RSV (respiratory syncytial virus) is a respiratory virus that in adults typically produces the symptoms of a mild cold. But an unseasonably early spike in RSV among children—particularly those age 5 and under—has been hitting communities across the U.S. pretty hard.

RSV can cause bronchiolitis and pneumonia in very young children and can be life-threatening in infants and adults over 65. Most children get RSV at least once before age 2, but cases took a dip over the past two years because so many of us were observing pandemic-related safety measures

With the recent relaxing of masking and social distancing, RSV has made a significant comeback—and now some children are getting very sick.

The symptoms of RSV in very young children resemble those of the common cold: fever (104 F or higher), cough (dry or wet), congestion and runny nose, fussy behavior, and poor eating and drinking. These symptoms normally resolve in 7—10 days.

If your child’s cold-like symptoms are severe and do not resolve, then he or she could be developing bronchiolitis. This is an infection of the lower respiratory tract and can be marked by symptoms such as fast or short breaths, flaring of nostrils, grunting noises, bobbing of the head while breathing, belly breathing, tugging between the ribs and/or lower neck, and wheezing.

If your child’s rib cage seems to “cave in” and form an upside down “V” shape under the neck when inhaling, then he or she is working very hard to breathe. Cases of severe RSV, bronchiolitis, and pneumonia in young children can require hospitalization.

It’s time to call your child’s primary care clinician or pediatrician right away if a child has any of the following: symptoms of bronchiolitis (listed above), symptoms of dehydration (for example, fewer than 1 wet diaper every 8 hours), pauses or difficulty breathing, gray or blue color to the tongue, lips, or skin.

Certain children are at greater risk for severe RSV. These include children who are 12 weeks old or younger when RSV season starts (usually late fall).

Other children at higher risk for severe RSV include those born prematurely or with low birth weight, those with chronic lung disease associated with prematurity, babies with heart defects and/or weak immune systems, children in early learning programs and those in crowded living conditions.

As the covid pandemic wanes, and as more of us get back to our pre-covid lifestyles, many common viruses including colds, flu, and RSV are bouncing back. That’s why it’s important to take preventive measures such as keeping your children up-to-date with their immunizations (including Covid-19) and making sure every family member gets their annual flu shot.

And certainly don’t hesitate to call your child’s healthcare provider promptly if you notice that a cold seems to be hanging on and/or turning into something more serious. This year, especially, it could be RSV.

 Author Johanna Murphy, FNP is a board-certified family nurse practitioner with Brattleboro Family Medicine, a member of the Brattleboro Memorial Hospital Medical Group. She can be reached at 802-251-8455.