Help Prevent Annual Spread of Respiratory Virus
By Louise Jadwisiak, BSN, RN
Annual epidemics of Respiratory Syncytial Virus (RSV) occur during the late fall, winter and early spring months. St Louis Children’s Hospital is certainly no stranger to patients suffering its effects. The next RSV season will soon be upon us, and it’s not too early to begin preparing for the unique challenges in dealing with the effects of this familiar foe. It is important for the nurse at SLCH to be informed and prepared to teach parents the signs and symptoms of this virulent virus, as well as ways to prevent transmission.
Last year’s RSV season began in August and concluded in June 2008 with 607 documented cases. Of those, 252 were treated and released from the Emergency Unit, with 355 requiring hospitalization for treatment and care. 8E General Medicine nurses Beth Witzig and Stacey Schulte noted an increase in the time period that patients required supplemental oxygen as well as an increase in the number of older children admitted with RSV.
Many healthy infants, children and adults contract RSV every year and a person can acquire RSV more than once. It is one of the most common viruses contracted in the first two years of life. It is highly contagious and can progress into serious respiratory difficulty. Symptoms may begin with sore throat, cough and nasal congestion. Progression to the lower respiratory tract causes symptoms of tachypnea, dyspnea and retractions. In newborns, apnea may be the only presenting symptom.
Hospitalized patients generally recover with supportive care, respiratory treatments, supplemental oxygen, IV fluids for hydration, suctioning and close monitoring of respiratory status. In more severe cases intubation and ventilatory support may be required.
Patients at the highest risk of significant RSV complications include infants who are under 3 months of age or were born prematurely, or those with congenital heart or chronic lung disease. Children of any age who are immunocompromised or have been exposed to second-hand smoke are at significant risk for RSV-related morbidity and mortality. Parents of these high-risk children should be informed of options to prevent or reduce severity of an RSV infection.
Transmission and pathogenesis of RSV is by direct contact with contaminated secretions or indirectly from contaminated surfaces. The incubation period for RSV is, on average, 4-6 days and can be shed for up to 2 weeks or longer. Patients with more acute symptoms tend to shed the virus longer. Patients with positive or suspected RSV should have contact precautions initiated and continued until symptoms subside, even if testing for RSV is negative. Although contact precautions are an important factor in preventing the spread of this virus, good hand hygiene before and after patient contact remains the single most important means to preventing RSV transmission.
The author can be reached at
lmj3613@bjc.org.