Keep an Eye on That Cough: Respiratory Virus Reaches Epidemic Levels in Florida
Respiratory syncytial virus, or RSV, infiltrates preschools and day care centers each year, starting out like a cold and then morphing into more serious coughing and wheezing. Although RSV season typically runs from November to April in most of the United States, the virus thrives almost year-round in Central Florida, where the Centers for Disease Control and Prevention says it has already reached epidemic levels, the Orlando Sentinel reports.
According to statistics from the Florida Department of Health, 18 percent of the state's babies tested for RSV have it, Dr. Carlos Sabogal, a pulmonologist at Arnold Palmer Children's Hospital tells the Sentinel. The CDC considers the situation epidemic when levels rise above 10 percent, the newspaper reports.
Although many parents may not be familiar with RSV, pediatricians are well aware of the dangers of the illness -- especially for infants -- because it can develop into a serious respiratory illness. In fact, RSV is the most common cause of bronchiolitis and pneumonia in children younger than 1.
Babies born prematurely are most at risk of developing RSV, frequently requiring hospitalization when they catch the virus.
"One out of every of 100 kids who are not preemies will be admitted to the hospital with RSV, but one in five preemies will be admitted with RSV," Dr. Floyd Livingston, chief of pediatrics at Nemours Children's Clinic in Orlando, tells the Sentinel.
During RSV season, one out of every 12 pediatrician visits is due to RSV; while about 25 percent of all doctor visits for children younger than 5 involve the condition, Livingston says.
At first, RSV may appear to be a common cold, where children have the sniffles or a runny nose and a cough. But soon they get more of a "brassy, severe cough," Livingston says, which gets more frequent and eventually they develop wheezing.
Symptoms usually last a week or two in healthy kids, while the illness runs its course. Since RSV is a virus, antibiotics do not help, so parents are advised to ensure their children drink fluids so they don't get dehydrated, and to suction out runny noses to help them breathe more easily, the Sentinel reports.
Like the common cold, the RSV virus spreads through sneezes and coughs, which is why it spreads quickly in day care centers and schools. Frequent hand washing and sanitizing of toys and surfaces can help curb the spread of RSV in these situations, but older siblings also can bring the virus home from school and transmit it, according to the newspaper.
Kids and adults also contract RSV each year, but their breathing is usually not affected as much because their lungs and airways are larger.
"Babies in the first two years can develop a lower respiratory infection because of the immaturity of the immune system and smaller lungs and windpipes," Sabogal tells the Sentinel. "That's why it's more common in premature infants -- because their lungs are smaller and their airways are smaller."
Pediatricians have routinely given premature infants a monthly shot of the prevention drug palivizumab during the RSV season, but the drug costs about $1,000 per shot and new guidelines from the American Academy of Pediatrics (AAP) advise cutting back on how much palivizumab is used. In "older preemies," born between 32 and 35 weeks gestation, the AAP now recommends no more than three shots during RSV season, the Sentinel reports.
But, in Florida, where RSV season is nearly year-round, doctors worry three shots will not be enough.
"I think we're going to have more admissions to hospitals for late premature infants, especially if it's a really heavy RSV season," Livingston says. "I think we're going to have a lot of anxiety from parents and health-care providers."
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