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Column originally published Apr 3, 2012

RSV Infection Can Be Very Serious

Question: My best friend’s daughter was just admitted to intensive care unit. She got a bad cold, and has difficulty breathing. I was visiting them a few days earlier with our newborn baby. At the time, this girl was perfectly well, although her older brother had a cold and was coughing. I am very scared now. Our son is barely two weeks old, and I am nursing him. I am afraid that we may have caught the same virus. Our son is even younger than her daughter that is in the hospital. Is there anything that we can do?


I am sorry to hear that your friend’s daughter is sick and needs intensive care. Winter is the worst time for virus infection. There are many viruses that can infect young children. The most common, and probably the most serious one, is called Respiratory Syncytial Virus (RSV).

Almost all children will be infected with RSV by the time they reach two years of age. In older children, it is usually nothing worse than having a bad cold. They have running nose and a cough that usually lasts several days. Children who have underlying asthma can become sicker, and will require treatment for their asthma.

For those children under 6 months of age, RSV infection can be very serious. The younger the child is, the more severe are their symptoms. Their running nose can be like turning on a tap: lots of clear secretion coming out that requires frequent wiping or suctioning. Some children have difficulty coping with the secretion that can block their airway. As a result, some young children end up in intensive care unit. A few will even require a machine called ventilator to help them to breathe.

RSV is passed from one person to another. This can happen directly when a sick person coughs and droplets containing the virus are breathed in by someone close by. It can also spread indirectly through a sick person’s hands or on a surface that he has touched.

You have visited your friend when their older son was already sick. It is possible that you have been exposed to the virus, and you can get sick. Whether you actually develop any illness depends on your own immunity to the virus. Fortunately, when adults get infected with RSV, they usually have rather mild symptoms, but they still can have running nose and a cough. A person can spread the virus before they develop any symptom.

There is very little that you can do now. If you do develop symptoms of a cold, make sure you wash your hands for about 20 seconds with soap and water before taking care of your baby. You can buy face masks from pharmacy to cover your face and reduce the chance of your baby breathing in droplets that can contain the virus. I do not recommend spraying any kind of disinfectants in the air, or wiping down every doorknob around the house with disinfectants. You will be exposing him and everyone in the house to chemicals that can be potentially harmful.

The good news is that if you do get infected, your body will respond very quickly and produce antibodies to fight the virus. Your breasts contain very important immune cells that can produce a special antibody against RSV, and with your breastfeeding, you will pass the antibody to your baby, which may be enough to prevent him from getting infected, or at least reduce the severity of his infection.

If your son gets sick, you have to watch and see how he responds to it. Stuffy nose and a bit of cough is not a problem. If he has difficulty breathing, or if he cannot nurse, you should bring him to see your doctor, or to the emergency room, as soon as possible. The younger the child is, the more difficult it is for him to deal with a serious virus infection.

There is another virus that you should be concerned about in winter: the influenza virus. Not long ago, the whole world was gripped by the H1N1 scare. Through vaccination campaigns and other preventative measures, we dodged a dangerous bullet. However, other strains of influenza viruses are still very dangerous to young children and seniors, as well as to those with underlying medical conditions. We recommend pregnant women to get vaccinated with the flu shot so that babies can be born with antibodies in their system to protect them from influenza infection in the first few months of life.

You may also have heard that hospitals are giving new parents whooping cough vaccine shortly after their babies are born. This is to booster their immunity to the deadly bacterium called pertussis that causes whooping cough. Although babies are given whooping cough vaccine at 2, 4, and 6 months of age, it is not effective until after the third dose. Whooping cough is an extremely severe infection in very young children. Their cough is so severe that they cannot catch their breath, and some die or suffer permanent brain damage as a result.

Therefore, keep a close eye on your baby, continue to nurse him and watch his breathing and feeding. If you have any doubt, get in touch with your family doctor right away.