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We thank The Forum for its recent story on respiratory syncytial virus, or RSV , but would like to clarify a few issues with this virus and its management and hope to decrease the high level of anxiety that diseases such as this can induce in our community.
At our Sanford Pediatric Urgent Care clinic we are seeing a large increase in children with coughing and fever symptoms. We know that the majority of the children with these symptoms have an infection with the respiratory syncytial virus.
As parents we have spent many nights with our own children comforting them as they cough through most of the night with this and other viruses and realize how difficult these times can be. We are seeing many families in our clinics with high anxiety about RSV, even at times when families and we agree that their child is having mild symptoms. We feel we need to make some clarifications to help decrease this anxiety.
This disease is having its largest outbreak in our community in many years. Although many infants and children are ill from this virus, it very rarely leads to severe disease and need for hospitalization. It is extremely common to be infected by this virus and nearly all children will have had this virus by the time they are 2 years old.
In most children it is a bad cough and runny nose that may begin with a fever for a few days and coughing symptoms that can persist for several weeks. Coughing at times is forceful to the point of vomiting, and this is not an unexpected or severe sign of disease.
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In rare cases, particularly in the youngest babies, this disease can lead to difficulty breathing. Signs of this are exaggerated muscle use to breathe, poor feeding, decreased activity. In these circumstances we recommend evaluation by a health care provider to consider whether the child may need supportive care with oxygen or IV fluids. At times breathing treatments are attempted such as used for asthma, but often these treatments are not beneficial.
Two clarifications to the article in The Forum.
- Palivizumab, commonly known as Synagis, is an injection of antibodies that are very rarely given as prevention for RSV and is not used as a treatment for active infection. It costs several thousand dollars for one dose and there likely is a limited supply. We feel the article in The Forum did not represent this clearly.
- It was suggested that increased testing would help limit the spread. As this disease commonly causes mild symptoms that do not require evaluation from a healthcare provider, there are no guidelines to limit the spread outside of standard fever exclusions from school and day care. Children who have RSV can shed the virus for weeks after initial infection. Testing requires an office visit, deep nasal testing that can be painful, and the cost of the test can be several hundred dollars. Due to these factors we do not recommend aggressively testing patients for RSV.
By Drs. Aaron Jost, Kami Lucht, Sarah Lien, Stephanie Hanson, Christopher Tiongson, William Hutchison, and Certified Nurse Practitioner Elizabeth Osowski of Sanford Pediatric Urgent Care
This letter does not necessarily reflect the opinion of The Forum's editorial board nor Forum ownership.
