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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How to Maintain a Healthy Immune System

There are so many things that we have little control over. We can't control what genes we get, how old we are, or what viruses are circulating in our environment, but there is a lot we can do to prevent illness. Remarkably, many of the same habits that protect you from diseases like diabetes, cancer, and heart disease also help your immune system fight infections.

Most viruses can't hurt you until they get inside your body. So, we can help our immune system if we avoid viruses and cut off the ways they travel. Viruses can spread through the air, but not usually for very far. Keep your distance—at least 6 feet—from others, and be a good neighbor by wearing a mask in all public areas.

Viruses that cause the most common illnesses—respiratory infections, including the common cold, flu, and the new COVID-19—travel into the body through your mouth, nose, and eyes and make their way to the areas they infect, like the lungs. The best way to break this chain is to clean your hands frequently, and don't touch your face with hands that have touched anything else. In addition, you can reduce the number of viruses in your environment by cleaning frequently touched objects with a bleach- or alcohol-based cleaner.

Vaccinations are your next line of defense. Immunizations, like the flu shot, introduce a small and harmless part of a virus or bacteria. The vaccine gives your immune system an opportunity to make antibodies against the virus. A vaccinated immune system responds more quickly and effectively when illnesses are introduced. What's more, when we all get vaccinated, we decrease the likelihood that anyone will get sick. If you are unsure about whether you or your children are up to date on their vaccinations, call your primary care provider’s office.

Your third line of defense is living a healthy lifestyle. It is clear that the same things that help the rest of our bodies function also improve the strength of our immune response. Likewise, things that hinder our bodies' ability to function compromise the immune system.

Regular exercise might be the most powerful way to maintain a healthy immune system. By increasing heart rate and blood flow, we allow the cells and substances of the immune system to move through the body freely and do their job efficiently. Similarly, things that slow the movement of cells and substances, like smoking or drinking alcohol in excess, may decrease the body’s ability to function and decreases the immune response, as well.

Getting adequate sleep may also positively affect the immune response. Chronic sleep deprivation has been shown to decrease the beneficial boost in immunity from vaccinations.

Our emotional state, too—whether we are stressed, lonely, or depressed, for instance—affects our immune response so much that a relatively new specialty called psychoneuroimmunology now studies the connection. One pioneering study, conducted in the early 1980s, found that college students operating within a stressful 3-day exam period had fewer of the cells that fight tumors and viral infections. In simple terms, the students almost stopped producing immunity boosters and infection fighters.

Finally, physicians have concluded that eating a mostly plant-based diet—including fruits, vegetables, beans, nuts, whole grains, and lean protein—supports overall health and may also support immunity. Nutritious foods include important vitamins that the immune system needs to function, such as beta carotene, vitamin C, vitamin D, and zinc. Note, however, that supplements that claim to improve immune function have not yet been shown to do so to the extent necessary to protect against infection and disease. It is better to eat whole foods that are rich in vitamins rather than take supplements.

Always consult with your provider before making changes to your exercise plan or trying a new supplement and if you have any medical concerns. Physicians and the other professionals working in their offices also provide help for developing a plan for a healthier life. Call your primary care office or 802-447-5007 to find a primary care provider.

Healthy habits, like those that protect your body from disease and infection, are not always easy to adopt or maintain. Perhaps knowing just how important they are to maintaining a healthy immune response will provide the extra motivation necessary to make them a priority.

Kim Fodor, MD, is an internal medicine physician at SVMC Internal Medicine.

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