As the weather cools off here in Rexburg, you will start hearing the letters "RSV" a lot, from your pediatrician's office, from daycare newsletters, and from other parents comparing notes. RSV, short for respiratory syncytial virus, is one of the most common illnesses young children pick up every fall and winter. Here is what it actually is, and how to know when a cold is something more.
What RSV looks like
For most children, RSV starts out looking exactly like a common cold. According to the CDC, symptoms usually show up four to six days after a child is exposed, and they tend to build up in stages rather than all at once. Watch for:
- Runny nose and congestion
- Sneezing and coughing
- Reduced appetite
- Fever
- Wheezing
For most healthy toddlers and preschoolers, RSV runs its course like any other cold and clears up on its own within a week or two.
Why it is different for babies
The virus is not always as mild for infants. The CDC notes that very young babies with RSV may not show the typical cold symptoms at all. Instead, the only signs might be irritability, lower activity than usual, and breathing trouble. That is part of why RSV gets so much attention around daycare and pediatric circles each fall.
Infants younger than six months, premature babies, and children with certain heart, lung or immune conditions are the ones most likely to develop a more serious lower respiratory infection like bronchiolitis or pneumonia from RSV. If you have a baby in this higher risk group, it is worth talking with your pediatrician before the season really gets going about whether an RSV immunization makes sense for your family. Two options exist for eligible infants, and your doctor can walk you through which one, if any, fits your situation.
How it spreads
RSV spreads the same way most fall and winter illnesses do in group settings like daycare and preschool: through droplets from coughing and sneezing, and through contaminated hands and surfaces. That makes it a close cousin to the colds and stomach bugs we talked about in our post on managing seasonal illness in child care, and the same prevention habits apply.
- Wash hands often, especially after wiping noses, before meals and after diaper changes.
- Cover coughs and sneezes with an elbow instead of a hand.
- Wipe down shared surfaces and toys regularly.
- Keep sick children home until they are feeling and acting like themselves again.
When to call the doctor
The CDC advises calling your child's healthcare provider if your child is having difficulty breathing, is not drinking enough fluids, or has symptoms that keep getting worse instead of better. A fever in a baby under three months old is always worth a call too.
Trust your instincts here. If something about your child seems "off," even if you cannot quite describe it, it is always worth calling the pediatrician's office. That is exactly the kind of judgment call only your child's doctor can make, and no one will think less of you for asking.
When it is an emergency
Some signs mean it is time to seek care right away rather than waiting for a callback. Head to the emergency room or call 911 if your child has real trouble catching their breath, becomes unusually hard to wake or keep awake, or develops bluish or grayish lips, tongue or fingernails. That last sign can be harder to spot on darker skin, so also watch for a gray or blue tinge around the lips and eyes.
What this means for daycare
A child with a plain runny nose, no fever, and good energy can usually still come to group care. Once fever, a worsening cough, labored breathing or real misery show up, it is time for a day of rest at home. The same 24 hour, symptom free guideline we use for other seasonal illness applies here too.
RSV season can feel intimidating the first time you hear about it, especially with a baby at home. The reassuring truth is that the large majority of children who catch RSV, including most babies, get through it with nothing more than rest, fluids and a little extra snuggling. Knowing the warning signs ahead of time just means you will recognize the moment to call for help if your child happens to need it.
Sources: CDC, Symptoms and Care of RSV; American Academy of Pediatrics, HealthyChildren.org, RSV: When It's More Than Just a Cold
