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RSV (Respiratory Syncytial Virus), i.e. the RS virus, mainly affects premature babies, children with bronchopulmonary dysplasia and babies with heart defects and cystic fibrosis, i.e. children with reduced immunity. A complication of the infection is inflammation of the laryngotracheitis, middle ear, sinuses, bronchi and lungs with accompanying apnea. The most effective method of protecting children from the highest risk group is to administer antibodies against the RSV virus.

RSV (Respiratory Syncytial Virus) is the most common cause of lower respiratory tract diseases in infants, and is also responsible for respiratory infections in older children.

Statistics show that because of it, 75 percent of children are hospitalized with bronchiolitis and 25 percent with pneumonia. According to the World He alth Organization, RSV infects virtually the entire population of children. It is known that almost every small American, until the age of two, gets sick at least once from an infection caused byRSV .

There are 2 RSV antigenic types (A and B), within which there are numerous serotypes.

RSV: risk groups

It is known that premature babies (due to an immature immune system and not fully developed respiratory system), children with bronchopulmonary dysplasia, and children with congenital abnormalities are among the most exposed to the negative effects of infection (including death). hearts and those suffering from cystic fibrosis.

The risk increases further if the child has a serious medical condition (e.g. neurological, cardiological) and was also born prematurely.The RSV virus can survive for many hours on the surface of items such as a table or stair rails.Therefore, parents of babies up to 6 months of age should remember to wash their hands thoroughly and avoid crowds in the fall and winter season !

Premature babies often suffer from the so-called bronchopulmonary dysplasia (BPD) as a result of treatment of respiratory disorders, which is conducive to infections. In addition, the situation is made worse by the fact that a child born clearly ahead of time does not receive protective antibodies from his mother, helpful in the fight againstRS virus .

RSV virus: how do you get infected?

The source of infection is most often family members - the virus is spread by droplets as well as by contactthrough infected objects and hands.

Other factors that increase susceptibility to infection include: exposure to tobacco smoke (parents smoking), multiple pregnancy (increasing the risk of prematurity), older siblings (transmitting the infection), family history of asthma, short duration of breastfeeding, gender male (the virus more often attacks male infants), crowded human centers (nurseries, hospitals).

RSV in infants: symptoms of infection

  • shortness of breath
  • characteristic wheezing
  • cyanosis
  • accelerated heart rate
  • periods of apnea are frequent
  • feeding difficulties
  • sleepiness and irritability
  • increasing breathing disorders are associated with a more frequent tendency to vomit

In adults, the infection usually has a mild course and the form of a mild disease of the upper respiratory tract, i.e. a non-bothersome runny nose, cough and moderate fever.

Worth knowing

RSV infection prevention program

- In the last infection season, there was a dramatic increase in infections caused by RSV (respiratory syncytial virus). Meanwhile, this pathogen can lead to death in the group of premature newborns - warns prof. Ewa Helwich, national consultant in the field of neonatology.

According to an expertProf. dr hab. Ryszard Lauterbach, head of the clinical department of the Neonatology Clinic of the University Hospital in Krakow

Effective and costly prophylaxis

The highest incidence due to RS virus infections occurs in the period from November to March. A single dose of antibodies protects your baby for one month, so five doses are required. The importance of prophylaxis cannot be overestimated. This has been confirmed by numerous, objective scientific studies that are recognized by the entire civilized world.

Antibodies are successfully administered to children in the USA, Japan and all over Europe (except Latvia). In Poland, a very difficult compromise was reached and only the most immature children and those suffering from bronchopulmonary dysplasia are eligible for the use of antibodies.

A premature baby who is born a few or even several weeks before the planned date of delivery, has not developed alveoli yet. Therefore, it requires support, most often in the form of mechanical ventilation, which inhibits the maturation of the respiratory system.

Each subsequent inflammatory disease process clearly delays the maturation and differentiation of the respiratory system. The RS virus mainly affects the bronchioles, often stopping maturation altogetherspit. The child returns to the hospital, his life is sometimes in danger.

The long-term effects of infection are felt even in adulthood. Thanks to antibodies, the number of hospitalizations, even those caused by bacterial infections, is significantly lower. It is known that viral infections reduce immunity and clearly facilitate the attack of bacteria.

RSV virus: the most important prevention

The stronger and older your child is, the less the virus threatens him. The infection progresses more gently, often as a regular viral virus.

RSV: complications

In Poland, although there is no detailed research in this area, the situation is not better. Over 40 percent children admitted to hospital are infected with the RS virus. However, the statistics do not include children treated at home. The most common complications of such infections include:

  • laryngotracheitis,
  • otitis media,
  • sinusitis,
  • bronchitis and pneumonia.

The latter are often accompanied by apnea, and even respiratory failure, requiring mechanical ventilation. It is suspected that bronchial asthma may be a long-term complication of infection in early childhood.

Mother's milk - the most important for premature babies

It is important to strengthen the immune system from the first days of life and protect it against adverse external factors. The most important thing is to provide antibodies and other factors that protect against infections, and these are contained in mother's milk.

- Mum's milk is more important for a premature baby than for a full-term baby. Human food contains a lot of immunologically active ingredients, so it is important that a premature baby is fed with mum's milk as soon as possible. This can be difficult initially for both the mother - technically and emotionally and the baby - premature babies do not have the ability to suck, swallow and breathe at the same time. In the first days of life, mother's milk can be fed through the probe or even with a finger to the inside of the baby's cheeks. It has been proven that it is important in preventing infections and influences the motor and intellectual development of the child3- says Dr. Krystyna Bober-Olesińska, head of the Neonatology Department of the Międzyleski Specialist Hospital in Warsaw.

Newborns and babies must be protected against infection at all costs. Unfortunately, it is not that simple. Basically the same rules apply as for other viral diseases:

  • limiting the number of visitors to the orphanage during the intensified periodviral diseases
  • avoiding clusters of people
  • frequent hand washing (always before approaching the baby)
  • airing the rooms
  • taking care of broadly understood hygiene.

It is known that frequent illnesses and complications occur in families where children are exposed to passive smoking, the child does not have his own room and shares the bedroom with siblings attending school or kindergarten (from there it is easy to bring the ubiquitous virus ), the number of household members exceeds four.

RSV - vaccine

So far, it has not been possible to develop an effective vaccine against the RS virus - that is why it is so important to prevent and minimize the risk of the disease. The only available protection, saving the lives of premature babies and protecting them from the consequences of RSV infection, is palivizumab, a humanized monoclonal antibody.

Antibodies against RSV

There is no doubt that the most effective method of protecting premature babies and other high-risk babies is prophylactic administration of antibodies against the RSV virus, often mistakenly called RSV vaccination.

It pays off for everyone: children who do not get sick and the state that spends much less on prophylaxis than on the possible effects of the disease in the weakest patients.

The RS virus prevention program consists of the administration of 5 doses of palivizumab at monthly intervals during the RS virus infection season, which lasts from October 1 to April 30. The administration of the drug should be repeated, because the ready-made antibodies given to the child do not cause the body to produce them itself (as in the case of a vaccine) and they disappear after about 30 days.

In Poland, children who are eligible for the RSV infection prevention program:

at the time of starting immunization, they were under the age of 1 and meet the following criteria:

- gestational age up to the 28th week of pregnancy or - the doctor diagnosed them with the so-called bronchopulmonary dysplasia;

at the start of immunization, they were under 6 months of age and meet the

criterion

- gestational age between 29 and 32 weeks of pregnancy (32 weeks and 6 days). 2) If a beneficiary who meets the eligibility criteria described above, is discharged from the hospital during the RS virus season, then he or she receives 3 to 5 doses of palivizumab, but not less than 3 doses. The number of doses administered depends on the time remaining from the day of discharge from hospital to the end of the infection season.

Children with congenital heart disease also have the option of protection against RSV, although they are not included in the above drug program. Parents of these children should ask their doctor about the available prophylaxis options.

RSV: Treatment

In premature babies born before 32 weeks of gestation, lower respiratory tract infections are ten times more common than in full-term babies. The course of the disease is incomparably more severe: intensive care is almost always required, including oxygen, breathing, bronchodilators and intravenous fluids. Such treatment may take up to several weeks.

When a child is hospitalized for a viral infection, diagnosis and treatment are no easier than with bacterial infections. X-ray examination may even indicate that there has been an attack of bacteria, and then the doctors think it is most appropriate to administer antibiotics.

Meanwhile, viruses are not afraid of antibiotics: it does not bring any improvement, and may even worsen the course of the disease. In such a situation, all measures are taken to facilitate the baby's breathing and inhibit the development of the virus. However, it is a difficult, unequal fight.

About the authorMonika Majewska A journalist specializing in he alth issues, especially in the areas of medicine, he alth protection and he althy eating. Author of news, guides, interviews with experts and reports. Participant of the largest Polish National Medical Conference "Polish woman in Europe", organized by the "Journalists for He alth" Association, as well as specialist workshops and seminars for journalists organized by the Association.

"M jak mama" monthly

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