An Unexpected Culprit

More than just a cold, respiratory syncytial virus can do permanent damage to your baby'’s lungs.

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By now, you probably know what to do if your newborn gets a cold: give her lots of fluids, keep her warm, prop her head up if she has a stuffy nose. But there are colds, and then there are colds. If you have an infant or young child, respiratory syncytial virus is something you should know about.

The reason the common cold is so common is that not just one but hundreds of viruses can leave their victims with those all-too-familiar symptoms — runny noses and watery eyes. One such culprit, RSV, is one of the most prevalent bugs, and it causes a yearly epidemic that runs rampant from November to April. (The season can vary according to region of the country, so it's best to ask your doctor about your area.) It all but disappears the rest of the year.

Adults and school-age children infected with RSV usually suffer no more than an upper-respiratory infection, sometimes in conjunction with a sore throat and cough. But when passed on to babies less than a year old, it can lead to serious lower-respiratory tract problems.

In fact, according to the Centers for Disease Control and Prevention, RSV results in an estimated 90,000 hospitalizations and 4,500 deaths throughout the country each year in infants and young children. The virus is the leading cause of bronchiolitis, a disease of infancy in which the smallest airways of the lungs become swollen and filled with mucus; and pneumonia, both of which can cause respiratory distress — and sometimes respiratory failure. It also can spawn ear infections and croup.

Some experts say children who are infected with RSV as infants are more likely to develop lung problems or asthma later in life.

The Omnipresent Bug

The highly contagious RSV "infects virtually all children before their second birthday," says Ellen Wald, M.D., professor of pediatrics at the University of Pittsburgh School of Medicine. "In general, very young babies lack immunity to the virus until they get it one or two times. Each time they get it, it gets milder."

The most severe consequences of RSV infection occur in babies less than six months old. Children with heart or lung diseases and those who were born at less than 32 weeks of gestation are most at risk, says Dennis Murray, M.D., a professor of pediatrics specializing in pediatric infectious diseases at Michigan State University. Overall, "one in 50 of all kids who develop the infection ends up hospitalized," he says.

As with the common cold, there is no cure (although there is medication, Ribavirin, often given to severely ill infants with RSV). If your baby displays the typical cold symptoms, which may include low-grade fever, make him as comfortable as possible so his body can fight off the virus. A humidifier may help (but only one that is kept very clean), and for small babies, a nasal bulb syringe. Do not expose your baby to secondhand smoke. "Smoking around a baby with RSV is the worst thing you can do," Murray says. Also keep the baby away from paint, burning wood and irritating fumes.

Stop It In Its Tracks

RSV spreads like wildfire — throughout households, offices and day-care centers — by physical contact. You may be next in line if you touch or kiss an infected person or handle a toy or tissue that he recently has touched, sneezed or coughed on (the virus can live on hands and surfaces for up to six hours).

Prevention is key. To keep your infant healthy during RSV season, step up your standard operating procedure of frequent hand washing with warm water and soap. Insist that anyone who holds the baby has clean hands, and limit visitors until the baby is 2 months old. Wald also recommends that parents with colds wear masks around their babies. "Keep babies out of crowds and away from people who are sick," Wald says. "Try to separate very young babies from other children, especially preschoolers, who have colds."

The good news is a vaccine is in development. For high-risk infants — with breathing problems or damage to their respiratory systems as a result of prematurity (bronchopulmonary dysplaysia) — RespiGam (RSV-IGIV), a high-level antibody against RSV, can be used. But it has to be administered intravenously over several hours, and monthly during RSV season. A helpful source for parents of at-risk children is the Partners in Intensive Care RSV Information Line: (888) 778-4449.

If your baby is hospitalized with RSV, the oxygen saturation level will be checked. If it is low, oxygen will be administered. Some babies may also respond to aerosol breathing treatments — called nebulizers — which are used for asthma.

You can't make your baby invincible to RSV, but you can do everything in your power to lessen the chances of getting it.