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 Become a Mask Wearer

Long before COVID-19, online chat groups for people with pulmonary fibrosis (PF) were filled with posts about how uncomfortable it is to wear a mask in public: not physically uncomfortable, a fact that was barely mentioned, but psychologically uncomfortable. For people with this condition or the lung transplant used to cure it, catching a cold or the flu could be deadly. They need to wear masks in public to help protect themselves from getting ill.

The participants discussed how awkward it is riding the bus in a mask, going to the grocery store in a mask, or boarding a plane while wearing one. They were mostly self-conscious that others would think they were ill or weak. Many would rather suffer the risk of getting fatally sick than put a mask on in a department store.

Now, we've all been directed to wear masks in public. Both Bennington and Wilmington's Select Boards have passed local mandates requiring masks in public places. This—along with distancing and handwashing—are crucial parts of returning to a more normal way of life. Suddenly, we are all feeling the psychological discomfort PF patients have felt for many years.

People usually have an interest in blending in. And, just like doing anything out of the ordinary, wearing a mask for the first time definitely feels like putting yourself out there. If we want to return to a somewhat normal way of life, masks are crucially important, along with frequent, thorough handwashing and keeping a distance from others.

Here are a few tips for making the leap from being someone nervous about wearing a mask to being a person who wears one regularly.

Do it for others. We know that people can spread COVID-19 as many as a few days before they get sick. Even if you feel fine, you could have COVID-19 right now without knowing it. At the same time, masks are far better at keeping sick people from spreading germs than they are at keeping people from getting sick. So wearing a mask isn't a sign of weakness; it's a sign of altruism. It's like saying, "I am not certain that I am not sick, so I want to pay those around me the consideration of limiting the likelihood I will infect them." Think of it as a badge of kindness.

Get a mask that fits. We know that masks are not completely comfortable physically. Getting the right fit makes a big difference in their "wearability." Cloth masks are readily available online and from local groups. The Green Mountain Mask Makers have excellent information and resources. If you can, purchase a few types in a few sizes to see which you like best. Buy enough of that type to allow washing between trips out in public.

Get a mask that you like. Once you have found a mask source and as long as you have a choice, pick one that you like. You can choose colors that match your wardrobe or that represent your interests, like camouflage. There are even masks that look like fashionable scarves when they hang around your neck. The sooner we start thinking of masks as part of our outfits, as essential and unremarkable as shoes or a belt, the healthier we will all be.

Try to quit caring about what others think. This one is hard. But one wise PF patient wrote, "I just don't give a darn!" Essentially, he shared that if people want to judge him for wearing a mask, so be it. Their opinions don't have a single thing to do with him. Many in the chat group applauded his confidence and vowed to adopt his attitude.

If we all do our best, soon the cultural scale will tip. Wearing a mask or not wearing one will cease to be a political statement. It will be normal. And thankfully, if wearing a mask in public, handwashing and sanitizing, and keeping our distance are all normal, going out into public again can be safe and normal too.

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

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