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Ep. 9- RSV Update

There is an uptick in upper respiratory viral infections. Not the flu and not COVID. Find out all about Respiratory Syncytial Virus, or RSV, and why you need to protect your infant children and yourself from this virus on this edition of Straight Talk on Health

Welcome to Straight Talk on Health, I’m your host Dr. Chet Zelasko. Together with WGVU here in Grand Rapids, Michigan I examined the latest and greatest in the world of health. Whether it's research that makes headlines, another miracle diet, a new supplement or an exercise trend. I look at the science behind them and let you know whether it's real or not. You can check out other things that I do on my website: drchet.com and sign up for my free emails.

The topic today is a virus and this time it's not all about COVID. It's RSV the acronym of a pathogen called Respiratory Syncytial Virus. So you've got to be asking yourself, unless you have infant children, What the heck is RSV? It is a common respiratory virus that usually causes mild cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for two specific groups: for infants and children up to two years of age as well as for older adults.

How bad is this infection this year before getting into all the details. My daughter-in-law is a pediatric respiratory therapist and has been for 32 years. She was in Virginia now her and our son live in Charleston. And in her opinion, this is the worst year she's ever seen. Her mentor, whose been a respiratory therapist for 40 years, it's the worst she's ever seen in Charleston. They've got beds in the hallway of the NICU, that's the neonatal intensive care unit, because of all the overflow cases. Cases are up here in Grand Rapids, Michigan, and we're not even in the critical part of the season yet, which is winter and spring.

So is it serious? Yes, so pay attention, especially if you have young children and elderly parents. RSV is the most common cause of bronchiolitis. Any time you see the word “it is” it means inflammation. So this happens to be the inflammation of the small airways in the lung. It also contributes to pneumonia, which is an infection of the lungs. And this is especially true in children younger than one year of age here in the United States.

Now, let me give you another, let's say, up close and personal story about this, my best buddy who happens to be living Qatar right now, he created a school of physical education there just in time for the soccer world championships that are going to be there. His daughter, who is now 20 years old, when she was born, she weighed just over 2 pounds. She literally could fit in the palm of his hand. You know, one thing about preemies, they are absolutely susceptible to RSV. It can kill them and the reason is, if you don't understand it, their lungs are very, very weak. Born that early at that little weight. And so before she turned two, and this extended, because of her condition being a preemie, up until she was five, she got RSV twice and it nearly killed her. All within the first year of her life. And so I admire him greatly for all the time that he spent with it. But that's the first time that ever heard of RSV. And now that it's come back, I think especially all of you with infants need to need to pay attention to this.

So when I say dangerous, here's what I'm talking about: It's dangerous for some. If you're a numbers person, here's what the numbers look like in an average year. And this one is worse. An estimated 58,000 children younger than five are going to be hospitalized due to RSV in a typical year with between 100 to 500 deaths per year. And those at greatest risk for severe illness from RSV are those that I already talked about, premature infants are especially at risk most likely because of their week lungs and a compromised immune system. So, here's the rest of the list: young infants, especially those 6 months and younger, children younger than two with a chronic lung condition or congenital heart disease, children was weakened immune systems, children who have neuromuscular disorders including those who have difficulty swallowing or clearing mucus secretions.

When we look at severe RSV infections, look, virtually all children are going to get RSV by time they're two years old. Most of us adults have already it. Typically what you're going to get is mild cold-like symptoms. But it can also cause severe illness such as, as I already mentioned; bronchiolitis, it can cause pneumonia and so one to two out of every one hundred children younger than 6 months of age with an RSV infection may need to be hospitalized. For those of you who do have very young children, there's some things that my daughter-in-law told me that I think are worth sharing with you. She’s got 32 years of experience so she knows of what she speaks.

When you look at very young infants, they almost always show symptoms, but they can't tell you what's wrong. And there's one thing that's critically different from older children is that they are nose breathers. Infants up through 6 months and sometimes older are nose breathers. And so the things may not be typical. There may not always be fever, but there could be increased irritability, especially decreased appetite. Obviously, no oxygen, decreased activity, apnea, so you may notice pausing while they’re breathing and understand that fever doesn't always occur with RSV infections. So as I said, infants are nose breathers. The most important thing adults can do is suction the nose to keep their breathing pathway open. Now, this is what she told me, she said that you're going to hear wheezing, and it's going to sound like it's coming from the lungs. But in reality, it's actually sort of a rebound thing that's occurring in the nasal passages.

So the thing that's important is use saline drops if you need to, to make the mucus a little bit more pliable for lack of a better term, or liquidity. But use suction and make sure that their airway stays clear. Something else that I didn't know, if they have a fever, keep them cool. Don't pile on a lot of blankets, although that seems intuitive. That's what I would do. Well, that's just the opposite of that. They're breathing rate is higher to dissipate heat. So you've got to keep them a little bit cooler. I’m not saying to pack them in ice or anything like that. But you don't have to pile on the blankets if they do have the fever. Keep a humidifier going to help with the mucus so that it can stay liquid and not clog up. And finally do what, if you remember terms of endearment, what adults do, watch the baby. If they are really struggling to breathe, especially through their mouth and especially if their infants who are nose breathers, get medical attention right away. Now, what can we do to prevent this?

If I have time, I'll get to adults because it's serious for them, too. But we know through the experience of COVID what to do to try and keep things as safe as possible. Look, this is a very common virus. It's going to be passed on. But there are things that we know. One of the most important things that you can do is wash your hands a lot and keep your hands off your face. Avoid touching your eyes, nose and mouth with unwashed hands. That's the way germs spread. Tough to do all the time, but avoid close contact with sick people. Avoid contact such as kissing or sharing cups or eating utensils with people who appear to have cold-like symptoms.

Now, obviously, this isn't going to happen in public, people. You're not going to be going taking subset of everyone's coffee, but even at home if a spouse is sick or when the kids are sick, this is not the time to be eating after them. Does that tend to discard things, cover your mouth with coughs and sneezes, clean and disinfect surfaces, yada yada. You know this from all of our experience with COVID. Stay home when you're sick and if you feel you need to, wear a mask. people are wearing masks now because of COVID again. And regardless of what you may hear on on-air personalities and people that are in the medical profession, they can be quite effective, okay? But the closer that you are to an individual, the worse it can be, so keep your distance.

All right. We have enough time. So we're going to go and talk a little bit about older adults. Numbers again, 177,000, older adults are hospitalized and 14,000 of them much, much more are going to die due to an RSV infection. So who are most at risk? Those, especially those that are 65 and older, Chronic heart and lung disease, weakened immune system: when they get a severe RSV infection, odds are they are going to be hospitalized for it. We haven't gotten to that stage here. This seems to be particularly problematic with the young but the same things to prevent the spread of the disease are the same. And the most important thing is that when people have labored breathing from a respiratory infection, we all think COVID, but if it isn't necessarily COVID make sure that they get tested for RSV.

Here's the big problem. we currently do not have a vaccine for RSV. So from the preventive perspective, all you can try to do is all you can do from the things that we've learned through the COVID pandemic and from any type of virus. Wash your hands, cover your face, don't touch your face and on and on. This like everything will pass, but especially for infants, RSV can be very problematic. We want to make sure that we can keep it under control to the extent that we can control things. That's all for this show until next time, this is Doctor Chet Zelasko saying that health is choice, people. choose wisely today and every day.

Straight Talk on Health with Dr. Chet Zelasko was recorded in the studios of WGVU Public Radio in Grand Rapids, Michigan. The views and opinions expressed on Straight Talk on Health are not necessarily those of WGVU, its underwriters, or Grand Valley State University. Episodes are found at wgvunews.org and wherever you get your podcast, please rate and subscribe.

Dr. Chet Zelasko is a scientist, speaker, and author. Dr. Chet has a Ph.D. and MA in Exercise Physiology and Health Education from Michigan State University and a BS in Physical Education from Canisius College. He’s certified by the American College of Sports Medicine as a Health and Fitness Specialist, belongs to the American Society of Nutrition, and has conducted research and been published in peer-reviewed journals. You can find him online at drchet.com.
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