Rsv Treatment For Infants: Hospital Protocols And Care

Respiratory syncytial virus (RSV) is a common illness that affects the lungs and causes mild to severe symptoms. While RSV is often a mild infection, it can be serious for infants, young children, and older adults. RSV is the most common cause of hospitalization in infants, with up to 3% of infants who develop RSV requiring a hospital stay. In this article, we will discuss how hospitals treat RSV in infants, including the use of antibody treatments, oxygen support, and intensive care.

Antibody treatment

While there is no specific treatment for RSV, antibody treatments can help prevent severe illness in infants. Antibody treatments are especially important for high-risk infants, including premature infants, babies under 6 months old, and children with other health problems.

One antibody treatment option is the monoclonal antibody immunization, which gives infants and children antibodies to help them fight off an RSV infection. Babies up to 8 months old and some toddlers at high risk can receive this treatment. The medication's name is nirsevimab (also known as Beyfortus), and it is administered as a single-dose shot into the muscle. It is recommended by the CDC and approved by the FDA.

Another monoclonal antibody medicine called palivizumab is given as a series of shots (injections) once a month during the RSV season to babies and children at high risk for RSV infection.

In addition to antibody treatments, pregnant people can receive the RSV vaccine between 32 and 36 weeks of pregnancy to help protect their baby from birth through the first six months of life.

Oxygen, antiviral medications, and IV fluids

Oxygen support is often required for infants hospitalised with severe RSV. This may involve mechanical ventilation, where a machine helps the child breathe. Doctors will monitor the child's breathing and oxygen levels.

Antiviral medications may also be used to treat RSV in infants. The medication ribavirin, for example, can help treat very ill children or those with other health conditions. However, antiviral medication is not routinely recommended to fight RSV, as it is not a specific treatment for the virus.

In addition to oxygen and antiviral medications, IV fluids may be administered to infants hospitalised with severe RSV. This is done to treat dehydration that may occur as a result of the illness.

While hospitalisation is sometimes necessary for severe cases of RSV in infants, it is important to note that most children recover from RSV within one to two weeks, and many can be treated at home with over-the-counter medications to manage their symptoms.

Monoclonal antibody immunisation

Monoclonal antibodies are man-made proteins that mimic the immune system's naturally produced antibodies, helping to fight off harmful viruses. They are not a treatment for children who are already sick with RSV; rather, they are a form of passive immunisation, providing short-term protection.

The RSV monoclonal antibody, nirsevimab, is recommended for infants younger than 8 months of age who are born during or are entering their first RSV season (typically fall through spring). One dose of nirsevimab can protect infants for five months, the length of an average RSV season. It is highly effective in preventing RSV-associated hospitalisation, and side effects are usually mild and resolve quickly.

Babies and children at high risk for RSV infection may get a different monoclonal antibody medicine called palivizumab. This is given as a series of shots once a month during the RSV season. They help prevent the illness in premature babies and children with health problems such as certain heart conditions.

In addition to monoclonal antibody immunisation, there are other steps that can be taken to help protect infants from RSV. These include getting the RSV vaccine while pregnant, washing hands frequently, and limiting exposure to germs by avoiding taking infants to large crowds, especially during cold and flu season.

Tests to check for complications

If your child has been hospitalized with RSV, they may need to undergo some tests to check for signs of complications or other concerns. Here are some tests that may be performed:

Chest X-ray or CT scan

A chest X-ray or computed tomography (CT) scan can help doctors assess the lungs and look for signs of inflammation or infection, such as pneumonia or bronchiolitis, which are common complications of RSV in infants.

Blood tests

Blood tests can provide valuable information about the child's overall health, including checking for possible bacterial or viral infections that could be causing or contributing to their condition.

Urine tests

Urine tests are another way to check for possible infections or complications. They can also help assess the child's overall health and kidney function, which is important when managing fluid intake and output.

Nasal swab or wash

A nasal swab or wash is a painless test that collects fluid from the nose to confirm the presence of the RSV virus. It is a simple and quick procedure that can help in diagnosing and managing the condition.

Monitoring breathing and oxygen levels

Doctors will closely monitor the child's breathing and oxygen levels while they are hospitalized. This may involve the use of special equipment and frequent measurements to ensure the child is receiving adequate oxygenation and to detect any breathing difficulties early on.

It is important to remember that the specific tests performed may vary depending on the child's symptoms, age, and overall health. Doctors will use their clinical judgment to determine which tests are most appropriate in each case.

Preventative measures

Respiratory syncytial virus (RSV) is a common illness that affects the lungs and causes mild to severe cold-like symptoms. It can be serious for infants, young children, and older adults. While there is no specific treatment for RSV, hospitals can provide supportive care to treat symptoms and monitor breathing problems.

• Maternal RSV Vaccination: Pregnant people can receive the RSV vaccine between weeks 32 and 36 of pregnancy. This vaccination protects the infant during their first six months of life.
• Monoclonal Antibody Immunization for Infants: Babies up to 8 months old and some toddlers at high risk can receive a monoclonal antibody immunization called nirsevimab (Beyfortus). This provides antibodies that help fight off RSV infection.
• Hand Hygiene: Ensure that all household members wash their hands or use an alcohol-based hand sanitizer before and after touching the baby.
• Avoid Crowds and Sick Individuals: Limit exposure to germs by avoiding large crowds, especially during cold and flu season. Do not allow people who are sick to come into close contact with the infant.
• No Smoking: Do not allow smoking in the presence of the infant. Remove the baby from any area where people are smoking.
• Breastfeeding: Breastfeeding can help protect infants from RSV by passing on protective antibodies from the mother.
• Good Respiratory Hygiene: Encourage individuals to cover their mouths and noses when coughing or sneezing, and to dispose of used tissues appropriately.
• Clean and Disinfect Surfaces: Regularly clean and disinfect surfaces that the infant comes into contact with, especially if someone in the household is sick.
• Limit Exposure to Other Children: RSV spreads easily in group settings like schools and daycares. If there are older siblings or other children in close contact with the infant, ensure they practice good hand hygiene and respiratory etiquette.
• Keep Infants Away from Childcare Settings During RSV Season: If possible, avoid sending infants to daycare or other group settings during the peak RSV season, which typically occurs from November through March in the United States.
• Get Preventive Medications: Discuss with your healthcare provider whether any preventive medications are recommended for your infant, especially if they are at high risk of severe disease.

These preventative measures can help reduce the risk of RSV infection and protect infants from developing severe complications.

Frequently asked questions