RSV, or Respiratory Syncytial Virus, is a highly contagious virus that frequently spreads among preschool children, especially those who are less than 6 years old and attend kindergarten or pre-kindergarten. In Thailand, this virus becomes particularly concerning during the rainy season, which typically spans from July until November. This period also coincides with the opening of the school semester, creating an environment where children are more susceptible to respiratory illnesses. During this time, various viruses, including Influenza, Parainfluenza, and other respiratory viruses, become prevalent. Additionally, diseases not directly related to the respiratory system, such as hand-foot-and-mouth disease, tend to spread more easily in the rainy season. Among these, RSV is one of the most significant concerns for parents.
 

What is RSV?

RSV, short for Respiratory Syncytial Virus, is a virus that primarily causes respiratory diseases. It can affect both the upper respiratory system, which includes the nose, larynx, and throat, and the lower respiratory system, which includes the large bronchi, small bronchi, and lungs. While children above 6 years old, and occasionally adults, may only experience symptoms in the upper respiratory system, RSV in young children from birth to 6 years can impact both the upper and lower respiratory systems.
 

Symptoms of RSV in Children:

• Fever (low to high), usually the first 2 days
• Clear nasal discharge initially that may become stickier over the next few days
• Productive cough, sometimes coughing until vomiting
• Wheezing and difficulty breathing (if the virus spreads to the lower respiratory system)

Treatment for RSV

When parents bring their child to a pediatrician, the treatment approach will depend on the severity of the symptoms. Children with milder symptoms may be treated as outpatients, while those with more severe symptoms or multiple congenital diseases may require hospitalization. Since there is currently, no medication available to completely eradicate the RSV virus, treatment primarily focuses on alleviating the symptoms. This may include IV fluid hydration, the use of nebulized bronchodilators to loosen up sticky phlegm, and drugs to reduce mucus production. In some cases, especially when super imposed bacterial infection is suspected antibiotic may be indicated.  Or if the child has pre-existing conditions such as respiratory allergies problems, or reactive airway disease, anti-inflammatory drugs or steroids may be needed.
 

RSV Outbreak Season

The rainy season in Thailand, lasting from July to November, is also the peak time for RSV outbreaks. During this period, parents need to be particularly vigilant. If a child begins to show symptoms of a cold, it is essential to consider the possibility of RSV or Influenza, which are more common during these months. Early detection and timely treatment are crucial to manage the illness effectively and prevent more severe complications.

Prevention Strategies for RSV

Preventing RSV involves a combination of general and specific preventive measures. General prevention strategies include maintaining good hygiene, such as regular hand washing, wearing masks, and avoiding crowded places where sick individuals may be present. If a child is unwell, they should remain at home to prevent spreading the virus to others. Specific prevention measures can involve vaccination or immunization against RSV. However, it is important to note that in Thailand, there is currently no RSV vaccine available, for children in general. The existing RSV vaccine is intended for adults aged 60 and older, as elderly individuals can also experience severe symptoms from RSV infections.
For young children who have congenital diseases or other risk factors, such as premature birth, lung disease, heart disease, or weakened immune systems, there are ready-made immunizations available, called specific immunoglobulin.  This immunoglobulin is different from regular vaccines as they offer immediate immunity.  However, this immunity is short-lived, lasting for no more than one month. Therefore, during the rainy season, from July to November, these long-acting antibodies must be administered every month for five consecutive months to provide adequate protection. It is essential for parents to consult with a pediatrician to determine whether their child should receive this type of immunization.
Hopefully, in the near future we may have regular RSV vaccination for our heathy kids.
 
 
by Dr. Karl Kalavantavanich