RSV and High-Risk Infants

Respiratory syncytial (sin-SISH-shul) virus, better known as RSV, is a very common virus that affects most children during their first two years of life, the symptoms of which can be as innocent as a runny nose, ear infections or other cold-like reactions.  Unfortunately, this common virus can also have life-threatening symptoms and consequences for high-risk infants if not taken seriously.  The more serious symptoms of RSV may include rapid breathing, vomiting, fever, wheezing, and sometimes even apnea and respiratory failure.  It is also the most common cause of bronchiolitis and pneumonia in toddlers under the age of one.

There are numerous risk factors for falling victim to severe RSV.  They are:

• Premature birth, because of under-developed lungs and/or a lack of antibodies from the mother

• Being born with a lung disease

• Being born with heart disease

• Low birth weight, which often happens with multiple births (another risk factor)

• Day care (exposure to other infected children)

• History of asthma in the family

• Tobacco smoke and air pollutants

• Siblings who carry the virus into the home

RSV is easily spread by airborne particles from coughing and sneezing or secretions of the nose and mouth passed from one to another.

There is a drug called Palivizumab, which is given to help prevent the RSV infection from becoming severe.  It cannot be used to treat a patient once severe symptoms have manifested nor to prevent RSV infection altogether.   No vaccine is currently available.

As part of Primary Pediatric Case Management’s plan for helping high-risk infants, we are instrumental in working with the insurance companies and pediatricians in both ordering and securing the preventative monthly injections of Synagis (Palivizumab) for our patients who meet the criteria.  Typically, we arrange for the drug to be shipped and then set up visits from a pediatric nurse once a month to give the injection.  This service is of added benefit to the parents of these infants who otherwise would have to transport these sick babies out in the cold…possibly in inclement weather…to a hospital or doctor’s office, perhaps exposing them to other infected people.

It’s important for these families to be reminded that just because their infants are getting these injections each month, it does not mean they should become lax in their infectious illness hygiene.  Parents cannot let down their guard after a few doses have been administered.  Consistency of injections is vital into the time of the year when occurrences of the virus begin to subside (usually spring).

Home visits for monthly injections also give our nurses an opportunity to assess how these high-risk babies are doing in other areas of health and growth, as well.

If you have high-risk infants in your home and are concerned about RSV infection, don’t hesitate to contact your pediatrician, your insurance company, and your case manager.

For more detailed information on RSV, you can also visit the CDC website.