Respiratory Syncytal Virus
RSV—common cause of Pn and Broncholitis in children less than 1 yr.
Fever, Runny nose, cough, sometimes wheezing
Prevalence: 0.5 to 2% requires hospitalization
Most recover is 8 to 15 days
Most common in late fall or winter—is the cause of one of the com. cold
A little about the virus:
(The virus is unstable and can not survive on counters or doorknobs for more than a few hours. Soap and water gets rid of it)
Acquired through contact
Diagnosis: viral antigen detection and viral RNA detection taken from nasal secretions…but mostly diagnosed through the symptoms
CXR show chest hyperinflation
Treatment: mostly symptom relief (Tylenol for fever)
Sometimes hospitalization and O2 therapy
Ribavirin is a medication used for severe treatment
--because of toxicity, pregnant health care workers should not care for children taking this medication.
--VERY occasionally given, but IF given, it is given through O2 t tent q 12-18 hours, for 3-7 days.
--turn off machine before lifting hood, because med can cause burning eyes and crystallization of eyes when wearing contacts.
Cluster care to minimize intrusions
IV fluids are given because of weakness, fatigue, and tachypnea
--given until acute crisis of disease is over
I & O monitoring (when wearing diapers ~ 1g wet diaper = 1 mL Urine)
Bronchodilators and steroids are rarely used
Prevention: Strict hand washing
RSV immune globulin IV monthly infusion
Synagus (palivizumab) medication given IM is a monoclonal antibody
given to “high risk” infants and children up to age 2 during winter season.
--this is the preferred way of prevention!
“High risk children” include…
Those that have chronic lung disease (CLD) and who have required medical therapy for CLD.
Premature infants born at 32 weeks of gestation or earlier
Premature infants born at 28 weeks of gestation or earlier benefit from IV RSV immune globulin.
If the infant is born between 32-35 weeks of gestation and are less than six months old during the winter season (so they would be born after July) they may get this IM therapy, however, this is carefully chosen)
RSV a impaired gas exchange, hypoxemia, and respiratory acidosis
Parent Education: contact Dr. when…
high fever, severe wheezing, difficulty feeding due to blocked nasal airway, chest retractions.
good hand-washing and keeping toys clean.
Frequent oral fluids
S/S of dehydration
All of these S/S get worse with worsening dehydration…
Drying Mucous membranes
Absence of tears
Loosing visibility of Jugular vein
Delaying capillary refill
Urine specific gravity h
Frequent respiratory infections
salty taste on skin
delayed sexual development
no meconium stool as newborn
frothy stools as a infant due to inability to digest food
abdominal distention & bloating
poor weight gain
Inability to digest or absorb