Health tips for patients with respiratory syncytial virus (RSV)

What do you need to bear in mind if you have acute bronchiolitis?

Acute bronchiolitis is a respiratory tract infection common in infants under two. This infection, caused by RSV, manifests itself in mild or moderate catarrhal symptoms, although if it is not treated, it may progress and cause serious bronchiolitis or pneumonia.

The symptoms of acute bronchiolitis may vary depending on the patient’s age:

• In adults and the majority of healthy infants: upper respiratory symptoms (rhinitis, mild cough, minor wheezing)
• In breastfeeding and premature babies: normally, lower respiratory symptoms (bronchiolitis, pneumonia)

This virus may be transmitted in two ways:

• Directly: through contact with secretions from an infected individual (wet mode)
• Indirectly: through contact with surfaces, such as furniture (for example, those that have been exposed to infectious secretions)

The preventive measures to avoid transmission of the virus are:

• Hand hygiene: hands should be washed before touching the child.
• Toys should be cleaned, especially after having been used by other infected children or adults.
• Personal utensils (plates and feeding bottles) should be washed properly and specific utensils used for the infant that are different to those used by adults.
• (Paper) disposable tissues should be used and immediately disposed of (not re-used).
• Physical contact with the infant should be avoided by people with respiratory symptoms or fever. Infection can be avoided if a distance of 1.8 m is maintained from the person with symptoms.
• Enclosed environments and crowds should be avoided.
• Avoid exposure to tobacco smoke.
• Breastfeeding should be encouraged, as it protects against infections.

Admission to hospital is more likely in infants belonging to high risk groups:

• Children born premature
• Children with chronic pulmonary illnesses
• Children with congenital heart disease

In the above cases, administering prophylaxis with palivizumab is recommended, as it is proven to reduce hospital admissions for RSV.

Palivizumab

• Palivizumab is a passive immunisation that prevents infections due to RSV (it is not a vaccine).
• It does not normally have adverse effects and it does not interfere with the vaccination schedule.
• Care must be taken to ensure that the doses are correctly given, since each dose last approximately 30 days.
• It must be administered by a healthcare professional in a hospital clinic (it cannot be administered in a primary care centre).
• The dose given will depend on the child’s weight, and will be administered once a month during an epidemic period (five doses in total) and by intramuscular injection to the face and/or outside thigh.