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RSV (Respiratory Syncytial Virus) is a common respiratory infection that most families have experienced without even knowing it. It’s so common that almost all of us and our kids have had RSV at least once before the age of 2. In most cases, the symptoms of RSV are indistinguishable from the common cold. However, in rare cases, RSV can cause a serious lung infection that may require hospitalization.

This article covers the treatment and prevention of RSV and information about when it is time to see a doctor. 

What Is RSV?

RSV is a common respiratory infection that most often produces mild cold symptoms including dry cough, sneezing, low-grade fever, sore throat, congestion, and headache. People usually fully recover in 1-2 weeks. 

However, in infants under 12 months, preterm infants, the elderly, people with underlying heart and lung disease, people with certain genetic polymorphisms, and immunocompromised people, RSV infection can result in bronchiolitis and pneumonia that could require hospitalization. Pregnant women are also at higher risk of severe RSV bronchiolitis, which may have an impact on their unborn babies.

Symptoms of RSV Bronchiolitis & Pneumonia

RSV bronchiolitis and pneumonia occur when RSV infects the bronchioles and lower lungs. Severe RSV lung infection symptoms include high fever, severe cough, wheezing, rapid breathing, difficult or painful breathing, difficulty breathing while lying down, and bluish color of skin.

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A diagram of the lungs.

In infants, severe RSV infection can include any of the above symptoms in addition to poor feeding, unusual tiredness, and irritability. Infants struggling to breathe will often breathe more quickly and shallowly and will demonstrate retractions (skin and muscles pulling inward with each breath taken).

When To See A Doctor For RSV

Seek emergency medical care if the person with RSV has a high fever, difficulty breathing, and/or bluish color to the skin, lips, or nail beds.

Complications of RSV Bronchiolitis And Pneumonia

RSV bronchiolitis and pneumonia may cause difficulty breathing to the degree that hospitalization is required. At the hospital, IV fluids may be necessary to prevent dehydration and humidified oxygen may be administered to keep blood oxygen levels high. In rare cases, mechanical ventilation could be needed.

Infants and children who get severe bronchiolitis as a result of RSV infection are at greater risk for developing asthma later in life. If a pregnant woman gets a severe RSV infection, her child is at greater risk for some types of immune deficiency and lung dysfunction later in life.

People with RSV may be at greater risk for a viral or bacterial co-infection with pathogens like influenza, SARS-CoV-2 (Covid-19), and others. Co-infections are infections that occur at the same time. If co-infection occurs, symptoms tend to be more severe.

Natural Treatment For RSV

Natural treatment for RSV includes keeping the airways clear and hydrated, preventing dehydration, and comfort. Providing support to the immune system may be helpful via immune-enhancing nutrients, immune system botanicals, homeopathic remedies, and natural antivirals.

1. Keeping Airways Clear And Hydrated

Keeping airways clear and hydrated is an important part of RSV management, especially for small babies. Because babies can’t clear mucus from their nostrils, manually removing mucus is necessary. I prefer a nasal aspirator for babies, but the NoseFrida or a simple nasal bulb works well too. Saline or xylitol drops can be administered to loosen mucus.

Steam inhalation is a common treatment for RSV and other respiratory infections because it soothes and hydrates the respiratory tissues. Calming, immune-stimulating, and antiviral herbs can be added for extra therapeutic benefit. For more information about how to set up a steam inhalation for your kids and which herbs and essential oils are helpful, see this article Botanical Steam Inhalation To Reduce Congestion & Soothe Coughs – Dr. Green Mom.

Note: Many people recommend cool mist inhalation for RSV and other coughs and colds. I hesitate to recommend it because even the most well-maintained humidifiers are often home to mold and other pathogens that may cause more harm than good.

2. Preventing Dehydration

Preventing dehydration is important anytime a child has an infection. Soothing teas with antiviral spices are a good option as are chicken soup and congee. You can also rely on homemade electrolyte drinks, coconut water, and breast milk for hydration.

Signs of dehydration to watch for include decreased urine output and fewer wet diapers, dry lips and mouth, decreased tears when crying, dizziness, sunken eyes, and sunken fontanelles in babies.

Read more: Signs of Dehydration & Homemade Electrolyte Drink Recipe – Dr. Green Mom

3. Fever Management & Comfort

Fevers are a normal part of childhood upper respiratory infections. When looking after feverish kiddos, the symptoms are more important than the number on the thermometer. If a child is quietly playing and acting like a slightly more subdued version of their usual self, I tend not to worry even when the fever is high. This is because fevers are part of the body’s natural defense system and fevers (less than 104F or 40C) are associated with faster and better recovery from infections.

Traditional herbal fever remedies are helpful for immune system support and for helping the body feel cooler and more comfortable without actually suppressing the fever.

Conventional fever reducers like acetaminophen and ibuprofen will suppress a fever and lower body temperature. I find them most helpful when uncomfortable body pain accompanies fever, when the fever is interfering with sleep, and/or when the fever is high (over 104F or 40C).

Read more: Fever Management Herbal Teas Safe in Childhood – Dr. Green Mom

4. Cough Treatment

Sometimes a mild cough can accompany RSV infection. There are many natural ways to soothe a cough, including essential oil chest rubs, botanical steam inhalations, and herbal teas. Read more: Natural Treatment for Coughs – Dr. Green Mom

I prefer to avoid over-the-counter cough suppressants when possible because coughing is an important reflex for clearing the lungs. However, I do use OTC cough suppressants when coughing interferes with sleep, causes exhaustion, and/or leads to vomiting.

5. Immune Enhancing Nutrients

Natural treatment of any viral infection usually involves increasing certain nutrients that enhance the immune response.

Better Vitamin D status in newborns is associated with lower risk of RSV bronchiolitis. This means that vitamin D supplementation could be an important preventative strategy, however, this strategy has yet to be fully researched. Early research also shows that zinc may decrease the amount of RSV in the lungs, but again these results are still preliminary.

To read more about ways to support the immune system, see Immune Support For All Ages – Dr. Green Mom.

6. Immune System Botanicals & Natural Antivirals

Immune enhancing botanical medicine like echinacea, elderberry, or medicinal mushrooms are traditionally used for preventing and treating upper respiratory infections, including RSV. 

Research into the antiviral activity of specific herbs against RSV is very limited, but there is promising initial evidence for echinacea, berberine-containing herbs (including oregon grape, goldenseal, and coptis), and licorice. However, much more research is required.

7. Homeopathic Remedies For RSV

Oscillococcinum is a homeopathic remedy that I always have on hand during cold and flu season. It is most effective if dosed at the onset of symptoms when there is just a tickle in the back of the throat. However, I’ve seen my little ones have a dramatic improvement within an hour of dosing Oscillococcinum, even when used on the second, third, or fourth day of symptoms.

Other homeopathic remedies to consider for RSV include bryonia (for dry cough), antimonium tart (for a wet cough), kali bichromium (for thick ropey mucus), pulsatilla (for thick yellow mucus and when the child needs a lot of reassurance), belladonna (for high fever), and rhus tox (for fever with body aches).

Things To Keep In Mind When Choosing Natural Remedies

When combining natural remedies, it is important to check the different herbs and nutrients in each supplement to ensure that you aren’t inadvertently getting double doses.

Homeopathic remedies don’t interact with each other, but care must be taken with appropriate dosing, especially for babies. Choose remedies that are 6C, 30C, or 200C. Avoid remedies marked with an “X” unless prescribed by a qualified healthcare provider. Remedies indicated with an “X” are less dilute than those indicated with a “C” and may include toxic levels of some herbs.

Conventional Treatment Of RSV

At present, there is no approved conventional treatment for RSV. Supportive care is recommended. This includes staying hydrated, resting with the head elevated, saline nasal drops, nasal suction, and fever management medication.

Bronchodilators and steroid inhalers have been evaluated as potential treatments for RSV, but haven’t been found effective. Hospital treatment of severe RSV includes IV fluids, humidified oxygen, and rarely mechanical ventilation.

Prevention Of RSV

Prevention of RSV is much the same as prevention of any contagious upper respiratory tract infection.

Hands lathered with soap hover over a bathroom sink. After two years of pandemic education, I believe that we are all well-versed in the merits of practicing good hygiene, limiting social contacts, getting lots of sleep, spending time outside, eating an anti-inflammatory diet, and keeping our immune systems healthy.

As mentioned above, low vitamin D status in newborns is associated with poorer outcomes for RSV infection. Maintaining good prenatal and postnatal vitamin D levels appear to be important for a healthy immune system at all ages.

Research suggests that probiotics are an important preventative measure when it comes to RSV. In my integrative medical practice, most families supplement with probiotics at during cold & flu season in order to support a robust immune system.

Palivizumab is a monoclonal antibody medication that can be used for the prevention of RSV in high-risk and preterm infants. This medication may be helpful for babies born before 35 weeks gestation and who are less than 6 months old or for children under 2 years of age with risk factors like congenital heart disease or bronchopulmonary dysplasia. Speak with your healthcare provider if you think your child might be a candidate for this medication.

The Impact Of The Pandemic On RSV Cases

RSV cases are rising higher, faster, and earlier this year than they have in other years. This news is naturally causing anxiety for a lot of parents, especially parents of very young or immunocompromised children. In this section, I will briefly unpack the reasons that RSV is spreading rapidly in the fall of 2022 and what this means for parents.

This RSV surge is unsurprising to many. Last October, scientists predicted that RSV cases would increase following the relaxation of social distancing, masking, and other public health measures that were put into place to reduce the spread of Covid-19. This is because there is a larger pool of young children who haven’t yet come into contact with RSV and consequently don’t have immunity to it. Furthermore, for the past two years, most new moms haven’t come into contact with RSV and therefore have less immunity to pass along to their children.

An important question is whether RSV is more severe this year than previous years. From what I’ve seen in my practice and recent research, my initial impression is that RSV infection is no more and no less serious in 2022 than it has been in previous years. However, we are at the beginning of the surge in RSV cases, research isn’t conclusive, and my impression may change as the season goes on and new data emerges.

I highly recommend that an infant or other vulnerable person stay home as much as possible if they get mild upper respiratory symptoms (like sniffles, coughs, and congestion) to prevent exposure to other viruses and possible co-infections that could potentially be more serious. I’m aware that keeping children home with mild symptoms isn’t a realistic option for many families; therefore, a second best course of action would be to promptly treat mild cold symptoms.

Summary

RSV (Respiratory Syncytial Virus) is a common virus that usually causes a mild upper respiratory infection. Usually, the symptoms of RSV are mild and similar to the common cold. In rare cases, RSV can be serious and require hospitalization, so it is important to be aware of warning signs.

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Dr. Green Mom

Dr. Mayer is a naturopathic medical doctor and an expert in nutrition and wellness as it relates to pediatrics and families. Her passion for prevention of disease as cure fueled her desire to immerse herself into specializing in adult onset chronic conditions, as well as childhood chronic illness.

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