Pediatric Nurse on What Parents Need to Know About RSV

A highly infectious respiratory condition is spreading across the country, and it’s not COVID-19. Respiratory syncytial virus (RSV) causes mild flu-like symptoms, but it can cause serious health issues in some people, including children and the elderly. Hospitals have seen a rapid increase in the number of RSV infections over the last few weeks, and health experts are warning parents to be on the lookout for cold and flu-like symptoms. 

Hannah Brand, a pediatric nurse from Nebraska, knows what it’s like to be a parent of a child with RSV. Her daughter Paitynn caught the virus when she was just two months old. She started having trouble breathing, which prompted Brand to take her to the pediatrician.

“When she would breathe, she was panting and you could see she was almost kind of sweating,” Brand explained. She had a feeling this was more than the common cold.

“A huge alarm to me was the sinking in of the skin around her ribs, called retractions, and for kiddos, especially in a 2-month-old, retractions is a huge sign of increased work of breathing. So that was a big, big indicator that something is wrong here, that this is more than just a cold.”

The doctor diagnosed her daughter with RSV, which can be serious in infants. Paitynn had to be airlifted to the nearest children’s hospital, which is over 100 mile away from the family’s home.

“I’m used to seeing this every day in other kiddos, but when it came down to it was my daughter experiencing this, it was almost like my nurse brain went out the window and it was mom brain 100% and it was very terrifying,” said Brand. “It was a huge advantage that I knew what to look for and how to intervene should I need to, but at the time I was 100% mom mode, and I was very terrified.”

She then encountered what has become a reality for many hospitals around the country. The pediatric ward was overwhelmed with cases of RSV. 

Facilities in Rhode Island, Washington, Colorado, Texas, Ohio, Louisiana, New Jersey and Massachusetts are nearing capacity due to higher-than-expected cases of non-COVID-19-related illnesses. RSV cases account for around 75% of the estimated 40,000 pediatric beds filled nationally, according to the Department of Health and Human Services.

“The hall that we were on was completely full,” said Brand. “Every room had a kid in it.”

Luckily, her daughter responded well to the treatment. They gave her a sedative to help her get a good night’s sleep.

“Once she started that light sedation, she was able to sleep and we noticed immediately on her monitors, her oxygen improved, her heart rate improved,” she said. “As she would sleep, her body was slowly recovering.”

Paitynn was discharged after just two days and is now on her way to a full recovery, but Brand considers herself one of the lucky ones.

“We do still follow up very closely with her pediatrician just because the risk of her later on maybe developing childhood asthma, reactive airway disease, those kinds of things can be a little bit more increased after they’ve had an RSV diagnosis,” said Brand. “We’ve just had to keep an extra close eye on her.”

She has some advice for parents of young children as the virus continues to spread. She encourages caregivers to trust their instincts and take their child to a pediatrician if they notice changes with their breathing.

“If for whatever reason you question the condition of your kiddo or you’re just not comfortable with how they look, trust your gut,” said Brand. “Please take them in to be seen. If you think at all that you’re not comfortable with something, trust that instinct and get them some help.”

RSV spreads via respiratory droplets when a person sneezes or coughs, intimate facial contact like kissing, and touching infected surfaces like tabletops and doorknobs.

People tend to be infectious for three to eight days, but the CDC says some infants can continue to spread the virus even after they stop showing symptoms. Premature infants and those with congenital heart conditions are the most vulnerable to RSV.

“Pretty much all kids have gotten RSV at least once by the time they turn 2, but it’s really younger kids, especially those under 6 months of age, who can really have trouble with RSV and sometimes end up in the hospital,” said Dr. William Linam, pediatric infectious disease doctor at Children’s Hospital of Atlanta. 

“That’s where we want to get the word out, for families with young children or children with medical conditions, making sure they’re aware this is going on.”

During the first two to four days, infants with RSV will exhibit a mild fever or cough, but they may have trouble breathing later on. Parents should also watch out for signs of dehydration and lack of appetite.

“Not making a wet diaper in over eight hours is often a good marker that a child is dehydrated and a good reason to seek medical care,” he said. “Sometimes kids under 6 months of age can have pauses when they’re breathing, and that’s something to get medical attention for right away.”