In addition to the coronavirus and new flu strains, the Respiratory Syncytial Virus it is a danger that should not be underestimated, especially for small children and the elderly.
It is a virus that circulates more frequently during the cold season (generally from November to April), so much so often cause epidemics, especially in children under two years of age. It is transmitted mainly through the air, like coronavirus and influenza viruses.
How do we get infected?
A person can become infected by inhaling the droplets of saliva or mucus emitted by an infected individual while sneezing, coughing or talking. Contagion, however, can also occur indirectly, touching objects used by the patient and then putting your hands to your mouth, eyes or nose. The VRS, in fact, survives outside
from the body for several hours and spreads easily in closed and crowded environments, such as kindergartens, schools, offices, clinics, shops.
What is the incubation period?
The incubation period, i.e. the time between infection and the appearance of symptoms, is four to six days. The first infection does not make you completely immune, so you can get sick again several times during your life.
As adults, the symptoms are generally mild, be careful with newborns and the elderly
«Fortunately, in most cases the virus causes a mild infection that is not a cause for concern. However, it should not be underestimated because it represents a concrete danger for two categories that are more likely to develop a serious form of the disease: newborns under one year of age, and in particular under six months of age, and elderly people over 60 years of age». Antonella Castagna is head of the infectious diseases unit of the IRCCS San Raffaele Hospital in Milan and director of the specialization school in infectious and tropical diseases at the Vita-Salute San Raffaele University.
Respiratory Syncytial Virus: why is it dangerous for young children?
Infants have an immune system still unprepared to respond to viral attacks. They are also at great risk those born prematurely and children with other illnessessuch as chronic lung, cardiac and neuromuscular diseases.
What happens when the virus hits frail elderly people?
As regards the elderly, the greatest vulnerability depends on the age-related decline in immunity and possible concomitant pathology conditions: the most fragile are those who suffer from other respiratory diseases, such as chronic obstructive pulmonary diseaseheart disease and systemic disease.
Complications: bronchiolitis and pneumonia
They depend a lot on the general health conditions of the affected person.
Healthy people
In healthy people, respiratory syncytial virus typically causes a mild respiratory tract infectionwhich manifests itself with:
rhinorrhea (i.e. runny nose), sneezing, cough, tiredness, malaise, sometimes fever, muscle pain.
Symptoms they are destined to resolve spontaneously within a few days.
In fragile people there can also be serious consequences
In more serious cases and in risk categories, breathing difficulties may also occur. The person is in trouble, breathes faster and emits the characteristic hiss or whistle. Also may have a longer cough
persistent and deep.
It means that theinflammation has become more prominent and the airways have become narrowed or compressed, obstructing the flow of air. «VRS, in fact, is one of the main viruses it can cause bronchiolitis and pneumonia”, continues the infectious disease specialist.
Bronchiolitis
«In the case of bronchiolitis, the inflammatory process ends up affecting the bronchi and bronchioles, the small terminal branches of the bronchi inside the lungs. In this way increases mucus production and blocks the airways».
Pneumonia
«In pneumonia, however, both lungs are diffusely involved. These are diseases that should not be underestimated because they can develop seriously, to the point of requiring hospitalization in intensive care.”
Half of newborns who get sick will develop asthma
Epidemiological data suggest that 50-60% of newborns who were hospitalized for respiratory syncytial virus they present episodes of bronchospasm until school age and subsequently develop asthma. The causes are not known, although it seems that there is a basic genetic predisposition to develop respiratory diseases, on which various factors then intervene.
Respiratory syncytial virus: when to contact your doctor
So what signs should you pay attention to and when should you contact your doctor? «Breathing difficulties, e.g especially the hissare always important alarm bells that should prompt you to request a consultation, urgently if it concerns newborns and the elderly”, replies the pediatrician.
«In children, attention should also be paid to:
very fast breathing or, on the contrary, breathing pauses, indentations at the intercostal level (valleys of the skin between the ribs that appear during inspiration: the lungs have difficulty expanding so they suck in the skin between the ribs), dilation of the nostrils, decreased appetite.
If action is not taken promptly dehydration may also occurwith reduced urine flow and lack of tears and saliva, e a bluish color due to decreased blood oxygenation”.
Are there effective therapies for respiratory syncytial virus?
Treatments vary depending on the case. When the infection does not affect the bronchi, bronchioles and lungs and the person is not at risk, generally you wait for it to resolve spontaneously. Symptomatic drugs may be used, such as antipyretics for fever and, rarely, sedatives for cough.
Antibiotics have no effect on the virus
They do not existIndeed, specific therapies for respiratory syncytial virus. Antibiotics are not needed unless a bacterial super-infection has occurred or certain conditions are present (such as immune compromise).
In more serious situations, when bronchiolitis or pneumonia has occurred, the doctor will evaluate how to proceed.
How to treat a child with mild to moderate symptoms at home
«For example, a child without breathing difficulties, who is able to eat and drink correctly and is well oxygenated, it should be treated at home with:
frequent nasal washing, aspiration of respiratory secretions, aerosol therapy with hypertonic solution, in the most serious forms bronchodilators and/or cortisone can be used, obviously under the indication of the pediatrician.
Respiratory syncytial virus: when to go to the emergency room?
If there are breathing difficulties and dehydration It may be necessary to be admitted to hospital to provide respiratory assistance, with supports such as masks and cannulae, and to hydrate through an IV. The patients
more serious cases may require hospitalization in intensive care.
Preventive drugs
The best weapon against respiratory syncytial virus is prevention. For the high-risk children And the drug palivizumab is available. It is a monoclonal antibody that prevents the virus from penetrating the cells of the bronchi and lungs and reduces the severity of any illness and hospitalization. It is generally administered monthly from late autumn to spring, with intramuscular injections.
The guidelines recommend that all newborns at high risk for high prematurity or the presence of cardiac, pulmonary or neuromuscular diseases and other debilitating diseases receive this drug.
It should also be approved soon nirsivamabanother new monoclonal antibody that compared to palivizumab has the advantage of requiring a single administration.
Are there vaccines?
«Then I’m studying different vaccinessome aimed at frail elderly people and others to pregnant women. The latter act by stimulating the maternal immune system in order to produce large quantities of antibodies that can be transmitted to the unborn child”, adds the expert.
Infographic by the Italian Society of Pediatrics
Good habits that help
Prevention also involves the adoption of certain behavioral rules.
To protect fragile subjects, and in particular infants, it is best to always wash your hands with soap and water before coming into contact with them, avoid taking them into crowded indoor places, such as shopping centres, do not expose them to passive smoking, protect them as much as possible from smog, carry out all the recommended vaccinations both for early childhood and for the elderly (anti-flu and anti-pneumococcal in particular) so as not to weaken the body with other diseases, if you have a cold, keep a certain distance , avoid close contact and perhaps wear a mask, if possible, breastfeed the little ones: breast milk contains antibodies against numerous infectious agents and reduces the risk of serious RSV infections and hospitalization for bronchiolitis.
Together Against RSV
Precisely to increase new parents’ awareness of this virus, Sanofi, with the patronage of the Italian Society of Paediatrics, the Italian Society of Neonatology and the Italian Society of Hygiene, Preventive Medicine and Public Health, has promoted the campagna Together Against RSVwhich is developed online, on social networks, but
also in the area, thanks to a widespread distribution of information materials in pediatric clinics and vaccination centres.