10/05/2025
🫁*Respiratory syncytial virus (RSV) and bronchiolitis* 🫁
Trust a parent’s instincts when they discourage kissing their babies, there’s a serious reason behind it. Respiratory viruses, including RSV, are putting pressure on paediatric wards in South Africa. Cooler weather increases the risk of exposure to and sustaining an RSV infection, with RSV being a leading cause of bronchiolitis in children, alongside Rhinovirus, Enterovirus, Parainfluenza, and Metapneumovirus.
🫁*What is bronchiolitis?*🫁
Bronchiolitis is a viral lower respiratory tract infection, most commonly caused by RSV, affecting infants and children under 2. RSV is highly contagious, with nearly all children infected at least once by age two. It starts with cold-like symptoms but can lead to breathing difficulties and hospitalisation. RSV accounts for up to 90% of bronchiolitis hospitalisations and half of winter pneumonia admissions.
🫁*How is RSV transmitted?*🫁
RSV spreads through contact with infective droplets that spread with eg. coughing and sneezing, lingering for hours on surfaces.
It is better to avoid kissing babies and children that are not in your immediate family circle.
Risk factors include to***co exposure, school-age siblings, daycare attendance, and crowded living conditions.
🫁*Who is more at risk for RSV?*🫁
Premature babies and those with lung or heart conditions face the highest risk of severe RSV, often requiring intensive care. While healthy children and adults handle mild symptoms, at-risk infants are 2-5 times more likely to be hospitalised in their first six months. Even healthy children can suffer severe RSV complications.
🫁*What are the symptoms of RSV?*🫁
RSV starts with mild fever, runny nose, sore throat, cough, congestion, and ear infection—essentially, a common cold. Most older children and adults recover without issue. While not every child with RSV requires hospitalisation, complications can lead to admission.
🫁*What are the danger signs?*🫁
Worsening RSV symptoms include wheezing, breathing difficulties, and trouble feeding, which can lead to dehydration and hospitalisation. Inflamed lung tissue can make breathing harder. In severe cases, ventilator support in the ICU may be needed. If your baby's chest pulls in with each breath or they show shallow, rapid breathing and lethargy, seek medical help immediately.
🫁*How is RSV treated?*🫁
Home care for RSV includes nasal saline drops, a humidifier, hydration, and age-appropriate fever medication. Antibiotics won’t help unless a secondary bacterial infection develops. Most children recover in 1-2 weeks but can still spread the virus for up to three weeks. Hospital treatment may involve IV fluids, humidified oxygen, or mechanical ventilation.
🫁*How can RSV be prevented?*🫁
✅Regular washing of hands with soap and water.
✅Teaching kids proper coughing and sneezing etiquette.
✅Keep your child below 2 years away from others with cold symptoms during the RSV season.
✅Wash toys and surfaces that have come in contact with children with cold symptoms.
✅Discourage other people from kissing your baby.
✅Don’t expose your baby to second or third-hand smoke.
✅Try to breastfeed as long as possible.
🫁*What are the long-term effects of RSV?*🫁
RSV infection doesn’t provide immunity, meaning children can get it again. Severe cases can lead to long-term respiratory issues, with nearly a third of hospitalised children experiencing wheezing for up to 10 years, sometimes mistaken for asthma. RSV can be serious—if you or a guest feel unwell, it's okay to postpone visits to protect vulnerable infants. Even minor colds can have major consequences.
