Friday, September 20, 2013

Are You and Your Preemie Ready for RSV Season?

Got sniffles?  Unfortunately, I do. 

As hard as I've tried to avoid contact with germs, I have developed a sore throat and a mild case of the sniffles.  It's disappointing -- as I'm the primary caregiver for our preemie, Emily. 

I can't afford to be sick and I can't put Emily at risk.  So, I'm wearing a mask and gloves in an attempt to protect her from whatever bug has invaded my body.  I'm also loading up on Vitamin C and chicken noodle soup.

I'm not sure what ails me.  Perhaps the change in weather has caused me to develop a cold -- or maybe it's allergies.  Whatever it may be, I hope it is minor and short-lived.
 
Nevertheless, my sniffles are causing my internal alarm bells to go off and are causing me to stress about things like Respiratory Syncytial Virus (RSV) and the flu.
 
RSV Season May Already Be Underway
 
RSV season already appears to be underway in Northern Virginia, according to one Northern Virginia mom.  Earlier this month, her Manassas preemie was infected with the virus, which impacts the lungs and breathing passages, and was ultimately hospitalized.  During that preemie's hospitalization, seven other babies were admitted for RSV.
 
Typically, RSV season occurs from October through April.  The National Respiratory and Enteric Virus Surveillance System (NREVSS), which is part of the Centers for Disease Control and Prevention (CDC), tracks RSV trends on a national, regional, and state-by-state basis.   
 
Although NREVSS surveillance graphs do not show a significant increase in RSV in Northern Virginia at this time, perhaps the gentle summer weather followed by the recent cold front are contributing to the early infections that have been reported to me.  NREVSS Surveillance reports by state can be viewed at the following website:  http://www.cdc.gov/surveillance/nrevss/rsv/state.html
 
If you haven't heard of RSV, you're not alone.  I learned of it earlier this year, when we were still in the Neonatal Intensive Care Unit.  Ironically, most children become infected with RSV before age two.
 
For many full-term babies, RSV is said to be like the common cold, but for preemies and other babies with chronic conditions or weakened immune systems, the virus can be quite different.  Preemies are among the highest risk for serious complications like pneumonia, bronchiolitis, and other sometimes fatal complications. 
 
Preventing the spread of RSV is very challenging.  RSV is spread through physical contact, in the air via a cough or a sneeze, or by touching an infected object, such as a doorknob or a handle.  The virus can live as long as six hours on hands and up to 12 hours on objects.  It spreads very easily -- which can be nerve-wracking, especially for preemie parents.
 
Although no vaccine is currently available to prevent RSV, a monoclonal antibody called Palivizumab (Synagis) can help reduce the severity of the illness.  According to our pediatrician, Synagis will not be made available to patients in Northern Virginia until November. 
 
With the hopes of making it through RSV season without contracting RSV or a similar illness, we have developed a few RSV prevention tips.
 
5 RSV Prevention Tips
 
1.  RSV Outreach to Family and Friends
 
We recently e-mailed information to immediate family and close friends about RSV.  The e-mail message expressed thanks for the love and support we have received during pregnancy, hospitalization, the NICU, and beyond.  The e-mail message also included valuable information about RSV and how it is spread, as well as prevention strategies.  We also mentioned that the e-mail message and any verbal comments we may make (including, but not limited to -- "Have you washed your hands?" -- "Please wash your hands before touching Emily" -- or -- "Mommy and Daddy are only holding Emily today due to RSV season") are not meant to offend anyone or hurt anyone's feelings.  The e-mail message was simply an effort to provide family and friends with a thorough explanation concerning RSV, and to remind everyone that Emily's health status is still incredibly fragile. 
 
2.  Tdap and Flu Vaccine
 
My husband, Craig, and I already have our Tdap vaccines and are researching the various types of flu vaccines and their availability.  We are also encouraging immediate family and close friends to obtain these vaccines if they have not already done so.  I will write more on the flu vaccine in a follow-up blog post.
 
3.  Limit Participation in Events
 
Unfortunately, we will not be attending many events during RSV season.  As much as we would like to attend family activities and community functions, we want to do everything we can to limit Emily's exposure to germs.  This means that only one of us will be able to attend my father-in-laws installation as a deacon.  We are disappointed that we will not be able to attend the installation service or reception, but we don't want to expose Emily to a crowd of strangers during RSV season.  We are also considering cancelling Emily's upcoming in-church baptism and are contemplating possible alternatives, such as a home or "do it yourself" baptism. 
 
4.   Limit Visitors
 
We are asking family and friends to refrain from coming over if they  are sick and have not been symptom free for at least five days, if they live with someone who is sick, or if they have been in close contact with someone who is sick. 
 
5.  Increase Hand-Washing and Use of Hand Sanitizer
 
We are diligent about hand-washing, but are increasing our hand-washing regimen and the use of hand sanitizer.  I am currently in the process of putting hand sanitizer in each room of our house.  We are also asking any visitors to our home to wash their hands thoroughly and use hand sanitizer throughout their visit, especially before touching Emily.
 
RSV Resources
 
Below are some helpful resources concerning RSV:
 
American Academy of Pediatrics, "Modified Recommendations for Use of Palivizumab for Prevention of Respiratory Syncytial Virus Infections" - http://pediatrics.aappublications.org/content/124/6/1694.full.html
 
Centers for Disease Control and Prevention - http://www.cdc.gov/rsv/
 
RSV Protection Website (MedImmune) - https://www.rsvprotection.com/
 
Synagis Website (MedImmune) - https://www.synagis.com/

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