RS Virus Infection: Causes, Symptoms & Treatment

In the autumn and winter months, children are constantly cold. However, if pronounced shortness of breath and a marked lassitude are added, the pediatrician should be consulted immediately to rule out an RS infection. This is especially true for babies and young children.

What is RS virus infection?

Respiratory syncytial virus (RS virus) spreads via droplet or smear infection and causes sometimes severe cold and respiratory symptoms, especially in babies and children up to two years of age. These manifest as cough and cold with high fever. The virus can spread to the bronchial tubes and cause bronchitis, pneumonia or bronchiolitis. This disease makes the mucous membrane of the bronchial tubes swell and causes massive discomfort when breathing. Noticeably rapid and shallow breathing are also signs of respiratory distress. The lips and fingernails may be bluish in color due to insufficient oxygen saturation in the blood. RS virus usually occurs in the winter months and spring. Older children and adults have less pronounced symptoms when infected with RS virus and usually become only mildly ill.

Causes

The causative agents of RS virus infection are viruses that spread especially during the months of September through April. They are passed by smear or droplet infection in daily contact with the baby or young child and are highly contagious. Because the first signs of illness are delayed, virtually any person in contact with a child can unknowingly become a carrier. The time between infection and the onset of the disease is about two to eight days. Children whose immune systems are still weakened by an illness they have just overcome and premature infants are particularly susceptible to RS infection.

Symptoms, complaints, and signs

Children in their first year of life often develop RS virus infection. Permanent formation of antibody particles does not occur. Therefore, the immune system is not prepared against reinfection in subsequent years. The inflammatory disease affects the upper and lower respiratory tract. The pharynx, mouth and nose, but also the bronchial tubes and lungs are affected. Outbreaks in the bronchi are referred to by physicians as RSV bronchiolitis. After about three days of incubation, the first symptoms appear. Increased body temperature and breathing difficulties are the main characteristic features. In addition to an accelerated respiratory rate with rales, a cough with mucopurulent sputum accompanies the disease. In some cases, those affected find it extremely difficult to catch their breath. Children may also develop severe coughing fits similar to whooping cough. Due to the high loss of fluid, dry, hypothermic and colorless skin is also manifested. Newborns sometimes exhibit a depressed fontanel. The remaining symptoms are similar to those of influenza, with a general feeling of illness, fatigue, and a low desire to drink and eat. The severity of the infection tends to be considered lowered in adults. Nevertheless, the spectrum of symptoms remains highly variable. Extremely mild cases in otherwise healthy patients are also called silent RSV infections. Otherwise, rhinitis, irritable cough and sore throat dominate the clinical picture. Severe disseminations are still possible, but remain relatively rare. A special and dangerous unique feature primarily causes danger to life in premature infants: due to the RS virus, breathing tends to be increasingly interrupted up to a complete stop.

Diagnosis and course

Because RS virus infection is dangerous, especially for babies and young children, a pediatrician must be consulted immediately in the event of a cold that is accompanied by massive breathing problems. This is especially the case if the child shows significantly worse drinking behavior. The doctor can exclude this dangerous infection by a blood test. In case of a severe course with impairment of the respiratory tract, it is necessary to hospitalize the child to ensure constant monitoring of respiratory function. In addition to the RS virus infection, there is often an infection with bacteria, which can be life-threatening, so that ventilation is necessary. To prevent dehydration (dehydration), a feeding tube is placed in this case to ensure an adequate supply of nutrients.

Complications

RS virus infection can lead to severe complications in some high-risk patients. The risk is particularly high in newborns and babies in the first year of life. In infants and young children, fever always occurs up to a temperature of 38 to 39.5 degrees. Furthermore, infants suffer from cough, breathing difficulties and runny nose. The breathing difficulties often also cause weakness in drinking, which can lead to dehydration. Young children are also at risk of developing acute bronchiolitis. This results in severe respiratory distress, which can even be fatal. Affected children must be supplied with sufficient oxygen via an oxygen mask. Parenteral nutrition is administered so that the airways are not irritated by possible aspiration of food residues. Otherwise, there is a risk of superinfections with bacteria, which can even be fatal. In about five percent of children, pseudocroup subsequently develops as a complication. Infants are even at risk of dying from sudden infant death syndrome. Premature babies and children with cystic fibrosis or heart and lung diseases are particularly at risk. However, RS virus infection does not only occur in infants and young children. All other age groups can also be affected. In adulthood, the disease is usually mild or even asymptomatic. However, there are high-risk patients in whom serious complications can occur. These risk groups include people who have cardiovascular disease, immunocompromised individuals, and people with Down syndrome.

Treatment and therapy

Treatment of RS virus depends on the symptoms that occur. For mild courses, administration of nasal sprays as well as medications to dilate the bronchial tubes as well as liquefy mucus can help relieve respiratory symptoms. Inhalation with a saline solution is also helpful, but must always be done with necessary caution and under supervision in babies and young children. It is important to offer the child enough to drink during the illness and not to lay the child completely flat in bed. A pillow in the back makes breathing easier. However, babies under six months of age are often hospitalized because they are more likely to have a severe course of the disease. In the hospital, they can receive supplemental oxygen or be ventilated for a short time in an emergency. The use of antibiotics is only relevant if there has been an additional infection with bacteria, as these drugs have no effect on viral diseases such as RS virus infection.

Prevention

There is currently no vaccination against RS virus infection that is available to all children. Because of cost, only children from special risk groups can be immunized. In addition to the cost aspect, this immunization is also very costly, as it must be repeated monthly. To prevent infection, all persons in contact with babies and young children should ensure adequate hygiene of their hands. These should be washed with warm water and soap for at least one minute. If the parents have a cold, contact should be limited. Wearing a mouthguard to prevent RS virus infection is also recommended.

Follow-up

RS virus is transmitted from person to person by droplet or smear infection. There is no direct therapy or chemoprophylaxis against these viruses; only symptoms can be treated. Only in high-risk patients such as premature infants, people with previous pulmonary or cardinal disease, or immunocompromised patients, passive immunization with monoclonal antibodies is recommended. The protective effect begins after the 1st dose of vaccination, but reaches the full maximum effect only after the second dose administered. Since the disease can reoccur even after a previous infection, strict hygiene rules should be observed for follow-up care, especially in vulnerable groups. These include: frequent hand washing, coughing and sneezing not into the hands but into the crook of the elbow. Persons infected with the virus should avoid communal facilities during the infectious period and regularly clean and disinfect used objects, such as toys. The generally recommended vaccination status should also be checked and, if necessary, refreshed in order to avoid further complications such as co-infections.Since the RS virus infection mostly affects the bronchial system, the symptoms of the so-called hyperreactive bronchial system may remain even after the disease has subsided. This in turn increases the risk of developing asthma. Therapy is therefore also directed at suppressing this symptom complex with anti-inflammatory and/or bronchodilator drugs.

What you can do yourself

Infants and children affected by RS virus infection absolutely must seek medical treatment. The younger the child, the more dangerous the course of the infection may be. If a severe course of the disease is indicated, parents should take their child to a hospital, where he or she can be provided with fluids and oxygen if necessary. Respiratory syncytial virus (RS virus) is highly contagious and can infect anyone, including adults. Like most viral infections, it can only be treated symptomatically. This means that the individual symptoms such as sore throat, cough, cold, bronchitis and fever should be relieved accordingly. If the course of the disease is mild, a nasal spray is sufficient to decongest the mucous membranes of the nose. If the illness is more severe, the doctor will recommend medications that liquefy mucus and help with expectoration. It is important that the patient drinks a lot. Chicken soup is also recommended in this case. It warms from the inside and its hot steam moistens the mucous membranes. In addition, the soup contains cysteine, a protein substance that has an anti-inflammatory and decongestant effect. Calf wraps are a gentle way to lower the temperature, because cold wraps draw heat from the body. Saline or chamomile inhalations have also proven effective. The hot steam clears the nose and soothes irritated mucous membranes. Since the RS virus infection is often accompanied by shortness of breath, it is advisable to elevate the patient slightly. This makes breathing easier.