Introduction

Winter is here, hot coffee, cosy blankets and a warm hug. Does it get any better than this? It surely doesn’t, you have plans coming up with your friends, and you’re excited about the new memories you’re about to make but the bad news is it all got cancelled because of getting flu from nowhere. Well, that ruined it but what's next is worse, after visiting the doctor you get diagnosed with RSV. Lucky for you, you’re in safe hands and will learn how to take care of yourself or your loved one when suffering from RSV.

RSV stands for Respiratory Syncytial Virus.¹ It is a respiratory infection affecting the lungs, like the common cold but more intense. RSV is a very contagious disease and its symptoms range from mild to severe.

RSV is at high risk of transmission during winter, so extreme care must be taken around this time of year. The virus is transmitted by inhaling airborne viral droplets or by contact with the infected surfaces. Most people who get this disease recover fully without any complications but some populations like infants, and adults with low immunity are at high risk and need medical attention right away.

Studies have shown that One to three of every 100 patients with RSV as the primary infection are hospitalised, mostly 2–6 month-olds.1 Five per cent of patients with RSV are intubated.²

Sign and symptoms

• Sneezing
• Cough
• Runny nose
• Fever

Severe symptoms

• Difficult breathing
• Not drinking enough
• Decreased activity
• Nasal flaring
• Bluish lips & fingernails
• Wheezing (caused by inflammation of the bronchioles and narrowing of the airways)
• Ear infections and croup (a barking cough due to inflamed upper airways) can also occur in children

Importance of taking precautions when caring for an infected person

Your loved one is suffering from this disease and it all falls upon you to take care of so that they can get healthy again but you must also take care of yourself in times like these. Your health matters because the infected person is relying on you for their recovery. Your health is crucial and you must take care of these precautions such as

• Washing hands frequently 
• Wear masks to prevent from inhaling any infectious agent
• Wear gloves to make sure you don't come direct contact with the contaminated water
• Eat healthy food, ones that boost your immunity. 
• Say no to snacks and unhealthy food

Understanding RSV transmission

RSV is a viral disease which is transmitted when a person comes in direct contact with airborne virus droplets, coughs and sneezes of an infected person. It can also be transferred by touching a contaminated surface and then touching the eyes, nose and mouth with unclean hands. Since it is a virus it rapidly replicates inside the host cell and makes multiple copies of the virus and affects the whole body. It normally takes 2-3 days to show symptoms but in the case of infants or immunocompromised patients, it is very deadly and shows symptoms within one day.

Direct contact

If you come into direct contact with an infected person, such as cuddling an infected infant, drinking contaminated water, or touching a contaminated individual, you are likely to be affected.

Respiratory droplets

This is one of the main modes of transmission where viral droplets are inhaled which ultimately affects the lungs' upper region (nose, throat, pharynx) and lower region (Bronchi and Alveoli). This is the most common source of infection and can be avoided with proper care.

Contaminated surfaces

People often tend to forget about this part however it is the most important point. The contaminated surfaces must be properly cleaned, disinfected and sanitized to ensure proper cleanliness. 

Risks of getting RSV³

This virus can affect anyone regardless of age but some of the population is better at fighting against this disease and show less severe symptoms. However, some populations that are at risk of showing more severe symptoms include

• Infants under 6 months
• Premature Infants
• Adults or children with weak immune system
• Adults or elderly patients with multiple diseases e.g. Hypertension or diabetes

Personal protective measures

Hand hygiene

Washing hands is important after close contact with an infected individual or touching a surface contaminated with the virus. Always carry a hand sanitiser and ensure it contains at least 60% alcohol. Use it regularly, especially when soap and water are unavailable. Additionally, wash your hands with special soaps and proper techniques to maintain hygiene. This must be strictly followed because you can protect yourself from this disease by maintaining proper hygiene.

Mask wearing

When you encounter an infected person you must always wear a mask because this virus can travel in the air as droplets and inhale which will ultimately reach the lungs and cause the infection. The infected person must also wear a mask which decreases the chance of spreading the virus to a great extent.

Glove usage

Proper wearing of gloves provides a protective barrier between contaminated surfaces and hands. This ensures that your hands are clean even if you forget to wash them. You must always wash hands thoroughly but it's always better to take precautions.

Environmental precautions

Surface cleaning and disinfection

This includes cleaning surfaces like doorknobs, staircase rails, bedside side tables etc. with detergents and disinfectants. With proper cleaning, there is very little chance of spreading the virus. If there is any spillage of fluids like the blood of the infected person then must be cleaned immediately to remove any source of contamination.

Ventilation

Ventilation improves the indoor atmosphere and helps them, this will increase the ventilation and decrease the chances of transmission of the disease. You can set HEPA filters (high-efficiency particulate air)⁴ or HVAC ( Heating, Ventilation, and Air Conditioning)⁵. These are optimum for filtering the air and providing filtered and clean air.

Isolation

Just like COVID-19 this disease also requires quarantine and isolation protocols. The infected individuals are isolated for 2-3 weeks depending on the severity with minimum contact with everyone. This is beneficial for the caretaker and the infected person. Normally, in large hospitals people with this condition are made to live together because of a shortage of rooms. This is also a great step to avoid any spreading of the virus. 

Managing symptoms and care

Monitoring symptoms

The symptoms of RSV should be closely monitored to check for any serious disease. If you do have any of the severe symptoms then immediately visit the doctor for a proper diagnosis and start the treatment plan as directed.

Supportive care

It is recommended to keep yourself hydrated, you must drink plenty of water as it leads to flushing of the infection agent in the urine. Moreover, Proper Sleep is recommended as this gives the body enough time to heal and get stronger which improves immunity and gives enough energy to fight against this disease. In case of severe nose blockage, saline nose drops can be administered, and people having trouble breathing are given oxygen masks. For children, Nebulizers are effective in clearing the airways and therefore improve the breathing of the infants.

Medication administration

Safely administer the prescribed medications and avoid over-the-counter options without consulting your physician or pharmacist. Medication prescribe includes

Ribavirin⁶

It is the only approved drug by the FDA which has shown therapeutic activity against RSV. It inhibits the DNA and RNA replication in the host cell and stops the spreading of the virus within the body. The activity of this drug varies from individual to individual so it must be used with precautions and care. It is contraindicated for pregnant women, therefore it must not be prescribed.

Antibiotics are not prescribed for this disease because RSV is caused by a virus.  Antibiotics will not improve the symptoms and will only lead to the development of antibiotic resistance.

Post-care precautions

Laundry care

Even after full recovery you must take precautions and ensure weekly handling and washing of contaminated cloth, bed covers, pillow covers and cushions.

Waste disposal

As a caretaker, it is your duty to make sure to safely dispose of contaminated materials, bandages, tissues etc.

When to seek medical help

If you have trouble breathing even while in a resting position, barking cough, or blue nails or if the infant shows no activity and loses appetite then you must seek medical help right away and consult doctors. An early diagnosis can be lifesaving, do not try to assume it as a common cold just because of the similarities in the symptoms and make an appointment with the doctor.

Summary

RSV is a viral disease which has symptoms just like the common cold. It is usually mild and has a high recovery rate. It is transmitted by inhalation of air droplets of the infected person, close contact or by touching the contaminated surfaces.

Most people who get infected recover within 2-3 weeks with mild or no symptoms however the population with low immunity such as infants, premature infants, children under age 2 and immunocompromised elders with underlying diseases. Severe symptoms of this include trouble breathing, loss of appetite, blue lips etc.

In such severe cases, it must be treated immediately with oxygen masks, ventilation and by prescription of ribavirin. It can be prevented by wearing gloves, and masks and controlling the environmental conditions when in contact with the patient. For speedy recovery, the patient must be isolated and ensure hydration and rest. This also helps in protecting the caretaker from the likelihood of getting infected. Thus, RSV can be prevented and treated quickly by following the rules and precautions.