Infections are one of the most common health problems in childhood. Although they usually do not cause serious problems, some viruses affecting newborn babies can lead to serious conditions. One of these is RSV (Respiratory Syncytial Virus), the covid-19 of infancy. So, how is RSV transmitted? How is it treated? Details in our article.

What is RSV?

RSV (Respiratory Syncytial Virus) is a very common and contagious virus that threatens humans and can cause infection in the respiratory tract in different parts of the body depending on age. In our country, it causes outbreaks more frequently in winter and spring and infections all year round. The onset of the disease starts in November-December and peaks in January-February. It is a common cause of lower respiratory tract infections, especially in infancy and childhood. Up to 60% of newborns may be at risk of contracting RSV in the first outbreak after birth. 35-50% of bronchitis or pneumonia in infants younger than 6 months is due to RSV. The younger the child at this stage, the greater the risk of severe illness. This is why babies under 6 months of age may require hospitalization after contracting the RSV virus. Almost all children can get RSV until they are 2-3 years old. RSV does not induce a sustained immune response, and sometimes even multiple infections can occur during the same outbreak. The virus does not induce a sustained immune response, and sometimes even multiple infections can occur during the same outbreak. In children over 3 years of age and adults, it can be overcome like a simple upper respiratory tract infection with complaints such as malaise, runny nose, sore throat, a mild cough and headache.

How is RSV transmitted?

RSV is transmitted by airborne droplets from coughing or sneezing of an infected person, and by contact with the respiratory secretions of the infected person.

Why RSV poses a danger to premature babies

While RSV is usually not a serious problem in children over the age of 3 and adults, it can be life-threatening, especially for newborns and premature babies. Premature babies have weaker immune systems than normal babies. Their lungs are also not fully mature. This is why RSV-induced lower respiratory tract obstruction can lead to a serious infection that requires hospitalization and can sometimes result in death. Premature babies who have RSV may require medical supervision, medication and hospitalization for two years after the illness. Having this infection can also increase the risk of chronic lung disease and asthma, especially in premature infants. RSV can also be severe in infants with congenital heart disease and chronic lung disease.

What are the Symptoms of RSV?

Symptoms of RSV start with cold symptoms such as a mild fever, runny nose and cough. It can reach the small airways in the lung in 3-4 days, especially more frequently in premature babies, and cause bronchiolitis. This condition can become serious, such as respiratory failure, requiring emergency intervention.

Other symptoms that indicate that the situation is getting serious due to RSV can be as follows:

• To get enough air, the baby’s abdominal muscles contract, the muscles between the ribs collapse inwards and the wings of the nose open.
• After inhaling, the exhaled air produces an abnormal sound.
• The baby does not want to have a full mouth because it is in a constant state of air hunger, it refuses food and drink and immediately removes it.
• A “blue baby” picture may occur. The baby’s fingertips and lip turn a purplish color. This image indicates a serious respiratory failure and the baby should be taken immediately to the emergency room for oxygen support.

How is RSV Diagnosed?

To diagnose RSV infection, a sample of respiratory secretions is taken and tested for RSV antigen. This test is a widely used, rapid and 90% accurate method.

What can be done to prevent RSV?

First of all, continued breastfeeding can prevent this infection or make it milder. The following precautions should be followed to avoid infecting especially at-risk babies (premature or with diseases such as defense system diseases, congenital heart defects) with RSV.

• Hands should be washed with soap and water for at least 20 seconds before touching the baby.
• Smoking should not be allowed near the baby.
• Used handkerchiefs should be thrown away immediately as the virus can remain viable for hours in used handkerchiefs.
• Do not take the baby to crowded and closed places (public transport, entertainment centers, kindergartens, schools, etc.).
• Sick people and children should be prevented from being in the same environment with the baby.
• If possible, separate rooms should be prepared for other children and babies.
• Baby’s equipment and toys should be washed frequently.
• Kissing the baby should be avoided as RSV can be transmitted by kissing.
• The house should be regularly ventilated.
• When masks are required, due consideration should be given to this.

Hanging these rules in a corner and checking them until they are learned makes it easier to remember and apply them. These can be difficult to follow at times, but they are vitally important for the health of babies, especially those at risk.

How to Treat RSV?

There are no drugs or vaccines that act directly against RSV to change its clinical course. At-risk infants who meet the criteria for the disease should be offered a protective antibody (palivizumab) once a month for passive immunity. This vaccine can prevent the disease or make it milder.

The criteria for vaccination can be listed as follows:

• Babies under 1 year of age with a gestational age of 29 weeks or less
• Babies under 1 year of age with congenital heart disease
• 3- Those under 2 years of age with chronic lung disease

Since oral intake will be impaired in patients infected with Rsv, the first step is supportive care. It is important to replace lost fluid. Careful assessment of respiration may require oxygen support, upper airway aspiration and, if necessary, ventilatory ventilation. Antibiotics may be used if ear infections or bacterial lung infections develop after RSV bronchitis. Apart from this, there is no antibiotic effect. In severe cases, hospitalization and follow-up is a common practice. Especially for babies younger than 6 months, hospitalization may be necessary in case of diagnosis.