RSV Season Hits Early. What Parents Need To Know.
Bronchiolitis and RSV: The Latest Updates on the Best and Safest Ways to treat one of the most common illnesses seen in our Emergency Department
As fall arrives and winter approaches, parents all over Texas will prepare for more runny noses and doctor visits. As doctors, we are preparing too because RSV season seems to be here.
Last week, 10 children tested positive for RSV at Cook Children's. We've already had cases confirmed this week (and it's only Tuesday when we published this article).
As you can see from the chart, we are moving at a bit of a faster rate than in previous years. That's not a guarantee this year will be more severe, but it is a sign that we need to get ready for the upcoming Bronchiolitis/RSV season.
One of the most common illnesses we see is called bronchiolitis. Lots of viruses can cause bronchiolitis, but one of the most well known is RSV.
In 2016, almost 3,000 children visited Cook Children’s Emergency Department for bronchiolitis, and countless more saw their Cook Children’s pediatricians.Children with bronchiolitis may have a stuffy nose, cough, wheezing, fever, or fast and hard breathing.
So what is bronchiolitis, you ask? It is an infection of the small airway tubes in the lungs caused by a virus. It mostly affects children under 2 years old. The small airway tubes in these young children become swollen and fill with mucus.
The viruses that cause bronchiolitis live on surfaces. Your child may touch a surface contaminated with the virus at daycare, at the park, or even at the grocery store. The best way to prevent the spread of the virus is to wash your hands. We also know that children around cigarette smoke may become sicker from the virus because their airways are already irritated, so it is best to not smoke around your child.
Bronchiolitis is a frustrating illness for parents and doctors too. Children with bronchiolitis don’t sleep well due to stuffy nose and cough causing frequent nighttime wake ups. Your child’s snot can feel like a constant faucet. Unfortunately, there isn’t much we can do as parents or doctors to make it better.
The virus has been around for many years, which has given doctors lots of time to try out different medicines to try to make it better. In the past, doctors have tried breathing treatments like albuterol, steroid medicine, cough and cold medicine, and even sometimes antibiotics. We now know that these things don’t help and can make things worse.
Antibiotics treat bacterial infections, not viruses like bronchiolitis. Giving your child antibiotics when they aren’t needed may cause diarrhea, and over time can cause bacteria to become resistant to antibiotics. Breathing treatments are good for asthma, but the wheezing caused by bronchiolitis is different than the wheezing caused by asthma. Unnecessary breathing treatments can make children feel jittery and can make their heart beat too fast. Cough and cold medicines do not work either, and have dangerous side effects in children. The American Association of Pediatrics advises that children under 4 do not get these medicines.
Your doctor can listen to your child with a stethoscope and tell if they have bronchiolitis. A chest X ray is not needed, and doctors try to make sure that we never expose children to radiation from X rays when it is not needed. There are some tests that can tell if your child has a virus like RSV. These tests involve putting a swab in your child’s nose. Unfortunately, proving a child has a virus does not help us treat them better or change the way we manage their illness. For this reason, doctors will probably choose not to put your child through this uncomfortable test when it won’t make a difference.
The best way to treat bronchiolitis is to support your child and let their immune system do the work. This means making sure they have plenty of fluids and sleep. You also can help them clear out the mucus by using a cool mist humidifier and loosening up the mucus with saline drops in the nose. Do not use water.
Children under 2 have a hard time blowing their nose. You can help suck out the mucus in a couple of ways. One is the bulb suction that you likely received when your child was first born. There are also several new suction devices in stores that are easy and work well. One is called Nose Frieda. You should try to suck out the nose if your child is sounding very congested and before they eat.
You should call your doctor if your child is breathing very fast, using extra muscles between the ribs to breathe, is difficult to wake up to eat, will not calm down and is very irritable, or if you are worried about their fever. Tylenol can be used for fever, and ibuprofen can be used if your child is older than 6 months. If your child is younger than 2 months old and has a fever, you probably need to see a doctor right away.
You should head straight to the doctor’s office or emergency room if your child is blue around the lips or face, is struggling for each breath, or is limp and floppy. These are signs of serious illness. Thankfully, most of the time bronchiolitis is much more mild. Even mild symptoms can be scary for parents. Always talk to your doctor if you are worried or have a question that is specific to your child’s illness.
Get to know Stacey VanVliet, M.D.
I’ve known that I would be a pediatrician since kindergarten. Back then, I knew that I wanted to help people and couldn’t think of a better way. As time passed, I realized that working with children made my world a lot brighter. Practicing medicine can be challenging, but I feel it’s important to be challenged to grow as a person. Now, I have the best job in the world, helping children grow into healthy adults.
In my spare time I like to paint, play soccer, and garden. I also enjoy cooking and am always looking to try new foods. My husband and I also love to travel.
What is a Hospitalist?
Dr. VanVliet is a hospitalist at Cook Cook Children's. Cook Children's Hospitalist Group is a team of board eligible and certified pediatricians who specialize in caring for patients while they are admitted to Cook Children's Medical Center. One of the hospitalists will see your child daily and is available 24 hours a day to manage any urgent medical needs of hospitalized children. Click to learn more about them and how they care for your child.