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Posted January 26, 2010 | comments Leave a comment

RSV puts more babies in hospital than other winter illnesses

By Jessica Wiant - jwiant@nvdaily.com

WINCHESTER -- A little common sense can prevent some cases of the most common virus to put babies in the hospital during winter months, a local pediatrician says -- and no, he isn't talking about the flu.

Dr. John Volinsky, of Winchester Pediatric Clinic, said his practice has seen thousands of children with RSV -- respiratory syncytial virus.

"We see a lot," he said.

In most children and in adults, the virus manifests itself as a bad cold, according to Volinsky. While parents of older children need not panic, in newborns and especially premature babies it can be fatal.

The virus frequently can trigger ear infections, croup and bronchiolitis, wheezing and trouble breathing, Volinsky said.

The virus is diagnosed by taking a mucous sample, said Janet Nordling, director of Women & Children's Services at Winchester Medical Center.

The diagnosis of RSV isn't as important as the treatment of the symptoms that result from it, Volinsky said.

Airway and breathing issues and dehydration are the two main reasons babies need to be hospitalized with the virus, he said.

For 4-month-old Isaiah Duncan, who was at Winchester Medical Center as of Friday, it was RSV that developed into pneumonia that caused him to be hospitalized, his mother, Sarah Duncan, said.

Isaiah was admitted Thursday after a third trip to the emergency room, she said. After the first trip, Isaiah began breathing treatments at home with a nebulizer, but when he wasn't eating well and was still fussy, wheezy and having difficulty breathing, she rushed him to the hospital again.

"I was just overwhelmed," Duncan said.

On Friday, tubes providing oxygen were taped to his face, and he was receiving breathing treatments every three to four hours in addition to other medications, she said.

"It's really hard for him to have oxygen," she said. "If he's awake, he's not happy."

Patients hospitalized with RSV normally spend one to three days, or as much as a week, in the hospital and receive oxygen and aerosol breathing treatments, Nordling said.

Premature babies and babies with asthma or other conditions are at higher risk of being more affected by the virus, she said.

Being around other children, the most common carriers of the virus, and living in a smoking household put children more at risk, Volinsky said.

"Often, it can just be bad luck," he added.

An initial case of RSV is often the worst, but that doesn't mean children are then immune, he said. Most will come down with the virus every two or three years, Volinsky said.

Additionally, RSV is only one of the colds that goes around during winter months, and it has two strains, Volinsky said. There are also three strains of the flu and many other viruses that go around, so babies and children can get sick several times over the course of a winter.

RSV leads to the most hospitalizations, he said.

The good news is that the same precautions that have been widely publicized for flu prevention, including washing hands frequently, will also prevent the spread of RSV, according to Volinsky.

The key thing, he said, is to keep new babies away from other children and anyone with any respiratory symptoms.

Duncan gave parents the same advice.

"Don't go out in public or get them near anyone, if you can," she said. "I think people don't think about it since it isn't as big of a deal in older kids and adults."

For high-risk babies, including those who are premature, Winchester Medical Center offers a clinic providing Synagis, a preventive medication, according to Nordling.

Those recommended for the treatment receive five to six injections over the course of the season.

Volinsky said any child with wheezing or respiratory distress should see a doctor, but for parents, if their child is sick enough that they are worried, "we'll see them," he said.

The RSV season is still on the up slope he said, and can sometimes peak as late as February or even March. On Monday, Winchester Medical Center had three patients hospitalized with the virus, according to Nordling.

"It's just getting going. It's been mild so far, but we've got a long winter to go," Volinsky said.

• RSV is spread by coughs or sneezes sending droplets through the air to others nearby or onto surfaces that others touch.

• RSV outbreaks typically occur during the winter.

• RSV spreads rapidly among children, and most children will be infected before age 2.

• Symptoms usually show within four to six days of infection. Recovery usually occurs within one to two weeks, but children can continue to spread the virus for one to three weeks.

• People at risk for severe RSV include premature infants, infants and children with chronic lung disease, boys under age 6 months, infants and children with congenital heart disease, infants in crowded day care settings and those with weakened immune systems.

• RSV is most serious for infants under age 1, and in children under age 1 it is the leading cause of pneumonia and bronchiolitis -- inflammation of airways.

• Children with RSV may need to be hospitalized for a few days to be treated with oxygen or have breathing tubes inserted.

-- Source: The American Lung Association

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