A mother’s worst nightmare is watching her child fall gravely ill, feeling helpless as the condition becomes worse. When Rahul (name changed) was born, his mother faced a similar situation. He was born prematurely at 29 weeks and suffered several complications. After two months of treatment in the neonatal intensive care unit, he was discharged. But little did his mother know that his struggle had only begun.
Exactly a month later, to his mother’s horror, he developed severe breathing difficulties, was very lethargic, and was not feeding properly. He had to be readmitted and placed on a ventilator. A rapid diagnostic test showed he had a severe respiratory syncytial virus (RSV) infection. After being treated for over seven weeks in the intensive care unit, Rahul was sent home.
Rahul’s condition is not as uncommon as it sounds. Newborns often catch cold and parents may often mistake it to be something harmless. However, for preterm infants, an innocent-sounding sniffle may be a prelude to a life-threatening illness such as an RSV infection. This virus is among the leading causes of severe respiratory infections in infants, especially premature babies. According to Unicef data, India witnesses almost 24 million births every year. Hence, being aware of the impact of RSV is crucial for protecting infants from this life-threatening disease.
Risks in preterm infants
RSV causes a common viral infection that affects the lungs and lower respiratory tract. Children often contract the virus by the age of two. In children less than a year old, especially preterm infants, it can cause a severe infection. An RSV infection causes symptoms similar to a common cold. In severe cases, it can spread to the lower respiratory tract causing pneumonia or bronchiolitis (lung infection).
The symptoms in severe cases include difficulty breathing, acute cough, lips, mouth and fingernails turning bluish, lethargy, not feeding properly, and fever. The virus is contagious and spreads from an infected individual when they cough and sneeze. It can also spread through contaminated surfaces such as toys.
An RSV infection can be life-threatening for extremely preterm infants, children less than two years old with chronic lung disease or congenital heart disease, and children with a neuromuscular disorder or compromised immune system.
RSV in India
RSV is a significant cause of mortality and morbidity among children worldwide. In a paper published in The Lancet, in 2019, there were 33 million cases of lower respiratory infections in young children, with one in five cases being children six months and below. During the same period, almost 1.4 million infants (<6 months) were hospitalised. In India, the RSV detection rates vary between 2.1% to 62.4% among children up to five years of age. The rates of RSV infections peak from June to October i.e. monsoon to early winter season. However, RSV can also slightly peak during December, January, and February.
Proactive steps the key
Here are some preventive steps that can be taken to reduce the risks:
Wash hands frequently to reduce the spread of germs
Keep infants away from crowded places, especially during RSV season
Breastfeeding is recommended as breast milk contains essential antibodies that boost immunity
In the case of high-risk infants, doctors may prescribe five monthly injections during first year of life
Avoid infants’ exposure to tobacco smoke or any other pollutant
Maintain utmost hygiene to prevent the virus from growing on surfaces
Wash toys and bedding often
In case a child has contracted RSV, diagnosis usually involves blood tests, a chest x-ray, swab samples from inside the mouth or nose, and pulse oximetry to detect oxygen levels. Treatment usually involves supportive care and over-the-counter drugs to reduce fever and make the child comfortable. The doctor may prescribe antibiotics in case of complications such as pneumonia. It is important to ensure the child is adequately hydrated. If hospitalised, intravenous fluids, humidified oxygen, or even a ventilator may be used. Early intervention is crucial to save lives.
To prevent RSV, knowledge and vigilance are of paramount importance. For preterm infants, the risk is higher. Being aware of the risks of RSV and its symptoms can significantly alter outcomes, ensuring timely intervention. Moreover, implementing simple preventive measures can protect the little ones. Every effort counts in safeguarding these vulnerable lives.
Speak to your healthcare provider to know more about how you can protect your child. The use of protective specific antibodies in ‘at risk’ neonates, during first year of life can not only reduce the burden of disease but also severity of illness.