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RSV (Respiratory Syncytial Virus)
Q: I had a recent outbreak of RSV in the Infant Section of the Child Care Center. I was trying to get some information from the Internet to pass onto the parents. I was unable to locate anything. I was hoping you could give me some info on "RSV." Thank you for your time and attention to this email.
A: Respiratory Syncytial Virus (RSV) causes acute illness involving the respiratory system. RSV is the most common cause of bronchiolitis (infection of the small air tubes of the lungs) and pneumonia (infection in the lung tissue) in young infants and children. It is spread person-to-person by direct or close contact. This virus can survive on hands for a short period of time, and on inanimate objects, such as a crib rail for as much as several hours. The incubation period is less than one week. The most severe illness resulting from RSV is in infants and young children who have less than optimal lungs, heart, or immune systems. It tends to happen most often in the winter and early spring. It can spread among children and adults in a household or a daycare situation.
There is no special medicine that is used routinely to treat a child with a RSV infection. Ribaviran, a medicine used against this virus, has had varied success in the more severe cases that require hospitalization. Good hand washing remains our best available treatment. This helps to decrease the chances of it spreading from one person to another, particularly when hands are washed well between caring for infants in daycare.
RSV- immune globulin intravenous (RSV-IVIG)--was licensed by the Food and Drug Administration (FDA) in 1996 to hopefully prevent severe RSV disease in those pediatric patients most at risk (for example, children younger than 2 years old with chronic lung disease or premature birth). Just recently, the FDA also approved the use of another antibody preparation directed specifically against RSV (palivizumab) for protecting high-risk children against serious complications from RSV. These preventive therapies are recommended from the beginning to end of the RSV season. Parents should check with their child's doctor about whether either preventive approach is considered appropriate for their child.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.