RSV a concern for parents

by Donna Lampkin Stephens

With the arrival of winter in the 501 comes an increased incidence of bronchiolitis, which can be very serious in young children — and especially in babies.

According to, bronchiolitis is swelling and mucus building in the smallest air passages in the lungs, usually because of a viral infection. It usually affects children under 2, with a peak age of three to six months, and sometimes is severe.

Respiratory syncytial virus (RSV) is the most common cause. More than half of all infants are exposed to the virus by their first birthday; according to the Centers for Disease Control, almost all children will be infected with RSV by the time they turn 2.

“RSV is very frustrating for families as the cough and congestion frequently last for several weeks,” said Dr. Steve Schexnayder, chief of Pediatric Critical Care Medicine at Arkansas Children’s Hospital. “Older children and adults get the same infection, but because their airways are much larger, it is just a common cold.”

ACH sees several cases of RSV each winter season, said Ginny Hensley of the ACH Public Relations office.

According to the CDC, RSV is a respiratory virus that infects the lungs and breathing passages. Most otherwise healthy people recover from the infection in a week or two. In adults and older, healthy children, the symptoms are similar to the common cold. But the infection can be severe for infants, young children and older adults. In addition to bronchiolitis, it is also the most common cause of pneumonia in babies under 1.

Breathing difficulties are among the key symptoms parents should be aware of, Schexnayder said.

“In infants, that is often manifested by trouble feeding,” he said. “They have a choice of breathing or eating and will not feed well because they can’t catch their breath. Sometimes parents will be able to see (the child’s) ribs outlined when they breathe, which means they are having to work hard to move air in and out.”

When babies won’t feed, Schexnayder said, parents should seek treatment promptly.

“While bronchiolitis affects thousands of infants and children every year, only a small number require hospitalization,” he said. “A small number of those sick enough to be hospitalized can become very critically ill, which cannot be predicted nor prevented. Those infants require expert critical care to survive this potentially life-threatening problem.”

He said most treatment for bronchiolitis was supportive.

“Because it is caused by a virus, antibiotics don’t help, and they have their own set of risks,” he said. “A minority of babies will respond to breathing treatments, and these are frequently tried. Keeping the nose clear of secretions with a bulb syringe and saline nose drops may help.”

According to the Mayo Clinic, RSV can also become serious in older adults, those with heart and lung disease or anyone with a very weak immune system.

Schexnayder said ACH had seen larger numbers of bronchiolitis every winter with scattered cases throughout the year.

“Last winter was a rather severe season compared to the previous two years,” he said. “While there are theories for the variation, the cause is really unknown.”