American Medical Association Family Medical Guide - American Medical Association [402]
Outbreaks of RSV occur throughout the year but are most common in the fall and winter. The virus is highly contagious and can be contracted when a person inhales infected droplets coughed or sneezed into the air or by touching an infected person or contaminated surface (the virus can live from 4 to 7 hours on inanimate surfaces).
Symptoms
The symptoms of an RSV infection resemble those of a cold, such as a runny and stuffy nose, sore throat, and a slight fever. In children who are at high risk, symptoms may be severe and include a high fever, coughing, wheezing, and difficulty breathing or rapid breathing. Severe cases can cause respiratory failure. The infection usually lasts about 5 days. A person can become infected with RSV more than once, but subsequent infections tend to be milder.
Diagnosis
It is especially important to identify an RSV infection early in children who are at increased risk. To diagnose an RSV infection, a doctor will listen to the lungs with a stethoscope to detect any unusual sounds. He or she may then recommend a chest X-ray and test samples of blood and phlegm to determine if the infection is caused by RSV.
Treatment
No vaccine exists for RSV. Treatment of mild RSV infections in older children and adults is similar to the treatment for colds—drinking water to prevent dehydration, inhaling steam to break up congestion, taking an over-the-counter pain reliever to reduce fever and ease pain, and using a saline nasal spray to relieve a stuffy nose.
To treat a severe RSV infection, a doctor may prescribe an antiviral drug called ribavirin, which is administered through an aerosol spray. In children who are at increased risk, a severe RSV infection may require hospitalization.
Prevention
To help prevent the spread of RSV, wash your hands frequently and avoid contact with people who seem to have a cold. When possible, keep at-risk children away from people who are sick. To prevent RSV infections in at-risk children, doctors may recommend giving them antibodies (immune proteins) to fight RSV. This medication, called palivizumab, is given in a shot once a month during RSV season (usually from November to April).
Acute Bronchitis
Acute bronchitis is inflammation of the airways of the lungs (the bronchi and bronchioles) that is usually caused by a viral infection such as a cold or the flu, although it may also be caused by a bacterial infection. Most cases occur in the winter. Acute bronchitis usually affects people who are very young or very old, have a lung disorder or congestive heart failure (see page 570), or smoke or continuously breathe polluted air.
Symptoms
The symptoms of acute bronchitis include a cough that may produce phlegm, a mild fever, and sometimes slight wheezing. You may also have pain in your upper chest that worsens when you cough. Acute bronchitis usually clears up on its own in a few days. See your doctor if you have a fever over 101°F, if your wheezing is severe, or if you cough up blood.
Diagnosis
If you have symptoms of acute bronchitis, your doctor will listen to your chest with a stethoscope and may recommend an X-ray to rule out pneumonia. He or she also may take a sample of secretions to test it for the presence of bacteria or other microorganisms. The sample (culture) is grown in a laboratory and examined under a microscope.
Treatment
For acute bronchitis, your doctor may recommend an over-the-counter pain reliever (to ease discomfort and reduce a fever) and a cough medication. If the phlegm produced by your coughing is green, which usually indicates a bacterial infection, he or she will prescribe an antibiotic. If you are having trouble breathing or are coughing, your doctor may recommend using an inhaler with a bronchodilator drug to open your airways.
Chronic Bronchitis
Chronic bronchitis is recurring inflammation of the airways of the