Is it RSV or Asthma?

     It’s a busy time of year for upper respiratory problems.  We’re seeing a lot of patients right now with — and getting a lot of calls about — RSV, or Respiratory Syncytial Virus. 
    The average child will get about six respiratory illnesses each year.  But do you know if that cough is more than just a cold? Is it asthma? Is it RSV?
       For some children, a cough and runny nose may progress to more severe symptoms such as wheezing and difficulty breathing.  Those symptoms can be signs of RSV.  RSV is the most common cause of pneumonia and inflammation in the lower airways in babies.  It is common in winter and spring months.  Most children are infected with RSV at least once by the time they are two years old.  For the majority of these children, the illness is mild and resembles the common cold with symptoms of cough, fever, sore throat and stuffy or runny nose.  Parents can help by offering fluids, keeping the nose clean, and using a cool mist humidifier.  Because antibiotics only work for bacterial infections, they are not helpful for RSV.
     For some infants, however, RSV can lead to rapid breathing, shortness of breath, poor feeding, listlessness, and wheezing, or a high-pitched purring or whistling sound when exhaling.  These children require immediate evaluation by their pediatrician or local emergency department.  At times, it may be necessary to hospitalize the child to monitor more closely, and provide fluids, oxygen, and medications to open the airways.
      Asthma, on the other hand, is an on-going disease caused by swelling in the airways in response to a certain trigger.   This trigger varies from child to child but may include allergies, viruses, weather changes, or exercise. Symptoms of asthma are similar to RSV:  wheezing, rapid or labored breathing, cough, and chest tightness.  Asthma, however, is usually not diagnosed until a child has had repeated episodes of wheezing.  It is most common in children ages 5-17 years, children with allergies or a family history of asthma, and in children who are exposed to secondhand smoke.
       Treatment of asthma includes avoiding known asthma triggers, monitoring symptoms and taking prescribed medications.  There are two basic types of medication for treating asthma.  The first is long-term controller medications which are taken daily, even when no symptoms are present.  These medications, such as Flovent, prevent swelling in the airways.  In addition, quick relief or rescue medications are used to relieve symptoms during an attack.  This group includes Proventil, Ventolin, Xopenex and others.                        
     As with RSV, please seek immediate medical attention if you feel your child is having difficulty breathing or may be having an asthma attack.
    If you have questions about your child’s symptoms, or need help finding a pediatrician, call the St. Louis Children’s Hospital Answer Line at 314.454.KIDS.

 Kathy Quirin, RN, is on the answer line staff.