Doctors warn of a common respiratory illness in children

October 30, 2017, Nationwide Children's Hospital

Like most moms, Shanisty Ireland had dealt with many bugs being passed between her three children. Last winter, she thought her newborn, Adam, had the same cold that had caused her older children to cough and sniffle. But as Adam ran a fever and struggled to keep his food down, she realized this was something far more serious. She took her baby to Nationwide Children's Hospital where he was diagnosed with respiratory syncytial virus, more commonly known as RSV. He spent four days inpatient receiving oxygen, IV fluids and breathing treatments that thankfully helped him fully recover.

Because its symptoms are similar to those of other viruses – coughing, sneezing, , fever, irritability and loss of appetite – RSV is considered the most common illness that many parents have never heard of. While in many healthy babies, RSV may not develop into a more serious illness, it is the most common cause of bronchiolitis and pneumonia in younger than one year of age in the United States, making it the most frequent cause of hospitalization for infants. More than 140,000 infants and in the U.S. end up hospitalized each year with illness caused by severe RSV infection.

"By age two, 90 to 100 percent of children have had at least one infection caused by RSV," said Octavio Ramilo, MD, chief of the Division of Infectious Diseases at Nationwide Children's. "Babies under three months of age are very prone to get sicker for two reasons: their lungs are very small and therefore unable to handle a lot of inflammation, and the white cells of their immune systems that protect us against infections are not ready yet."

Signs that a baby may be experiencing a severe form of RSV infection include not taking their bottle and breathing more rapidly than usual. If a parent suspects their child may be experiencing RSV, they should talk to their child's pediatrician and go to the emergency department to help manage symptoms.

"In most cases, children with the virus recover on their own in about a week, although a lingering cough can persist for up to three weeks," said Asuncion Mejias, MD, PhD, principal investigator in the Center for Vaccines and Immunity in The Research Institute at Nationwide Children's. "However, for high-risk groups such as young infants, patients with conditions like and , and patients with compromised immune systems, RSV can become much more serious very quickly."

While there is no treatment for RSV, parents and caregivers can reduce the risk of RSV by washing hands frequently, disinfecting hard surfaces, and avoiding sharing dishes and utensils. Very young babies should not be exposed to many people, especially during the winter, and families should avoid even other siblings in the home having contact with an infant during this time.

While it is still early in the development process, researchers at Nationwide Children's are making strides to develop a vaccine to prevent RSV that may someday keep kids like Adam out of the hospital.

"While we're working diligently to develop this vaccine, we are still a long way away from it being an everyday reality," said Mark Peeples, PhD, principal investigator in the Center for Vaccines and Immunity at The Research Institute at Nationwide Children's. "There is a lot more research that needs to be done. Our goal is to develop something that is safe and effective, first and foremost, and we are hopeful that such a vaccine will someday help prevent RSV on a global scale."

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