RSV bronchiolitis.  I’ve seen lots of bronchiolitis in the hospital recently.

Diagnosis and treatment.  Does your infant or young child have a hacking cough?  It may be respiratory syncytial virus or RSV.

Most patients present with two to four days of upper respiratory tract symptoms (like fever, runny nose and head congestion).  Then the symptoms go lower like with a hacking cough, wheezing, and increased work of breathing.

How does your kid get this?  RSV is transmitted through contact with respiratory droplets either from an infected person or they infected themselves by touching contaminated secretions on a surface and then touching their mouth/nose/eyes.

As difficult as this is with all of our fancy equipment, the treatment is supportive.  What does supportive mean? It means we give the patient oxygen if they are hypoxic (have low oxygen) and we give intravenous fluids if the patient is dehydrated.  Our “fancy” stuff like epinephrine, steroids, hypertonic saline, bronchodilators, and antibiotics are often NOT helpful.

Is there a way to avoid this infection?  Yes.   There is a prophylactic medication that is given to 3 types of patients: 1.  infants who were born premature (BEFORE 29 weeks gestation) or 2. infants with chronic lung disease or 3. premature infants and children with significant heart disease.  This medication is called  palivizumad which is a humanized monoclonal antibody, given in up to five monthly doses.