Welcome to Conejo Children's Medical Group

The staff of Conejo Children's Medical Group welcomes you to our practice. Our medical staff includes five pediatricians who provide personalized health care to infants, children and young adults with experience in all aspects of pediatric care. Our staff is dedicated to providing care with the old-fashioned medical ethic, "putting the needs of the patient first". Each member of our staff is proud to extend personalized care to you and your family as we look forward to following your children through to young adulthood!

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                        RSV Information                                          from Children's Hospital Los Angeles

RSV: Everything You Need to Know

 

Published on 
October 31, 2022

COVID-or-RSV-Blog-Post.jpg

Two experts explain what the virus is, symptoms to look for and how to take care of children who are sick.

 

Respiratory syncytial virus (RSV) is a common virus that affects the upper respiratory system, which includes the nose and throat, and the lower respiratory system, which includes the lungs. In most people, the virus causes a cough, a runny nose, and sometimes a fever.

“We presume most individuals had RSV at some point in their lives, which can occur during early infancy and as young as the newborn period,” says pediatrician Steven Abelowitz, MD, Medical Director of Coastal Kids, a pediatric group practice in Orange County and a member of the Children’s Hospital Los Angeles Care Network. “If they get it again and are healthy with no preexisting conditions, the virus will present like a cold, mostly.”

The virus can be dangerous to some people, though. In infants, RSV can cause pneumonia or bronchiolitis, an inflammation of the small airways in the lungs. People over the age of 50 or those with heart or lung disease are also at risk for complications, and they can catch RSV from babies, toddlers and older kids. If your child gets RSV, keep him or her away from anyone in your family who is at high risk of becoming very sick.

How contagious is RSV?

RSV is very contagious. It can live on surfaces for hours, although the main way people catch it is by being in close contact with an infected person. The virus typically causes symptoms that last between seven to 10 days, but some kids can develop a cough that takes up to six weeks to clear. Most people with RSV are contagious during the three to eight days that they show symptoms.

RSV typically circulates first on the East Coast, and then makes its way to the West Coast, where transmission peaks in January and February. But cases have been increasing over the last few months in California and elsewhere.

“In our Emergency Department, as well as at the CHLA Urgent Care in Arcadia, we have already been seeing a dramatic increase in respiratory viruses, including RSV since October,” says Deborah Liu, MD, Associate Director of Emergency Medicine at Children’s Hospital Los Angeles. “This is unusual for this time of the year and we should be especially vigilant in keeping our children and ourselves healthy.”

Taking care of children with RSV

Most kids can recover from RSV at home. There is no medicine that works against the virus, but you can comfort children by treating their symptoms.

If your child has a stuffy nose, for example, you can use a saline spray and a bulb to suction out the mucus. A humidifier may help soothe respiratory passages. If your older child is coughing a lot, prop up his or her head with a pillow. Keep kids hydrated. If you have a baby, give frequent breastmilk or formula feedings, but don’t overfeed because babies can vomit easily when they have a cough or runny nose. If your baby is irritable or if your child feels extra lousy, you can give a pain reliever such as acetaminophen or ibuprofen. Ask your pediatrician about the correct dose to give.

“For most viruses, the management is the same: Stay home, stay well-hydrated, get lots of sleep and take acetaminophen or ibuprofen for fever,” Dr. Liu says.

One thing to not give your child is a homeopathic medicine. According to Dr. Abelowitz, because homeopathic medications aren’t regulated by the U.S. Food and Drug Administration, there is no way to know if they are safe.

Symptoms to look out for

If you are concerned about your child’s fever or if your child isn’t eating, is urinating very few times a day, is acting lethargic, or is acting or just looks very sick, call your pediatrician, Dr. Abelowitz advises.

“Always feel comfortable calling your pediatrician when you’re worried about your child’s symptoms. There really should be no limit on that,” Dr. Abelowitz says.

Some symptoms require a trip to the emergency department (ED). Severe dehydration, which can cause a very dry mouth or sunken eyes, should be treated immediately. In babies and toddlers, a warning sign is not having a wet diaper for 8 to 10 hours straight. If your child is struggling to breathe—such as using extra muscles to do it—wheezing, or breathing very fast, those are signs that you should go to the ED.

“Bronchiolitis can cause significant respiratory distress, and some patients require hospitalization and assistance in how they breathe, such as by needing extra oxygen or even a ventilator,” Dr. Liu says.

If your child has had a fever for five days in a row or longer, you should take him or her to the doctor to rule out a secondary infection. Sometimes children can develop a bacterial infection such as pneumonia, or an ear infection on top of a viral infection.

                 from Healthychildren.org

RSV: When It's More Than Just a Cold

 
RSV: When it's more than just a cold

By: Andrea Jones, MD, FAAP

Almost all children get RSV at least once before they are 2 years old. For most healthy children, RSV is like a cold. But, some children get very sick with RSV.

What is RSV?

RSV (or respiratory syncytial virus) is one of the many viruses that cause respiratory illness―illnesses of the nose, throat, and lungs. This virus occurs in the late fall through early spring months, but can vary in different parts of the country.

With mask-wearing and physical distancing for COVID-19, there were fewer cases of RSV in 2020. However, once safety measures relaxed with the arrival of COVID-19 vaccines, a rise in RSV cases began in spring 2021. The spread of RSV and other seasonal respiratory illnesses like influenza (flu) has also started earlier than usual this year.

 

RSV symptoms in babies

Typically, RSV causes a cold, which may be followed by bronchiolitis or pneumonia. Symptoms generally last an average of 5-7 days.

Cold: Upper Respiratory Tract Infection

Bronchiolitis: Lower Respiratory Tract Infection

Cold symptoms may include:

  • Fever (temperature of 100.4 or higher)

  • Cough (dry or wet sounding)

  • Congestion

  • Runny nose

  • Sneezing

  • Fussiness

  • Poor feeding

Symptoms may include cold symptoms, plus:

  • Fast breathing

  • Flaring of the nostrils

  • Head bobbing with breathing

  • Rhythmic grunting during breathing

  • Belly breathing, tugging between the ribs and/or the lower neck (see video, below)

  • Wheezing

How hard is your baby breathing? What to look for.

Chest wall retractions happen when a baby must use muscles between the ribs or in the neck to breathe. It is a sign that your baby is having to work harder than normal to breathe.

Watch your child's rib cage as they inhale. If you see it "caving in" and forming an upside-down "V" shape under the neck, then they are working too hard.

 

Is your baby or young child at a greater risk of this respiratory illness?

Those infants with a higher risk for severe RSV infection include:

  • 12 weeks old or younger at the start of RSV season

  • Premature or low birth weight infants (especially those born before 29 weeks gestation)

  • Chronic lung disease of prematurity

  • Babies with certain types of heart defects

  • Those with weak immune systems due to illness or treatments

  • Additional risk factors for severe RSV infections include low birth weight, having siblings, a mother's smoking during pregnancy, exposure to secondhand smoke in the home, history of allergies and eczema, not breastfeeding, and being around children in a child care setting or living in crowded living conditions.

When should you call the doctor?

RSV symptoms are typically at their worst on days 3 through 5 of illness. Fortunately, almost all children recover from an RSV infection on their own.

Call your pediatrician right away if your child has any:

  • Symptoms of bronchiolitis (listed above)

  • Symptoms of dehydration (fewer than 1 wet diaper every 8 hours)

  • Pauses or difficulty breathing

  • Gray or blue color to tongue, lips or skin

  • Significantly decreased activity and alertness

Some children with RSV may be at increased risk of developing a bacterial infection, such as an ear infection. Call your doctor if your child has:

  • Symptoms that worsen or do not start to improve after 7 days

  • fever (with a rectal temperature of 100.4°F or higher) and they are younger than 3 months of age (12 weeks).

  • fever that rises above 104°F repeatedly for a child of any age.

  • Poor sleep or fussiness, chest pain, ear tugging or ear drainage

 

 

How do doctors diagnose RSV?

Pediatricians diagnose children with a cold or bronchiolitis by asking about their symptoms and by doing a physical exam. Your pediatrician may do a nasal swab test to determine if your child has RSV or another virus. A chest x-ray and/or oxygen saturation test may also be done to check for lung congestion. Because most children recover without difficulty and because there is no treatment for RSV, these tests usually are not necessary.

Is RSV contagious?

Yes. RSV spreads just like a common-cold virus―from one person to another. It enters the body through the nose or eyes or, usually from:

  • Direct person-to-person contact with saliva, mucus, or nasal discharge.

  • Unclean hands (RSV can survive 30 minutes or more on unwashed hands).

  • Unclean objects or surfaces (RSV can survive up to 6 hours on surfaces, toys, keyboards, door knobs, etc).

Symptoms can appear 2 to 8 days after contact with RSV. According to the U.S. Centers for Disease Control and Prevention (CDC), people infected with RSV are usually contagious for 3 to 8 days. However, some infants and people with weakened immune systems can be contagious for as long as four weeks―even if they are not showing symptoms.

Keep in mind, children and adults can get RSV multiple times–even during a single season. Often, however, repeat infections are less severe than the first one.

What can you do to help your child feel better?

There is no cure for RSV and medications, like steroids and antibiotics, do not help with RSV.

To help your child feel more comfortable, begin by doing what you would for any bad cold:

  • Nasal saline with gentle suctioning to allow easier breathing and feeding.

  • Cool-mist humidifier to help break up mucus and allow easier breathing.

  • Fluids and frequent feedings. Make sure your child is staying hydrated. Infants with a common cold may feed more slowly or not feel like eating, because they are having trouble breathing. Try to section baby's nose before attempting to breast or bottle-feed. Supplementation with water or formula is unnecessary for breastfed babies. If difficult for the baby to feed at the breast, expressing breastmilk into a cup or bottle may be an option.

  • Acetaminophen or ibuprofen (if older than 6 months) to help with low-grade fevers. Always avoid aspirin and cough and cold medications.

Only 3% of children with RSV will require a hospital stay. Those children may need oxygen to help with breathing or an (intravenous) IV line for fluids. Most of these children can go home after 2 or 3 days. Rarely, a child may need care in a pediatric intensive care unit (PICU).

How can you protect your children from RSV?

Wash your hands! Just as you would to prevent germs at any time, use soap and water and scrub for at least 20 seconds. Remind children to practice good hand hygiene all through the year.

Other things that can help prevent RSV

  • Vaccinate. Keep your children up to date on their immunizations and get the whole family annual flu shots. Getting vaccinated with Tdap―to protect against whooping cough is especially important for adults who are around infant—new parents, grandparents, babysitters, nannies, etc. Your child should also be immunized against COVID-19.

  • Limit your baby's exposure to crowds, other children, and anyone with colds. Keep them home from school or child care when they are sick and teach them to cover their coughs and sneezes.

  • Go germ-free. Disinfect objects and surfaces in your home regularly and avoid exposing your child to smoke from tobacco or other substances.

  • Feed your baby breastmilk. It has unique antibodies to prevent and fight infections.

Injections for high-risk infants

There is a monoclonal antibody treatment that may reduce the risk of severe RSV infection in some high-risk infants. Your pediatrician will let you know if your baby is a candidate.

Hope on the horizon

Medicine is always advancing! Scientists are currently studying vaccines to prevent and medications to treat RSV. We may have more options in the future. In the meantime, rest assured that most children recover well from RSV and grow to be healthy adults.

More information

FLUMIST AND FLU INJECTION VACCINES AVAILABLE NOW!

Flu injection vaccine, preservative-free, is recommended and available for ages 6 months and older.

Flumist, also preservative free, is available for patients 2 years and older without any underlying medical conditions like asthma, aspirin therapy,chronic diseases.

There is no preference for either vaccine per the CDC or AAP.

            COVID 19 vaccines                                                  are now available for                                                ages 6 months and older

COVID 19 VACCINES ARE AVAILABLE NOW.

 

 

COVID vaccines are for ages 6 months  and above. We also have Pfizer  BIVALENT BOOSTERS available for ages 5 and older.

Please call or message us through the patient portal to schedule an appointment.

 

Some information to consider before you make an appointment-

 

  • Conejo Children Medical Group doctors in general have no preference for either Moderna or Pfizer. 
  • If a patient has a need to be “fully vaccinated” sooner, like traveling or in daycare,  consider Moderna because series will be complete in 1 month 
  • There is no preference for either vaccine if a patient has underlying conditions like asthma or diabetes 
  • Currently we are stocking both products, but we may change to one product based on requests 
  • Per the CDC website, COVID vaccines can be administered with other vaccines.  Some families may want to give the COVID vaccine alone and return for routine vaccines. 
  • Moderna can be be given to age 6 months up to age 5 years 11 months, and age 18 years and above.  Pfizer is indicated at ages 6 months and above.
  • COVID vaccines can be given 10 days after having COVID; either from symptom start or day of a positive test.  Most of our MDs recommend waiting 2-3 months after infection. 

 

There have been many phone calls about COVID vaccines for infants and young children.  Here are a few great resources:

                            Please visit our                                                          COVID 19 Page                                                  for updated information

Need a form completed?

Did you know your child's Annual Physical Exam can be applied to sports and camp forms if it was within the last year?

 

If your child hasn't had a checkup in the last year, call us or request an appointment through our patient portal TODAY.

We are now an affiliated provider

with the

CHLA Health Network!

We are so excited to be a part of this premier network dedicated exclusively to pediatric care!  Together in collaboration with the Network and Children's Hospital Los Angeles, we are committed to delivering innovative and seemless healthcare for you and your family.

www.CHLA.org/HealthNetwork

 

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We offer ear piercing services.  Cost is $90 which is not covered by insurance.  Call to schedule an appointment.

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Monday - Friday

9:00 am - 5:00 pm

 

Saturday

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Conejo Children's Medical Group

558 N. Ventu Park Rd.

Suite D

Thousand Oaks, CA 91320

 

Phone  (805) 499-5525

Fax       (805) 499-5554

email: frontoffice@conejochildrens.com

 

Patient Portal:

https://health.eclinicalworks.com/conejochildrens

 

 

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