What is the RSV Virus?

Respiratory Syncytial Virus (RSV) is a virus that causes respiratory tract infections, especially in young children, adolescents, and the elderly. RSV is a leading cause of pneumonia and bronchiolitis in infants. Transmission occurs very easily through contact with respiratory droplets from an infected person, whether by coughing, sneezing, or touching contaminated surfaces.

Symptoms of RSV Infection

Children infected with the RSV virus may initially exhibit symptoms similar to a common cold, but as the condition worsens, the following symptoms may occur:

• Heavy cough and phlegm
• High fever and chills
• Difficulty or rapid breathing
• Wheezing
• Pneumonia or bronchiolitis in severe cases: Especially infants and children under 2 years old are at high risk of developing severe symptoms, which may require hospitalization.

Treatment Methods for RSV Infection

Treatment for Respiratory Syncytial Virus (RSV) is generally supportive care, as there is currently no specific antiviral drug or vaccine to prevent this virus. Therefore, care focuses on treating the symptoms and waiting for the body to build up immunity to fight the virus, which can be divided into several methods based on the severity of the symptoms.

• Basic Treatment for RSV Infection:

  1. Fever and Pain Relief Medication:

     • Use medication such as Acetaminophen or Ibuprofen to relieve fever and pain if the patient has a high fever.
     • Caution should be exercised with the use of aspirin in young children, as it may increase the risk of Reye's Syndrome, a condition that causes abnormalities in the brain and liver.

  2. Nasal Congestion and Cough Medication:

     • Nasal sprays or drops containing Saline Nasal Drops can help reduce nasal congestion and facilitate easier breathing.
     • Avoid using certain cough medicines in young children, especially those under 2 years old, as they may cause harm.
     • For some children with thick, sticky phlegm, it may be necessary to administer bronchodilator or saline nebulization, chest percussion, and phlegm suction.
  3. Adequate Hydration and Nutrition:
     • It is crucial for the patient to drink enough water or fluids, as RSV often causes the body to lose water easily. Dehydration can worsen symptoms.
     • Warm liquids such as soup or honey mixed with warm water (for children older than 1 year) may soothe a sore throat and help the patient feel more comfortable.
  4. Rest and Supportive Care:
     • The patient should get sufficient rest and avoid strenuous activity.
     • Using a vaporizer or humidifier may help reduce irritation in the respiratory tract and make it easier to sleep.

• Treatment in Severe Cases:

  1. Supplemental Oxygen: If the patient shows clear difficulty breathing or has low blood oxygen levels, the doctor may provide treatment with supplemental oxygen, either via a mask or a tube connected to the nose.
  2. Ventilator Support: In cases of respiratory failure or insufficient respiratory function, the doctor may need to use a ventilator or positive pressure breathing machine to ensure the patient receives sufficient oxygen.
  3. Antiviral Medication (For High-Risk Patients): Although direct antiviral medication for RSV is not widely available, in some cases, the doctor may consider administering Ribavirin, an antiviral drug used in emergencies for patients with severe symptoms or complications from other diseases, especially high-risk patients such as those with chronic lung disease, premature babies, or patients with weakened immune systems.
  4. Intravenous Fluids (IV Fluids): If the patient cannot drink enough water or fluids, the doctor may provide IV fluids to prevent dehydration and maintain body balance.

Prevention of RSV Infection

Preventing RSV infection is crucial, especially in families with young children or the elderly. Recommended prevention methods include:

• Frequent Handwashing: Regularly, especially after touching objects or surfaces in public. Using alcohol gel helps prevent the disease somewhat, but frequent handwashing is more beneficial.
• Avoid Close Contact: With sick individuals, such as those coughing or sneezing.
• Clean Toys and Surfaces: That children frequently touch, such as tables, chairs, or personal items.
• Wear a Face Mask: When in crowded places or near people with symptoms of illness.
• Avoid Smoking: Infants exposed to cigarette smoke are at a higher risk of RSV infection and may experience more severe symptoms.
• Sick Children Should Stay Home: Especially young children under 2–3 years old should stop attending nursery until symptoms are gone, or for at least 5–7 days, to prevent spreading the infection to others.

Summary

The RSV virus is a serious threat that can affect children of all ages, especially young children with insufficiently strong immune systems. Prevention through maintaining hygiene and avoiding contact with sick individuals is crucial. If a child exhibits abnormal symptoms, they should be taken to see a doctor immediately for proper treatment.

Currently, although there is no specific treatment for the disease, an RSV prophylaxis injection (ready-made immunity) is available for infants, which is not a vaccine but ready-made immunity that, when injected, can reduce the chance of RSV infection by 79%, reduce hospitalization from lung infection by 83%, reduce disease severity, and reduce the chance of entering the ICU by 75%.

The Royal College of Pediatricians of Thailand recommends additional options for generating immunity to protect infants and children from RSV, including:

1. RSV preF Vaccine (Abrysvo) Injected into mothers between 24–36 weeks of gestation.

2. Specific RSV Immunoglobulin Injected into infants.

   • Recommended for all children under 8 months old.
   • Considered for children aged 8–12 months.
   • Recommended for children aged 12–24 months with certain underlying diseases that put them at risk of severe RSV disease upon infection.