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The ABCs of RSV
Fundamentals for Protecting Preemies and Other Babies from this Common Virus

By Phyllis Dennery, MD

Parents gearing up for winter need to know that sometimes seasonal sniffles mean more than just a cold. Respiratory syncytial virus (RSV) is a common virus that usually causes cold-like symptoms in adults and children. But for some babies, especially those born premature or susceptible to other risk factors, RSV can be very serious.

All about RSV

RSV is very common with virtually all babies contracting it at least once by the age of 2. RSV infects the upper respiratory system with symptoms similar to a common cold or influenza. It’s the leading cause of hospitalization of children under the age of 1, accounting for more than 125,000 hospitalizations in the United States annually.

RSV occurs yearly throughout the world and can be contracted more than once over a person’s lifetime. In most of North America, the typical “RSV season” begins in October/November and lasts four to five months.

Babies who are most at-risk

All babies are at risk for contracting RSV, particularly within the first six months of life. Babies born premature (earlier than 37 weeks) are particularly vulnerable to contracting RSV because they generally have underdeveloped lungs and lack important antibodies they need to fight off infections.

Additional factors, such as low birth weight (less than five-and-a-half pounds), contact with other children, family history of asthma, and exposure to tobacco smoke, also put babies at high risk for contracting RSV.

Preemies and babies suffering from lung disease, heart disease or immune deficiency should be watched more closely for a longer period of time because RSV can lead to life-threatening lower respiratory tract infections, including bronchiolitis or pneumonia.

What to look for

Common symptoms of RSV include a severe cough, persistent wheezing or difficulty breathing. Possible signs of a more serious infection that require a trip to the emergency room include apnea (if the baby stops breathing for more than 10 seconds) or breathing so fast that you can’t feed the baby.

Caring for your baby

Prevention is the key to helping your baby stay healthy. RSV lives on surfaces like countertops and in tissues for up to several hours and is easily transferred through direct contact —especially from the hands to baby.

Frequently clean your baby’s bedding, toys and personal items. Anyone handling your baby should wash his hands or use antibacterial gels. Also, keep your baby’s nose clear of secretions and make sure he is receiving enough fluids.

Tips for Protecting Your Baby

Parents should remember the following during RSV season and beyond:

1. Check with your pediatrician to see if your baby is at a higher risk for RSV and understand your options.

2. Ask visitors to wash their hands before touching your baby (and keep hand sanitizer nearby).

3. Limit your baby’s exposure to small children who attend daycare or school.

4. Monitor your baby for persistent coughing, wheezing or difficulty breathing, and seek a pediatrician’s care if symptoms develop.

5. Remember that you know your baby best. If you’re at all concerned, call your pediatrician.

Phyllis Dennery is chief of the Division of Neonatology and Newborn Service at The Children’s Hospital of Philadelphia and the University of Pennsylvania Health System. In addition, Dr. Dennery is associate professor of Pediatrics with tenure at the University of Pennsylvania School of Medicine.




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