Annoying call from emergency department or urgent care physicians (I know I disparage these poor folks, and most of them know better, but its the few that drive me crazy): I have a 2 year old kid here who has had several days of runny nose, cough, and fever. He looks great, but I tested him for RSV and it was positive, so we need to admit him.
Me: Doh! Where did you go to medical school?
There are many problems with what this ED/UC physician had to say, but its meant to illustrate that even many health professionals don't understand RSV all that well.
Lets have a little Q and A on the subject:
Q: What are the symptoms?
A: Most people who get RSV get a cold-like illness: runny nose, cough, fever, etc. This virus more than most other viruses produces TONS of snot. (I held back posting my snot pictures due to the reception they got last time). Some people, especially infants develop severe disease.
Q: What are the chances my baby will get RSV?
A: You should know that RSV is VERY common. Almost EVERY child will get it before they are two years old. VERY FEW of them are sick enough to need hospital admission.
Q: Which infants are a risk of getting severe disease?
A: The younger, the higher risk. Especially those who are premature (usually less than 35 weeks) or have significant congenital heart defects.
Q: How do you get it?
A: You mostly have to come in contact with the virus and then touch your eye/nose/etc. The virus can live on surfaces (doorknobs, shopping carts, etc) for many hours. There is some transmission by inhaling droplets, but you have to be within 3 feet of the sick one, and they basically have to cough in your face. Wash your hands!
Q: How long are you contagious?
A: The virus can be spread for a 3-4 weeks in nasal secretions after infection (but usually only for a week). Take home message #1 for this: if your child is in daycare they will get it. Take home message #2: Wash your hands!
Q: How can I prevent my kids from getting it?
A: Those high risk patients can get a very expensive vaccination once a month during RSV season, usually just premature babies and those with heart defects. If you think your baby may qualify, talk to your pediatrician. Wash your hands (and your kids')!
Q: I heard my child can only get this in the winter, is that true?
A: Kind of. It can happen at any time of the year, but for reasons not completely understood the VAST majority of cases happen within one month of the start of the outbreak. It seemed to hit here in
Q: What do you feel is the most frustrating thing about RSV, Dr Jay?
A: Hmmm. This question doesn't sound spontaneous, a little forced. Almost as thought this conversation is scripted or something. RSV is one virus that DOES NOT confer lifelong immunity. So if you've had it once, congratulations, you can get it again. It is felt that we likely get RSV over and over again throughout life, but it isn't followed too much after childhood because it is usually mild disease from then on.
Q: My child was hospitalized for RSV, someone told me that it will give him asthma for the rest of his life, is that true doc?
A: Yes. I mean no. I mean I don't know. Babies that are hospitalized for RSV tend to develop asthma later in life. It really depends on if you are a fan of the chicken or the egg. I think I'm an egg fan, in that I think those kids who were going to get asthma anyway are likely the ones to get severe RSV, not that the RSV causes asthma. Or does that make me a chicken fan?
Q: What is the treatment?
A: You are going to love this: fluids, rest, etc - you know the old cold/flu/virus protocol. Infants only need hospitalization if they are having difficulty breathing, needing extra oxygen, or if they are so sick they are refusing to drink (and thus getting dehydrated).
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