When to Test for Respiratory Syncytial Virus (RSV)
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/ Categories: WELLNESS, 2022

When to Test for Respiratory Syncytial Virus (RSV)

Respiratory Syncytial Virus (RSV) is a common virus that infects children and some adults. We are experiencing higher levels of RSV in our community, and it is important to understand the expected course of symptoms for adults and children, how to identify patients who are at risk for respiratory complications, and who may benefit from testing.

The Centers for Disease Control and Prevention (CDC) considers patients under the age of 2 years to be at the greatest risk of a serious case of RSV. RSV testing is mostly reserved for this age group.

If your young child is experiencing cold-like symptoms, follow the guidance below.

  • Hydrate with formula, breastfeeding, or water, if age appropriate.
  • Clear any nasal drainage and congestion with saline nose drops, bulb syringe, or a nasal aspirator (NoseFrida).
  • Use over-the-counter fever reducers per package instructions for temperatures over 100.3 °F.
  • Monitor for signs of severe illness in young children and infants, including rapid, shallow breathing; periods of not breathing; retractions or “sinking-in” of the spaces between the ribs or below them; flaring or “spreading-out” of the nostrils; or if skin turns blue around the mouth or fingertips.
  • Watch for signs of dehydration, as well, such as poor feeding, reduced wet diapers, dry mouth, reduced energy levels, or uncommon drowsiness.
  • If any of these signs or symptoms develop, please have the infant or child seen by a healthcare provider immediately.

In most cases, RSV causes mild common cold-like symptoms. Neither children nor adults with common cold-like symptoms need testing for a diagnosis. Most RSV infections resolve in 1 – 2 weeks, but the cough can last up to 4 weeks.

For those NOT at high risk, follow the guidance below.

  • Infections of COVID-19 and RSV are very similar and can happen at the same time. Patients with respiratory symptoms should use an at-home rapid antigen test for COVID-19.
  • If you test positive for COVID-19, follow the instructions for isolation as listed on the Vermont Department of Health website.
  • If you suspect you have RSV, stay at home and away from others, rest, increase fluids, and try over-the-counter fever-reducing medications, such as ibuprofen and acetaminophen. Most people with this illness will have mild symptoms and will not need medical care. 
  • Testing is not required, as a healthcare provider can reasonably make a diagnosis of RSV, based on an exam, particularly if community levels are high.
  • You can reduce your risk of contracting RSV by avoiding those who are ill and washing your hands consistently.

Crystal Labbe-Hasty, PA, is a physician assistant at SVMC’s Respiratory Evaluation Center/ExpressCare in Bennington. The practice is part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care. 

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Cautious Entertaining

After almost 3 months of staying home and with the weather getting nicer, many of us are itching to invite friends over and catch up. While this is a natural inclination, it should be approached with significant caution. COVID-19 is still circulating. If you are planning to host, follow these helpful tips for a safe gathering at your home.

Keep the numbers small. Invite as few people as possible. One-on-one meetings are safer than group gatherings. The recommendations from Vermont Governor Phil Scott recommend 25 or fewer. I would still aim for fewer than 10, especially depending on the size of your entertaining space.

Choose invitees carefully. You should know almost everything about the socializing habits of the people you are inviting. Your guests should be as careful in their social interactions as you are in yours. You should also trust that your guests would be cancel if they were feeling ill, as should you if you are suddenly symptomatic. Those at high risk, due to age or a medical condition, should be very careful about hosting or accepting invitations.

Stay outside. Outdoor air movement disperses aerosolized particles more readily than indoor environments. And plenty of space outside allows guests to stay distanced. UV light, like the rays found in sunshine, may also provide some small benefit. It has been shown to decrease the viability of the virus on objects, but it is not yet clear how intense the light must be and for how long the object needs to be exposed in order to kill the virus.

Keep it short. Duration of exposure to others has been identified as a key risk factor. The longer you are near someone shedding the virus, even if they don't have symptoms, the greater your likelihood of catching it yourself. While it is awkward to say that you are inviting people over for a 10-minute chat in the driveway, this is certainly among the lowest-risk types of socializing.

Clean beforehand. If you expect guests to touch anything, the arms of patio chairs, for instance, wipe them down in advance. Ask everyone to sanitize or wash their hands as they arrive, if they touch their face, and about every hour or so.

Stay distanced and masked. People standing tend to drift. Place chairs 6 feet apart so that people will be more likely to stay apart. Unless you are eating, keep your masks on. Share this expectation in advance, so your guests bring their masks with them.

Limit contact points. If you are preparing food, be sure to wash well before cooking and ensure everyone has a portion of his or her own. Forget about platters of vegetables or bowls of chips everyone shares and even buffets, where people share spoons and tongs.

Clean after. Wipe down anything your guests may have touched after they leave.

Keep track. Be sure to take note of who was there, the date of the social event, and each guest's contact details. If any one of the attendees becomes ill with COVID-19 or learns that they may have been exposed at the time of the event, they will be able to reach out directly to the others and to share information readily with contact tracers.

With these tips, you can host a relatively safe get-together and relieve some of the social isolation of the past several weeks. Do know, however, that no party—regardless of how careful—is risk free. Weigh the risks, decrease those you can, and then, try to have fun.

Donna Barron, RN, is the infection preventionist at Southwestern Vermont Medical Center.

 

 

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