RSV is common but not as deadly as once believed
Respiratory syncytial virus (RSV) has been worrying parents of young infants for decades. This infection has long been characterized as dangerous and even deadly. It can cause severe breathing difficulty and is one of the most common causes for pediatric hospitalization, especially in infants less than six months of age. Since the 1970s, RSV had been thought to cause death in as many as 4,500 babies a year. However, a December 2014 study published in Pediatrics revealed some encouraging data on just how deadly this virus can be.
Dr. Carrie Byington, professor of pediatrics at the University of Utah and the study’s lead investigator, looked at over 850,000 RSV-associated hospitalizations between 2000 and 2011. From two large datasets, she found that instead of roughly 4,500, only about 42 children die annually in the United States from RSV infection. That difference is huge and should be reason for parents to have much less fear if their young infant contracts the virus. “The news is very good for parents and their babies,” says Dr. Byington.
Since the 1970s, medical care for RSV has dramatically advanced. “Although RSV is one of the most common causes for infant hospitalizations, we can support infants through this infection.” Byington said.
What was found in the study is that among those with RSV who died, a majority had complex chronic medical conditions such as congenital heart disease, immune disorders, or lung disease secondary to prematurity.
RSV affects nearly all children prior to age 2-3 years old. Symptoms of RSV include common cold symptoms such as mild cough, nasal congestion, and sometimes a fever. If your child has these symptoms and is having difficulty feeding or breathing, your pediatrician should be contacted for prompt evaluation. Most hospitalizations will be 2-3 days in length and typically only require supportive care (such as intravenous fluids, supplemental oxygen, and nasal suctioning).
Reviewed by Dr. Sara Connolly, January 2020
Takeaways
- Deaths associated with RSV are uncommon in the United States in the 21st century.
- Infants with complex chronic medical conditions account for the majority of deaths associated with RSV.
- High-risk infants and children with cold symptoms causing difficulty feeding or breathing should be evaluated by their pediatrician promptly.
Because most children less than 2 years of age become infected with RSV, there seems to be a statistical correlation with asthma. But, are we talking about the chicken or the egg? Is RSV bronchiolitis just the first asthma exacerbation an infant or toddler has or is the RSV bronchiolitis the cause for future asthma exacerbations? More studies are needed to find out whether prevention of severe illnesses (in young children) can prevent or modify severity of future problems with respiratory illnesses. Remember, most children end up having an infection with RSV and most children do not have asthma. But, children with asthma often have a history of early respiratory infections like RSV.
Thank you for your feedback. My pediatrician believes she might have pediatric asthma and will hopefully outgrow it. My fingers are crossed that she does!
My daughter had RSV bronchiolitis at 4 months old. She was hospitalized, treated and recovered fairly quickly within several days. The pediatrician had said she was “clear”upon discharge and then wanted her to come back every three weeks because she had “asthma.” Clear, but asthma? I took her to another pediatrician. No asthma. She never had a respiratory episode other than a regular cold ever since, and she is now 24.
My daughter got RSV at 2 months old. Now at 17 months, she continues to have respiratory issues. She was recently diagnosed with RSV yet again and needs the nebulizer almost every time she gets a cold. Is there any link between having RSV at such a young age and continuing to have respiratory problems though out childhood?