Q&A: An RSV refresher for EMTs and paramedics

Pediatric infectious disease specialist Priya Soni, MD, answers questions about RSV symptoms, treatment and COVID-19 co-infection

By Cedars-Sinai

Respiratory syncytial virus, commonly called RSV, usually affects very young children in the winter months, and can even be seen in warmer months.

Infectious disease specialist Priya Soni, MD, an assistant professor at Cedars-Sinai Medical Center, noted out-of-season surges of RSV identified in California and across the country earlier this year could be attributed to last year's pandemic restrictions, which prevented infants and children from being as exposed to the virus as they normally would be.

Soni answered the following questions about RSV symptoms and treatments.

Q: What is RSV and how common is it?

Soni: RSV is a common childhood respiratory virus that mostly afflicts young children, often under the age of 5. The virus can give children a cough and a fever and sometimes wheezing. These symptoms usually crop up in stages. Some of the youngest afflicted with RSV can just show poor feeding, irritability and breathing difficulties. While it is most often treated at home, severe cases can land children in the hospital. In the United States, RSV is responsible for 58,000 hospitalizations a year.

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Is RSV being confused with COVID-19?

Soni: RSV manifests similarly to COVID-19, so while parents might think of COVID-19 first, it is important for them to know that RSV is also circulating now. In addition to the common fever and cough symptoms, there are some differentiating symptoms. For example, we know that COVID-19 often presents with unique symptoms, such as loss of taste and smell, fatigue and muscle aches. This is not so common with RSV. There is a reliable test for RSV, an antigen-based test as well as a PCR test. Unfortunately, although it's rare, co-infection is a possibility.

How is RSV treated?

Soni: The treatment is supportive measures. That includes managing fever, hydration and, in small babies, suctioning of the nasal secretions so they can breathe better is very important. We often encourage the use of a humidifier at home. In severe cases, some children and infants do require hospitalization for oxygen support and on rare occasion, have to be placed on ventilators. Usually these are infants born prematurely or with chronic lung disease or other preexisting conditions, like congenital cardiac defects. There is a monoclonal antibody medication available that is used as a protection for these vulnerable patients.

Are there any preventive measures?

Soni: The main thing parents can do is continue to be vigilant about hygiene for themselves and their children. That means encouraging hand-washing, especially after interacting with other children, and mask-wearing, when possible, particularly in indoor settings. As with all respiratory infections, it is always a good idea to cover coughs and sneezes with a tissue or upper shirtsleeve instead of your hands.

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