Sunday, February 11, 2001
Steamboat Springs Adults in Northwest Colorado are probably more familiar with the common cold than they care to be. It often starts with a warning tickle in the throat, progresses to an upper respiratory infection complete with congestion, cough and runny nose, and lingers for a week or more before becoming a bad memory.
Children under 3 years of age are susceptible to a more serious illness that can appear at first to be nothing more than a mild cold. The illness is Respiratory Syncytial Virus commonly called RSV. It's the most frequent winter cause of respiratory infection for infants and toddlers.
As with other epidemic viruses, RSV is highly contagious. It is largely spread through respiratory secretions that contaminate hands and inanimate objects, such as toys. The virus can live on surfaces for hours to days, coming into contact with multiple susceptible hosts.
An adult who contracts RSV might have mild to typical cold symptoms. Without careful hand washing, such an adult could spread the disease to children. Frequent hand washing and avoidance of contact with those who are sick are the most important factors in preventing the spread of RSV.
Annually, about a million children under the age of 3 will get RSV. The virus peaks in Colorado in late winter to early spring, just as influenza is on the wane. Most infants and children who get RSV have common cold symptoms: fever, nasal congestion, cough and fussiness. A few children will progress to worrisome symptoms of high fevers, lethargy and breathing difficulties. Moderate to severe RSV does put some children at risk of subsequent "wheezy" spells, similar to asthma, when they develop future colds.
One percent of young children who contract RSV will typically require hospitalization due to low oxygen or dehydration. The younger the infant, the more at risk he or she is. Premature newborns and infants with chronic medical problems are particularly high-risk. Parents of high-risk children may opt for the expense of monthly inoculations.
There are different strains of RSV, so children can develop recurring RSV illnesses in the same winter. Symptoms typically last 10 to 20 days, and the virus is most contagious during the first five days, when symptoms are barely perceptible. Most infants and children with RSV do not need to be seen by a doctor. Parents can treat milder cases of RSV with vaporizers, rest, fluids and fever reduction.
A physician's care is indicated if a parent is highly concerned or whenever children or infants:
Have persistent fevers of 103 to 104 degrees.
Have breathing difficulties such as fast or labored breathing.
Are excessively sleepy.
Are very pale or have a bluish skin tone.
Refuse to take adequate fluids.
Louise Thielen, M.D., is a pediatrician and internal medicine physician at Steamboat Medical Group.