When to Call a Pediatrician or Go to the Hospital if RSV is Suspected

The RSV season started early this year nationally, and according to Intermountain’s GermWatch, doctors are anticipating RSV may continue circulating for several weeks to come. There is also high influenza (flu) activity in Utah right now.

“We typically see the most severe illness with RSV in children under age one and to a somewhat lesser degree under age two. Usually by age two, most have had RSV once or twice. After age two, RSV doesn’t usually make children as sick. It looks more like a typical cold,” said Russ Bradford, MD an infectious diseases-trained pediatric hospitalist and medical director of the children’s unit at Intermountain Park City Hospital.

“However, perhaps due to the COVID precautions we took during the pandemic, we have more children who didn’t get RSV in the last two to three years, so they don’t have immunity. So, this year we are seeing rapid spread of RSV, and we seem to be seeing more older children with significant symptoms. Unfortunately, there is no specific treatment for RSV, but what we can do is provide kids with supportive care while they get better, like extra oxygen,” he added.

“Our hospitals are very busy and anticipating a few more tough weeks,” he said. “We are  happy we can care for children at Park City Hospital, because we’re trying to keep children at hospitals close to home, if possible,” he said.

“Often, children with RSV can end up with bronchiolitis, which is a viral infection of the smallest airways in the lungs. It is most famously caused by RSV but can also be caused by several other viruses. For many kids, RSV can be as simple as a cold, but in some it can cause more severe symptoms, such as low oxygen levels, labored breathing, fever, and sometimes dehydration. With severe symptoms, it may be necessary to keep children overnight at the hospital,” he added.

Many Intermountain hospitals in Utah from southern Idaho down to St. George are able to admit children overnight, including several with a dedicated inpatient pediatric unit with pediatricians who specialize in taking care of hospitalized children. Keeping a child at a hospital close to home is much more convenient for families. They’re closer to their social support system and their primary pediatric providers.

A good rule of thumb is if your child needs to go to the emergency room, take them to the closest hospital. They can help stabilize your child and determine if they can be treated locally. If needed, pediatric providers at community hospitals can consult with pediatric experts to help provide the child with the best care. In severe cases, sick children can be transferred to Primary Children’s Hospital.

Why young children are susceptible to RSV

Young children have narrow airways and the inflammation and mucous that are associated with RSV infection can make it difficult to breathe and to get oxygen into the bloodstream. They may start to wheeze. Younger infants can have trouble eating or drinking and can get dehydrated.

Ways to help protect babies and toddlers from RSV

Dr. Bradford says there’s not a vaccine for RSV, although one is being worked on nationally. So, the best way to protect young children from RSV is to keep them from being exposed to the virus, if possible. Recommendations are to:

1.  Stay away from people who are sniffling and sneezing.
2. Keep infants at home and don’t let sick people come visit your children.
3. Wear a mask if you have any scratchy throat or runny nose and are around infants.
4. Wash hands frequently.
5. Cover coughs with an elbow or tissue.
6. Use a disposable tissue once and throw it away, and wash hands afterward

“Mild symptoms in adults may be because of dry air, inversion, RSV or another virus, and it’s difficult to tell the difference because RSV is so mild in adults,” said Dr. Bradford, “but remember that your mild symptoms could be from a virus that is potentially dangerous for young children.”

Protect children from the flu and COVID-19 with vaccinations and boosters

Dr. Bradford says that it is equally important to protect children from the flu and COVID-19. It’s recommended that children over six months of age get a flu vaccine. The flu vaccine is the best way to defend against the flu virus each year. It reduces your chance of getting sick from the flu and can minimize the severity of your symptoms if you do get it. The flu can be deadly for young children. If you haven’t gotten your flu vaccine yet, it isn’t too late. Flu has a long way to go before it peaks, and we can have multiple outbreaks of flu in the same season.

It’s also recommended that older kids and adults receive a COVID booster. The CDC recommends everyone five and older receive one updated bivalent booster if it has been at least two months since their last COVID-19 vaccine dose. Parents should talk to their pediatrician if they have any questions.

When to seek medical help

If your child does get sick, there are signs you can look for to help you know when to talk to your pediatrician or go to an urgent care center or emergency room:

• Breathing faster than normal
• Struggling to breathe
• Skin between the ribs or below the ribcage pulling in when breathing (called retractions)
• Noisy breathing
• Coughing episodes that they have trouble recovering from
• Bluish color around the lips or face
• Infants who are not able to breastfeed or feed from a bottle
• Older children who are not able or willing to drink liquids
• Decrease in urine (fewer wet diapers)

Russell Bradford, MD, is an infectious diseases-trained pediatric hospitalist with Intermountain Medical Group.  He serves as medical director of the children’s unit at Intermountain Park City Hospital, consults with patients at Park City, McKay-Dee, Utah Valley, and other Intermountain Healthcare hospitals.

For more information call your pediatrician or visit:

• https://intermountainhealthcare.org/services/pediatrics/
• www.germwatch.com
• https://intermountainhealthcare.org/COVID
• https://intermountainhealthcare.org/flu

About Intermountain Healthcare

Headquartered in Utah with locations in eight states and additional operations across the western U.S., Intermountain Healthcare is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 3,900 employed physicians and advanced care providers, a health plans division called SelectHealth with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information and updates, click here