Cases of RSV (respiratory syncytial virus) infections in North Texas commonly increase in the winter. But this year, it's arrived earlier than usual. During the week of Nov. 20, 2016, 47 Cook Children’s patients tested positive for RSV. During this same time frame in 2015, only 9 kids had tested postive and the number was 18 in 2014.

A simple cold can quickly progress to bronchiolitis caused by the RSV virus, especially in kids under 2 years old. As a parent, here are a few things you need to know about RSV.

1. What is RSV?

RSV is a virus that impacts the respiratory tract, including both the upper and lower airways. It usually starts with cold-like symptoms, such as a stuffy nose and sneezing, but could progress to include a cough, fever or wheezing.

2. How does my child get RSV? Is it contagious?

The virus is spread through droplets caused by coughing and sneezing that linger in the air or land on surfaces. This virus can live on surfaces for about six hours and survive in the air for about 30 minutes.

3. How long does the illness last?

Illness can begin between four and six days after exposure to the virus, and can last for a week or two. Symptoms may continue longer in infants or patients with weakened immune systems.

4. How is it treated?

In most cases, supportive care is all that is necessary. This includes elevating the head of the bed, running a cool mist humidifier and using a nasal bulb for suctioning to clear secretions. Some children develop wheezing, in which case treatment with prescription albuterol through a nebulizer may be helpful. In more severe cases, deep suctioning, supplemental oxygen and hospitalization may be necessary.

5. When should I be concerned?

If your child is having difficult or labored breathing, as evidenced by retractions (tugging of the muscles around the ribs and abdomen), nasal flaring or shallow breaths, they need to be evaluated by your pediatrician.

6. How do I prevent it?

As with any other airborne disease, it is important to cover coughs and sneezes to prevent spread of the virus. Kids should avoid touching faces with unwashed hands, practice good hand-washing techniques and avoid contact with sick individuals. Parents should keep surfaces, like crib railings and toys, sanitized regularly and use disinfectant sprays. There is a vaccine available for certain premature babies or babies with underlying diseases. Talk to your pediatrician to see if your child qualifies for the vaccine.

In the absence of complications, RSV can usually be handled at home with supportive care and kids will feel better fairly quickly. If your child’s symptoms concern you or they show signs of difficulty breathing or dehydration, see your pediatrician right away.

Because societal factors such as TV, school, friends and the Internet can strongly influence a young child’s behaviors, it’s important that parents help young ones map out and focus on a few simple, healthy resolutions that can later translate into positive behaviors as children grow and develop.

“Making New Year’s resolutions can be very beneficial for children because it teaches them the importance of setting goals and following through,” said Lizy Varughese, M.D., a pediatrician with Cook Children’s in Lewisville. “Not only can goals be applied to a child’s eating habits and physical activities, but they also teach important life lessons about the benefits of planning ahead and the success that comes from it.”

While it may be tempting as a parent to jump ahead and make a list of New Year’s resolutions for your child rather than waiting for them to develop a list on their own, empowering your kids to creatively embrace this time-honored tradition can be filled with good times and great memories.

Encourage children to start with a list of broader, bigger goals such as eating less junk food, picking up their toys or making better grades. No matter how far-fetched the goals may seem at first glance, parents should stay open-minded and flexible, resisting the urge to criticize their child’s resolutions. Remember, keeping the mood light and enthusiastic makes goal setting seem less like work and more like fun.

From there, Dr. Varughese suggests children break down their resolutions into small bites by using journaling as a method to solidify goals.

“Begin the new year by writing down specific goals for eating and participating in sports and exercise activities,” Dr. Varughese said. “Children are more likely to complete a task if it’s written down and there is accountability for their progress. It’s also important to be flexible so the parent can help kids for a more attainable goal if a particular goal is not met or seems difficult for the child.”

About the source

Dr. Varughese attended Texas A&M University and received a B.S. in Biomedical Sciences. She attended medical school at the University of Texas Health Science Center in Houston, Texas and completed her residency at Stony Brook University Hospital, Long Island, New York. She was then appointed Clinical Professor of Pediatrics from 2005-2006. After that, she joined a private practice in New Jersey for five years. She moved back to her hometown of Dallas, Texas, and joined Cook Children's Physician Network in Lewisville in 2013.

She is married to Dr. Shane Varughese and has two children, Noah and Sarah. Dr. Varughese enjoys photography, cooking, and church activities. Her passion in life is taking care of children and educating families on preventative care and battling childhood obesity.

The flu season is upon us once again ... what do you need to know as a parent?

1.What are symptoms of the flu?

The flu may start like the common cold with symptoms of cough, congestion and runny nose, but may also be associated with prolonged fever, muscle and body aches and fatigue. It is spread from person to person when an infected person, coughs, sneezes or talks and droplets are released into the air. It can also be spread less often from touching surfaces where drops are present. The flu virus is contagious from up to 1 day before the person presents with symptoms and up to 5-7 days after the symptoms resolve.

2. How can you protect yourself?

The best way to protect yourself is by getting the flu vaccine as soon as it becomes available. Most doctors’ offices and clinics currently do have the flu vaccine available. Last year, flu activity peaked at the end of December to the beginning of January, but you may start seeing it as early as September-October this year.

Other means to protect yourself are effective hand washing and wiping down surfaces with anti-bacterial/viral cleansers.

3. Why get the flu vaccine?

In the United States each year, more than 200,000 people are hospitalized from seasonal flu-related complications. Last year, there were more than 105 pediatric flu related deaths in the United States. On average the effectiveness of the flu vaccine last season was about 61 percent.

4. Who should get the flu vaccine?

• Everyone over the age of 6 months.
• Higher risk populations include those between the ages of 6 months to 5 years, children with asthma or other chronic disease, pregnant women, people with immune problems and adults  more than 65 years old.
• Children under the age of 8 MAY require 2 doses of the vaccine 4 weeks apart from each other depending on their previous immunization status.

5. Which flu vaccine is recommended?

There are several options for flu vaccines this year. For 2014–15, U.S.-licensed influenza vaccines will contain the same vaccine virus strains as those in the 2013–14 vaccine.

Trivalent flu vaccine protects against two influenza A viruses (an H1N1 and an H3N2) and an influenza B virus. This is only available in the injectable form.

The quadrivalent flu vaccine protects against two influenza A viruses and two influenza B viruses. The quadrivalent form is available as an injection and a nasal spray.

Specific Age Recommendations

• 6 months to 2 years: injectable flu vaccine only.
• 2 years to 8 years: nasal form is preferable according the Centers for Disease Control and Prevention (CDC). There was 50 percent more effectiveness with the nasal form vs. the injectable form in this age group. If the child is between the ages of 2 and 4 and has asthma or wheezed in the last year, then the injectable form is recommended.
• 8 years and above: either form is acceptable.

6. What happens if you get the flu?

See your health care professional as soon as possible because if it is treated with anti-viral medications in the first 48 hours, the duration as well as the severity of the illness can be decreased. The CDC does not recommend treatment of healthy individuals with anti-viral drugs, but certain high risk populations will benefit from treatment.

1. What do you need to know as a parent?

The flu may start like the common cold with symptoms of cough, congestion and runny nose, but may also be associated with prolonged fever, muscle and body aches and fatigue. It is spread from person to person when an infected person, coughs, sneezes or talks and droplets are released into the air. It can also be spread less often from touching surfaces where drops are present. The flu virus is contagious from up to 1 day beforethe person presents with symptoms and up to 5-7 days after the symptoms resolve.

2. How can you protect yourself?

The best way to protect yourself is by getting the flu vaccine as soon as it becomes available. Other means to protect yourself are effective hand washing and wiping down surfaces with anti-bacterial/viral cleansers.

There are multiple flu vaccines available but the two common types are the inactivated virus which comes in the injectable from and the live virus which is the nasal form. The determination of which vaccine is right for you will be made by your healthcare professional.  Most important to remember, you CANNOT get the flu from either vaccine. Minor side effects may include congestion and runny nose for 2-3 days.

3. Why get the flu vaccine?

Even healthy persons who have never had the flu in the past can get the flu and experience serious complications. Older people, young children, pregnant women and people with medical conditions like asthma, diabetes, heart disease, or kidney disease are at especially high risk from the flu, but kids, teens and adults who are active and healthy also can get the flu and become very ill from it. In the United States each year, more than 200,000 people are hospitalized from seasonal flu-related complications. Last year from September 30 to February 9th, 64 children died from flu-related complications.

4. Who should get the flu vaccine?

Everyone over the age of 6 months.

Higher risk populations include those between the ages of 6 months to 5 years, children with asthma or other chronic disease,  pregnant women, people with immune problems, and adults  more than 65 years old.

Children under the age of 8 MAY require 2 doses of the vaccine 4 weeks apart from each other depending on their previous immunization status.

5. How is this year’s flu vaccine different than last year’s?

Last year, the flu vaccine contained two common Type A strains called H1N1 and H3N2, and one strain of Type B. This year, a new quadrivalent form of the vaccine is available which includes the two Type A strains and 2 Type B strains.

Manufacturers anticipate producing between 135 million and 139 million doses of flu vaccine this year, but only about 30 million doses will offer the four-strain protection. All of the nasal live virus formulations will be the quadrivalent and a portion of the injectable form will be quadrivalent. The CDC and the AAP does not recommend one over the other, as long as you get vaccinated.

6. What happens if you get the flu?

See your health care professional as soon as possible because if it is treated with anti-viral medications in the first 48 hours, the duration as well as the severity of the illness can be decreased. The CDC does not recommend treatment of healthy individuals with anti-viral drugs, but certain high risk populations will benefit from treatment.

Lizy Varughese, M.D., joined Cook Childrens Physician Network in Lewisville in 2013. She is married to Dr. Shane Varughese and has two children, Noah and Sarah. Dr. Varughese enjoys photography, cooking, and church activities. Her passion in life is taking care of children and educating families on preventative care and battling childhood obesity.