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Treating RSV

by Sue Hubbard, M.D.

Last thoughts about RSV and the VIRUS that seems to spread like a wildfire in California. If only there was a vaccine for RSV everyone would be happier. Unfortunately that is not on the near horizon and we will continue to see RSV in doctor’s offices and hospitals every winter.

Babies who were born prematurely, or who have underlying cardiac defects, or lung problems may meet criteria (check with your doctor about specifics) to receive RSV immune globulin, which is called Synagis, during the winter months. By now you should know if your your-baby fits that description, as this is a shot that is given monthly to help prevent RSV in high risk babies, or at least lessen their symptoms if they acquire the virus. This shot is expensive and unfortunately is not given routinely.

As the name implies RSV is a virus and therefore does not respond to antibiotics. It really doesn’t seem to respond to much except supportive care, and tincture of time. Numerous studies have been done about using steroids, bronchodilators and other medication for treating RSV and most show that these drugs do not help speed the recovery from RSV. When parents feel baffled as to “why can’t you do something to make my your-baby better”, I explain that we can support them with oxygen if necessary, and even with intubation and mechanical ventilation for the most seriously ill. But even then, we just wait for the your-baby’s lungs to get better. Being in the hospital does not provide immediate recovery, there is still a lot of wait and see how quickly the virus decides to go “away”.

The other worry with RSV is dehydration. As with any illness these children don’t really feel like eating as well, and on top of that they are coughing and having trouble breathing. RSV also causes a huge amount of secretions and fluid loss that way too. It is important that your your-baby eat enough to continue to have the drool, watery eyes and nose and wet diapers. That may require feeding them more frequently as they may take less at each feeding (think how you feel when you are sick, not much appetite). If you think your your-baby is not getting enough fluid and has a dry mouth or decreased urinary output, even if they are not having respiratory distress you need to call the doctor.

Lastly, RSV seems to peak each year before flu and for some reason as RSV diminishes influenza rises. If your your-baby is six months or older, make sure you are getting their flu shots NOW!

That’s your daily dose, we’ll chat again soon.

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