RSV and Toddlers

I’m always so surprised that while RSV is just another virus like rhinovirus, enterovirus, or coronavirus, families almost never have heard of any of those prior viruses but have very often heard of RSV. It’s true, that the virus does have quite a reputation. It has the potential, just like any virus, to land infants in the hospital due to difficulty breathing. However, RSV is able to be contracted by older children as well. According to the CDC, each year in the United States, an estimated 57,000 children younger than 5 years old are hospitalized due to RSV infection. It’s unclear the exact percentage of RSV amongst toddlers, but we do know that virtually, almost all children get an RSV infection by the time they are 2 years old.

Those at greatest risk for severe illness from RSV include

  • Premature infants

  • Very young infants, especially those 6 months and younger

  • Children younger than 2 years old with chronic lung disease

  • Children younger than 2 years old with chronic heart disease

  • Children with weakened immune systems

  • Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions

The absolute best things you can do to prevent your child from contracting RSV (or any other virus for that matter?)

The best thing to do are really the old fashioned principles- washing your hands often. Make sure you wash your child’s hands before eating and make sure it’s with soap and water which is preferred to alcohol based sanitizer. Try to keep your child’s hands off his or her face, especially nose and mouth, as this is the fastest way for most common infectious particles to spread. If your child is sick, encourage them to cover their coughs and sneezes by turning into his or her elbow or turning away. Try your best to clean and disinfect surfaces that people frequently touch-door knobs, counter surfaces, and toys. When people infected with viruses such as RSV touch surfaces and objects, they can leave behind germs. Also, when they cough or sneeze, droplets containing germs can land on surfaces and objects. And of course, if your child is sick, try your best to stay at home. This will help protect others from catching the illness.

It’s interesting that we know infants who get an RSV infection almost always show symptoms as opposed to toddlers and adults. Adults can get RSV infections and not have symptoms. In toddlers, it might just appear like the common cold and nothing worse. With very young infants (less than 6 months old), the virus can sometimes become complicated with symptoms of irritability, decreased activity and low appetite, and more seriously, apnea or a long pause in breathing which is why it has such a known reputation.

As a pediatrician, I always have my patients, especially the younger ones, return for the next few days during the onset of RSV or any virus that can cause bronchiolitis. This is because RSV bronchiolitis can often take a turn around day 3-5 of the virus where it can become more severe. I like checking back in frequently with the parents and laying eyes on the child myself to ensure feeding is going well and breathing isn’t labored. For children who are at risk (premature infants, infants with chronic heart or lung disease), there is an RSV vaccine which I highly recommend to my patients who qualify.

I hope this article helps to inform the general public and parents about RSV and many of the common questions surrounding it. Again, if you have any concerns regarding your child’s health status or feel he or she is unable to breathe easily, seek medical attention and let your pediatrician know!

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