Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Preparing for RSV and Flu

Category: Child Care


It appears that we are experiencing another busy winter of influenza and RSV (respiratory syncytial virus). Influenza is a big cause of wintertime disease in both children and adults. RSV is the most common respiratory virus to affect the lower airways in children. Most cases of RSV occur in children under age 3 and several factors determine which kids will have the most trouble. The usual presentation is upper respiratory infection with coughing and congestion, progressing to wheezing and retracting and, occasionally, apnea and loss of breath. There is a lab test which can diagnose RSV from the nasal secretion washings. Positive test results allow the doctor to guide the patients therapy and have a better idea of what to expect. The majority of patients with RSV upper respiratory infection or even pneumonia will do well on an outpatient basis. A small percentage, perhaps 1 in 10, will have significant respiratory distress and require hospitalization and occasionally treatment with a drug called ribovirin. This antiviral medicine is given by inhalation treatment over 12 to 18 hours for three to seven progressive days. The cost can range from $500 to $1,000 per day and there have been concerns about potential dangers to respiratory therapists, nurses and parents in the room who inhaled the medicine as well as the child. Most of these concerns have not panned out, however, and the medicine is approved and used often and appropriately in high risk patients such as children who were premature who have marked respiratory susceptibility and who's condition seems to be worsening rapidly. Perhaps the best way to prevent the spread of this highly contagious infection is frequent hand washing among family members as well as health care givers. Influenza, of course is characterized by an achy feeling with fever and symptoms ranging from headache and respiratory symptoms to occasional GI symptoms. The best treatment for influenza, in my opinion, is prevention since the vaccine has become so safe over the past several years. One school of thought is to give all children and adults the vaccine. Most people, however, follow the old recommendation which is to give only high risk patients the vaccine such as patients with asthma and lung disease, elderly patients and sick children with serious chronic diseases such as kidney or heart disease. At any rate, we are in the midst of the influenza season, experiencing many cases on a weekly basis, both in Louisiana and nationally. If you feel that your child has the flu, the important thing is to give Tylenol and sponging in the tub, and to consider using Children's Advil or Pediaprophen for fevers over 102 degrees. If the child appears very ill or has any scary symptoms (such as worsening severe cough, stiff neck very ill appearance or anything else which seems out of line) contact your physician immediately. In most cases, influenza, like so many other infectious diseases, will run it's course and the child will be fine and back to work within a week. Because of the contagion, both influenza and RSV children should be isolated from their siblings and their friends and not sent to school.