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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The Latest Testing Information

The world of COVID-19 testing is very complex and changing rapidly. But gratefully, unlike early on in the pandemic, tests are available for everyone who wants one, whether they have symptoms or not. Below is a list of common questions, along with answers from SVMC’s Laboratory Services Director Karen Bond and SVMC’s Director of Perioperative Services Tanya Cowder, MSN, RN, CNOR.

What are the reasons someone may get tested for COVID-19, even if they don't have symptoms? People without symptoms of COVID-19 are being tested when they are admitted to SVMC, before being discharged to other facilities, before scheduled surgeries, or because they may have been exposed to the virus. Primary care providers are also able to order a test for those who need to return to work or school or to end quarantine or isolation. And anyone can be tested through the Vermont Department of Health's Pop-Up Clinics.

What types of tests are available for detecting active cases of COVID-19? SVMC offers Polymerase Chain Reaction (PCR) testing that is processed at both outside labs and our own lab, depending on how quickly results are needed. PCR, which was pioneered by American biochemist Kary Mullis in 1983, actually amplifies and detects the presence or absence of small gene sections. In this case, it determines whether or not COVID-19 is present.

The specimen is most often taken from deep in the nose-throat passageway (nasalpharyngeal). Patients experience eye watering and a burning sensation for 30 seconds or less. The test can also be taken from inside the nose (anterior nares), depending on the patient population. The most common type of test, like those administered both at SVMC’s drive-up testing station and at the Vermont Department of Health’s Pop-Up Clinics, is greater than 90% sensitive (meaning that the test picks up the virus, if it is present) and greater than 90% specific (meaning the test detects the COVID-19 virus, as opposed to other viruses).

How do I get my results and what should I do? Results are usually provided by a primary care provider within 48 hours. Your primary care provider will share specific directions regarding what you should do next. The Centers for Disease Control and Prevention is sharing this table, which provides a synopsis of tests, what results mean, and guidance for what to do. If the test is positive, the Vermont Department of Health may call before the primary care provider to initiate contact tracing.

Are all of the tests sufficiently available? Yes. Anyone with an order from their primary care provider can be tested at the drive-up testing site at SVMC. Anyone can be tested at the Vermont Department of Health's Pop-Up Clinics. Visit https://humanresources.vermont.gov/popups for times, dates, and locations. Tests for inpatients at the hospital are also in adequate supply.

Important Note: Remember test results offer a snap shot of the current active viral load. A negative test result doesn’t reveal whether you have been exposed in the past or predict whether you will be infected in the future. Whether or not the result is positive, we should all continue to wash our hands frequently, wear masks when in public and in proximity to those outside of our household, and stay 6 feet from others.

What about antibody tests? Antibody tests (serology) are also available. It does not tell you if you have active disease. Antibody tests check for antibodies that appear in the blood between about 1 – 3 weeks after symptom onset and may remain as long as a lifetime. Antibody tests may be positive while a person is infected. It is not yet known whether these antibodies protect against reinfection with the COVID-19 virus. For many other similar viruses, antibodies are protective for years or longer, but we do not yet have adequate data to know for COVID-19. Patients who would like the test would get a referral from their primary care provider and come to the SVMC Lab to have blood drawn. Results are delivered by the primary care provider.

Those who receive a positive antibody test or who have recovered from COVID-19 may qualify to donate plasma with the American Red Cross. The plasma, which includes antibodies, may help those fighting the disease. Learn more at https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html.

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