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Rsv Identification & Treatment Respiratory syncytial virus (RSV) was first described as “acute catarrhal bronchitis” in 1901. However, it was officially discovered in 1956 and has since been recognized as one of the most common causes of childhood illness. It causes annual outbreaks of respiratory illnesses in all age groups. In most regions of the United States, RSV circulation starts in the fall and peaks in the winter. RSV is responsible for 60,000-120,000 hospitalizations and 6,000 to 10,000 deaths among adults 65 years and older. In addition, RSV is responsible for approximately 58,000-80,000 hospitalizations and 100–300 deaths in children younger than 5 years old. RSV infections can cause a variety of respiratory illnesses in infants and young children. It most commonly causes a “cold-like” illness but can also cause lower respiratory infections like bronchiolitis and pneumonia. One to two percent of children younger than 6 months of age with RSV infection may need to be hospitalized. Severe disease most commonly occurs in very young infants. Additionally, children with any of the following underlying conditions are considered at high risk: • Premature infants or those with birth weight <2500 grams (5.51lb) • Infants, especially those 6 months and younger • Children younger than 2 years old with chronic lung disease or congenital heart disease • Children with suppressed immune systems • Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions • Children exposed to tobacco or other air pollutants While children are most affected by RSV, adults are not immune to the virus. Specifically, those adults over 65 years of age, those with chronic lung or heart disease and those with weakened immune systems are at increased risk of RSV complication including pneumonia. In addition, RSV can exacerbate other chronic illnesses, such as congestive heart failure, COPD, and asthma. RSV symptoms varies between age groups. Infants typically present with poor feeding, irritability, lethargy, apnea, rhinorrhea (runny nose), cough, sneezing, fever, shortness of breath, wheezing, sore throat, or respiratory distress. While older children and adults typically present with “cold symptoms” such as congestion, cough, fever, runny nose and wheezing. Symptoms generally peak around day five of the illness, with improvement often seen by day 7 or 10. However, the cough may linger for up to four weeks. Treatment consists of early identification with airway and respiratory system management. Many affected children are managed well at home with symptom support. However, sometimes symptoms get out of control causing airway/respiratory difficulties. When responding to a potential RSV or a child with respiratory difficulties, the most important thing to do is make sure they have a clear airway and are oxygenating sufficiently. Many kids have a fear of strangers, especially when they are ill. It is important to decrease stimulation so that they do not become agitated or have increased fussiness. This can lead to an increased respiratory effort, tachypnea and difficulty performing interventions. In addition to maintaining a calm environment, interventions can include: • Maintaining open airway, suction as needed • Supplemental oxygen delivery • Nebulizer treatments • Fever management with anti-pyrectics • Steroids • Antibiotics for secondary bacterial infections In conclusion, RSV is a common viral illness that typically affects children more than adults. Generally, this virus runs it’s course in 7-10 days, but sometimes requires hospitalization and more aggressive treatment. Prevention includes, frequent handwashing, isolation from potential affected persons, and maintaining a clean home environment. Resources: Center for Disease Control

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