, but can lead to breathing difficulties if the lungs become affected.

It is most prevalent between October and March each year and around two-thirds of all babies will catch RSV before they are one year old. Often, parents will not know that the colds and sniffles that their children suffer during this period are caused by RSV.

If your baby was born prematurely, is prone to lung infections or was born with a congenital heart problem, he or she could be at greater risk of falling more seriously ill if infected with RSV.

What are the symptoms?

In the early stages, RSV symptoms are similar to a common cold (blocked nose, cough, sneezing and mild fever) and usually last between one and three weeks. If the lungs are affected, one or more of the following symptoms will develop:

  • Worsening cough
  • Wheezing – a whistling sound during breathing
  • Difficulty or increasing distress with breathing
  • Difficulty with feeding and drinking as a result of breathing difficulties.

How you can help

Your baby should be encouraged to drink extra fluids and should be kept cool and not overdressed if a fever develops. A paediatric paracetamol suspension (such as Calpol) may also be given to help reduce fever. Check the label carefully for the right dosage for your baby’s weight and age.

If your baby has increased breathing difficulties, he or she might need to be admitted to hospital. Staff may give oxygen and possibly respiratory support and/or drugs to help. The average stay in hospital for more severely ill babies is two to three days, but a baby with underlying lung problems might need to stay in for longer.

Treatment of RSV

From October to March babies born premature or sick are more prone to contracting  a cold or winter illness, one of these being RSV.

All parents of a premature or sick baby need to be given clear and consistent information around the treatment of RSV. Recently Public Health England updated their guidelines on the treatment and administration of immunisation.

Treatment is an injection into the arm or leg with five doses given, one month apart from the beginning of the RSV season.

Prescribing the treatment should be approached on an individual basis with discussions between the consultant and the baby’s family. 

Anyone with questions or concerns should speak with the consultant or GP.

Reducing the risk of infection

RSV is very contagious and passes easily between people via hand contact or in droplets produced by coughing and sneezing. It is therefore more likely to spread where there are groups of young children (in nurseries, playgroups and schools). It is impractical to avoid crowded places entirely, but during the high season of October to March, try to reduce your baby’s exposure to crowds and public transport.

Try also to discourage other adults and children with cold-like symptoms from handling and cuddling your little one.

RSV can survive for several hours on toys and work surfaces, making the spread of the infection by hand all the more common. Extra care should be taken when washing and drying hands during the high season.

Premature babies and those with fragile lungs can be seriously affected by cigarette smoke. Exposure to smoke has been found to significantly worsen the symptoms of RSV in young babies.

Unfortunately, catching RSV once does not make your baby immune to catching it a second time. However, re-infection usually results in less severe symptoms.

Long-term effects of RSV

This will depend on what problems, if any, your baby has had with the infection and on how bad these effects were on their lungs.

Babies recovering from RSV often remain wheezy or become wheezy with subsequent colds that they may catch. There is also a possible association of severe RSV with the later onset of childhood asthma.

In addition, RSV is a major cause of a common respiratory illness called bronchiolitis

Long-term prevention

While there is not yet a vaccine to protect babies from RSV, there is a monthly antibody injection that is thought to help protect against severe infection. It is recommended by the Joint Committee on Vaccination and Immunisation for children under two years known to be at high risk of infection (including those born prematurely or with chronic lung or congenital heart problems). This injection must be given once a month over the RSV season.

Availability varies throughout the UK and you should speak to your GP or neonatal staff before the start of the season to discuss whether this type of preventative therapy would be best for your baby.

Remember

  • Wash and dry your hands thoroughly before and after handling your baby
  • Reduce contact with your baby if you have a cold and try to keep other children and adults with cold symptoms at a distance
  • Do not smoke anywhere near your baby
  • Discuss the risks of RSV to your baby with your GP, neonatal staff or health visitor before October so that you are as prepared as possible.

Where to get help

NHS 111 England
NHS Direct Wales 0845 4647
NHS 24 (Scotland) 0845 424 2424

For further information you can order or download our booklet Common winter illnesses
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