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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COVID-19 Vaccine for Those Pregnant or Nursing

Here are the facts you need to know to make a good decision about whether or not to recieve the COVID-19 vaccine: 

  • During the COVID-19 pandemic we found out that pregnant women with COVID-19 disease are more likely to get a very severe infection.  According to the Society for Maternal Fetal Medicine, they are three times more likely to have to go to an intensive care unit, two to three times more likely to need advanced life support and a breathing tube, and sadly, they have a small increased risk of death due to COVID-19. They may have worse pregnancy outcomes, such as pregnancy loss, stillbirth, and preterm birth. It is difficult to know yet whether COVID infection causes these outcomes or whether they happened at the same time by chance.
  • Similarly, COVID-19 can cause chronic inflammation, which could decrease fertility in both men and women.
  • The Federal Drug Administration (FDA) has provided Emergency Use Authorization for the COVID-19 vaccine. It is recommended for everyone over the age of 16 who has not had an allergic reaction to the ingredients in the vaccine. Research has shown that the COVID-19 vaccine is 95% effective in preventing COVID-19 as soon as 28 days after the booster vaccine. These agencies directed all their effort to this work, day and night, which is how the vaccine was approved for use so quickly. No steps were skipped. 
  • It is not possible to get COVID infection from the vaccine. The virus is not in the vaccine.  It is like the flu shot, which exposes the body to something that looks like the part of the virus, so our bodies do the natural process of making antibodies to protect against disease. 
  • Many people have minor side effects, like tiredness, fever, muscle pain, headache, and pain where the shot was given. They could last a few days.  A few people feel very unwell. Having symptoms is a sign that the vaccine is working, and antibodies are being made.
  • Pregnant women were not allowed to be part of the research, which is very common for medical research trials. There were no reports of negative outcomes among the trial participants who became pregnant during the trial.
  • The vaccine does use a new technology called mRNA.  Two shots are required 3 weeks apart. Scientists believe that the mRNA can’t get into the placenta or the breast milk. The same kind of technology made vaccine against Ebola disease.  It has been given to pregnant and breastfeeding women.  No problems for mom or baby were found from this vaccine.
  • The vaccine does not cause birth defects or infertility. While the spike proteins on the virus and those found on the cells of the placenta are similar, they do not share enough amino acid sequences for the immune system to become confused.
  • The vaccine should also be offered to those who are breastfeeding/lactating. Like pregnant individuals, those who were breastfeeding were not included in the clinical trials for the vaccine. According to the Society for Maternal Fetal Medicine, the benefits of vaccination outweigh the very small safety concerns, and you do not have to stop breastfeeding because you get the vaccine.

Experts trusted by your providers recommend strongly that pregnant women be encouraged to get the vaccine.  We can’t tell you whether to get the shot, but we trust that you will make the right decision for you and your baby. Here are some points to consider as you decide:

  • How many people are getting sick with COVID-19 in your community?
  • What is your personal risk of getting COVID-19 based on your job or other exposures?
  • What is your risk of getting very sick with COVID-19, and what is the possible harm to your baby? What other medical conditions could increase this risk? Diabetes, being overweight, having lung, kidney, heart or immune illnesses or taking medicine that depresses immune function ( like chemotherapy, methotrexate, prednisone). 
  • Consider how well the vaccine is reported to work. These vaccines work exceedingly well!
  • What are the risks to other people in your household if you get sick, especially if you are living with people at risk for serious illness, like the elderly.
  • How do you feel about the lack of scientific evidence about the vaccine’s safety and effectiveness for pregnant women?
  • How do you feel you would manage the reported side effects of the vaccine?

If you do get the vaccine:

  • Pregnant women who experience fever, either as a result of COVID-19 infector or following vaccination, should take acetaminophen (Tylenol) to treat fever, since a very high fever can harm a baby. A fever is far more likely as a result of COVID-19 infection than it is from vaccination.
  • Your health professional will give you information about enrolling in the V-Safe After Vaccination Health Checker. You can provide feedback on how the vaccine experience went for up to a week following your vaccination and get help with any concerns that may arise.

If you have questions, please ask your OB/GYN.

Whatever you choose, be sure to continue with the important prevention steps like avoiding visits with those outside your household, masking and distancing when in public, and washing your hands frequently.

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