For the Diehl family of Duluth, Minnesota, RSV prevention hits close to home. Audrey Diehl was born 15 weeks early – weighing 12 ounces and measuring 10 inches – and had little hope for survival, as she struggled in the neonatal intensive care unit for nearly 100 days. She made it through but was still at high risk for RSV. Although their doctor recommended Audrey receive preventive therapy, the Diehl family had to fight for insurance coverage for the costly injections.
Audrey celebrated her first birthday in March, 2011 as a healthy toddler. The family posted this slideshow to document her progress:
Crystal and Marshall Diehl want to make sure other parents are aware of RSV and know that they, too, can speak up for their child's health care.
RSV causes upper respiratory infections in most adults and older children, says Dr. Lee Muskovitz, neonatologist and NICU medical director at Essential Health's St. Mary's Medical Center in Duluth.
"Most infections cause cold-like symptoms and the individuals get over the infection with little problems. High-risk individuals – those that are immuno-compromised, very young, have congenital heart or lung disease – can experience a more severe infection of the lower respiratory tract. Many need hospitalization and supportive therapy to recover." RSV is a winter virus in the northern hemisphere, November through April, so now is the time to be vigilant about prevention.
Hand-washing is critical. The virus is transmitted through sneezing or coughing, though you'd have to be very close to someone to catch RSV directly. The virus can live on surfaces, such as countertops, desks, phones and computer keyboards, so if you touch these items and then rub your eyes, or touch your nose or mouth, you may become infected.
After hand-washing, families should try to reduce exposures by avoiding obviously ill people, Dr. Muskovitz says. "Keep visitors from touching the baby until they wash their hands. Try to avoid daycare settings."
A RSV prophylaxis is available for the highest-risk patients, although it is expensive and requires a monthly injection for the entire season.
Dr. Muskovitz says that in healthy, older infants, children and adults, the signs are usually similar to typical cold symptoms: cough, runny nose, mild fever, possible wheezing. In very young infants and growing premature infants, at highest risk in their first two RSV seasons, the signs can be very different. RSV infection can cause apnea – a prolonged pause in breathing – and cyanosis, where parts of the body have a bluish or purple tinge. These infants frequently feed poorly, are more lethargic, need stimulation to wake up and can become dehydrated.
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