Unexplained rashes, sniffles, snot and all the other lovely body fluids that children can produce are an unfortunate consequence of being a parent. For some parents, September signifies the return to school and getting life back in order for at least the next 10 months. For those of us in the know, it really just signifies the start of cold and flu season (and by cold and flu I mean ALL of the viruses out there that cause respiratory or gastrointestinal infections).
Respiratory Syncytial Virus (RSV) is a virus that infects the lungs and airways and is considered the most common cause of lower respiratory tract infections in young children worldwide, with almost all children having their first RSV infection by two years of age. Similar to the Flu and Norovirus, RSV follows a seasonal pattern where annual outbreaks occur during fall, winter, and early spring among urban centres. In the Northern hemisphere, epidemics generally peak in February and March. Within USA, 100,000 hospitalizations and 4,500 deaths annually are attributed to RSV infections. RSV is also a major cause of nosocomial infections.
RSV is usually a mild disease that goes away on its own. In very young children RSV can sometimes lead to serious infections like pneumonia or bronchiolitis (a swelling of the bronchioles — the smallest air passages of the lungs). In most children, RSV usually causes symptoms similar to the common cold: stuffy or runny nose, cough, ear infections (sometimes), low-grade fever and sore throat. RSV is most likely transmitted through direct contact with infectious secretions (via fomites) and/or large-particle aerosols; however, close contact with infected individuals, or significant exposure of nasal or conjunctival mucosa with contaminated hands is required for transmission.
A 2004 study published in Pharmacoeconomics reviewed data from 2000 and found that nearly 98% of RSV infection-related hospitalisations occurred in children <5 years old. There were approximately 86,000 hospitalisations, 1.7 million office visits, 402 000 emergency room visits and 236,000 hospital outpatient visits with associated annual direct medical $US394 million!
A more recent study published in the Spring of this year by Jacobs et al, in the Canadian Journal of Infectious Diseases and Medical Microbiology developed a model to determine costs of community (CRSV) and nosocomial RSV infections (NRSV). Similar to stats in the US, 10% of hospitalized patients will acquire a nosocomial infection of which 71% are due to respiratory viruses! Annual costs of NRSV in Canada for patients <1yr of age was determined to be about $7.9 Million. The study determined that NRSV added $993 to each CRSV case and also found if improved infection control procedures were in place a reduction of transmitted treatment costs of $469/patient could be attained. What a novel idea - Infection Prevention programs can help save money!
It's very hard to keep from catching RSV, just like it's hard to keep from catching a cold. You can lower the chances by practicing good health habits such as washing your hands often, and teach your child to do the same. If you're in the Northern Hemisphere and your child has to be admitted to hospital I hope you'll remember that respiratory viruses this time of year are just as rampant in hospitals as in the community. Ask the nurse and doctor to wash their hands and don't be scared to find a disinfectant wipe to clean the area you're in!