Diagnosis

Your doctor may suspect respiratory syncytial virus based on the findings of a physical exam and the time of year the symptoms occur. During the exam, the doctor will listen to the lungs with a stethoscope to check for wheezing or other abnormal sounds.

Laboratory and imaging tests aren't usually needed. However, they can help diagnose RSV complications or rule out other conditions that may cause similar symptoms. Tests may include:

  • Blood tests to check white cell counts or to look for viruses, bacteria and other germs
  • Chest X-rays to check for lung inflammation
  • Swab of secretions from inside the mouth or nose to check for signs of the virus
  • Sometimes, painless skin monitoring (pulse oximetry) to detect lower than normal levels of oxygen in the blood

Treatment

Treatment for respiratory syncytial virus generally involves self-care measures to make your child more comfortable (supportive care). But hospital care may be needed if severe symptoms occur.

Supportive care

Your doctor may recommend an over-the-counter medication such as acetaminophen (Tylenol, others) to reduce fever. Frequent use of nasal saline drops and suctioning can help clear a stuffy nose. Your doctor may prescribe antibiotics if there's a bacterial complication, such as bacterial pneumonia.

Keep your child as comfortable as possible. Offer plenty of fluids and watch for signs of dehydration, such as dry mouth, little to no urine output, sunken eyes, and extreme fussiness or sleepiness.

Hospital care

If the RSV infection is severe, a hospital stay may be necessary. Treatments at the hospital may include:

  • Intravenous (IV) fluids
  • Humidified oxygen
  • Mechanical ventilation (breathing machine)

The doctor may recommend an inhaled form of an antiviral medicine called ribavirin (Virazole) for people with very weakened immune systems (immunocompromised).

An inhaler (bronchodilator) or steroids are not proved to be helpful in treating RSV infection.

Lifestyle and home remedies

You may not be able to shorten the length of a respiratory syncytial virus infection, but you can try to relieve some signs and symptoms.

If your child has RSV, do your best to comfort or distract him or her — cuddle, read a book or play a quiet game. Other tips for relieving symptoms are:

  • Create moist air to breathe. Keep the room warm but not overheated. If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing. Be sure to keep the humidifier clean to prevent the growth of bacteria and molds. An ideal indoor humidity is around 50 percent.
  • Drink fluids. Keep a steady supply of cool water at the bedside. Offer warm fluids, such as soup, which may help loosen thickened secretions. Ice pops may be soothing as well. Continue breast-feeding or bottle-feeding your infant as you would normally.
  • Try saline nasal drops. Over-the-counter (OTC) drops are a safe, effective way to ease congestion, even for young children. Drip several drops into one nostril to loosen hardened or thick mucus, then immediately suction that nostril, using a bulb syringe. Repeat the process in the other nostril. Do this before feedings and before putting your baby to sleep.
  • Use over-the-counter pain relievers. OTC pain relievers such as acetaminophen (Tylenol, others) may help reduce fever and relieve a sore throat. Ask a doctor for the correct dose for your child's age.
  • Stay away from cigarette smoke. Secondhand smoke can aggravate symptoms.

Preparing for your appointment

Unless severe symptoms result in an emergency room (ER) visit, you're likely to start by seeing your family doctor or your child's doctor. Here's some information to help you get ready for your appointment, and know what to expect from your doctor.

What you can do

  • Write down any symptoms you noticed and when they started, even if they seem unrelated to an upper respiratory infection.
  • Write down key medical information, such as if your child was born prematurely or if he or she has a heart or lung problem.
  • Write down details about child care, considering other locations where your family may have been exposed to respiratory infections.
  • Write down questions to ask your doctor. Your time with your doctor is limited. Preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out.

For respiratory syncytial virus, some basic questions to ask your doctor include:

  • What is likely causing these symptoms? Are there other possible causes?
  • What tests might be needed?
  • How long do symptoms usually last?
  • What is the best treatment?
  • Is medication needed? If you're prescribing a brand-name medication, is there a generic alternative?
  • What can I do to make my child feel better?
  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend?
  • To what extent should I isolate my child while infected?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask any additional ones you may think of during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time for you to discuss information in greater detail. Your doctor may ask:

  • When did you first notice symptoms?
  • Do the symptoms come and go or persist?
  • How severe are the symptoms?
  • What, if anything, seems to improve symptoms?
  • What, if anything, appears to worsen symptoms?
  • Is anyone else in the family ill? What symptoms does he or she have?

What you can do in the meantime

If your child has a fever, you can give him or her acetaminophen (Tylenol, others). Have your child drink plenty of fluids to prevent dehydration. Keeping your child upright and the air moist with a humidifier also may help ease congestion.

July 22, 2017
References
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Respiratory syncytial virus (RSV)