Preventing respiratory syncytial virus in child care settings

Coronavirus has been in the news a lot this year, for obvious reasons, but another respiratory illness that’s been attracting attention is respiratory syncytial virus (or RSV).

There was a spike in RSV cases at early childhood services over the New Zealand winter, and just because it’s now spring, doesn’t mean this virus can’t still be caught.

KidsHealth says RSV is very common in both seasons. It’s also highly contagious and can have serious health effects for babies and very young children.

Today, we see what RSV is, and explain how early childhood education (ECE) services are taking steps to stop the virus in its tracks.

Plus, we report on an increase to the number of sick days you may be able to claim when illness strikes.

What is respiratory syncytial virus? 

The Ministry of Health describes RSV as a common respiratory virus that causes lung and respiratory tract infections.

It’s spread when virus-laden droplets pass between people through coughing, sneezing or talking, and RSV can also jump from object to person (e.g. if a child touches a contaminated toy, then touches their nose or eyes).

Almost all children will get an RSV infection by the time they turn two, and  getting RSV once doesn’t make you immune from getting it again (though symptoms are usually milder the next time around).

What are the signs of RSV?

Although grown-ups and older kids experience cold-like symptoms when they get RSV, premature babies and very young children can get a lot sicker and may need hospitalisation to help them breathe and feed (when RSV causes bronchitis or pneumonia).

If you or your child get RSV, the symptoms can include:

• A runny nose
• Coughing
• Sneezing
• Fever
• Wheezing and having trouble breathing
• Loss of appetite or difficulty feeding because of breathlessness

That said, RSV symptoms can be subtle in very young babies, and irritability or decreased activity might be the only clue that they’re unwell.

If RSV progresses to pneumonia or bronchitis, your infant may be short of breath or breathing rapidly, and it’s very important to call your doctor or Healthline (on 0800 611 116) for advice.

KidsHealth says you need to seek urgent medical help if your baby or young child is:

• Under three months of age
• Breathing fast, breathing noisily, and having to use extra effort to breathe
• Pale and unwell-looking
• Taking less than half of their usual feeds
• Vomiting
• Not wetting their nappy (they haven’t had a wet nappy for more than six hours)

If you’re worried about your baby or young child, it’s important to see a doctor, and don’t be afraid to make a follow-up appointment if your little one’s breathing is getting worse or you’re still worried.

What is the treatment for RSV?

Antibiotics don’t work on RSV, and people generally get better on their own by resting and staying hydrated at home.

If you or your child gets RSV, you’re usually infectious for up to 10 days after the symptoms start, and because the virus is so contagious, it’s very important that you stay home from work, child care, school and anywhere else you’d normally be, until the symptoms are gone.

Your little one might not feel like eating much, so offer smaller feeds more often, keep your baby’s nose clear, and if your child is feeling miserable, KidsHealth says you can give them paracetamol (at the correct dosage for their age).

How can ECE services prevent the spread of RSV?

KidsHealth says that breastfeeding, immunisation and a warm, smoke-free house can help to prevent an RSV infection in your baby or child, and good hygiene is key – both at home and in the early learning environment.

This year, many educators and children at ECE services have fallen ill with RSV, but as with cold, flu and gastroenteritis prevention, the best way to limit the spread of RSV is by practising good hand hygiene, staying home if sick, and getting medical advice if needed.

In the early learning environment, the Ministry of Education says:

• Staff should stay home if unwell and stay away from babies and toddlers.
• Babies, toddlers and children shouldn’t attend their early learning service if they have symptoms and should stay away until the symptoms are gone.
• Staff and children should continue to regularly wash and dry their hands.
• Everyone should practice cough and sneeze etiquette, which means coughing/sneezing into tissues or elbows, and carefully binning used tissues.
• Frequently touched surfaces should be cleaned more often, especially those at child height.
• Shared toys should be washed in warm water and detergent at the end of the day or session, or more often if they’re put in the mouth or sneezed on.
• Services should also ensure there’s no sharing of cups, glasses and cutlery.

Paediatrician, Dr Jeff Brown says, ‘Children who develop respiratory symptoms at early childhood education centres should be isolated immediately and picked up by a parent/care-giver as soon as possible,’ and he says it’s also important for ECE services to report any suspected outbreaks of respiratory illness to their Public Health team.

What’s happening with sick leave?

We all need to work together to contain outbreaks, like RSV, so although it might be tempting to send your child off to ECE when they’re sick, it doesn’t do any of us any favours.

Fortunately, as of 24 July 2021, the government has increased the minimum employee sick leave entitlement from five days to 10, which frees up working parents (and educators) to take time off when they’re unwell – or their child is.

Employment New Zealand explains that, ‘Sick leave is paid time off work if an employee, their spouse, partner, dependent child, or other person who depends on them is sick or injured,’ so you’re encouraged to do your best to follow good hygiene, and rest up at home if illness strikes.

Although infections, like the common cold and lethal coronavirus, continue to plague humankind, you can take comfort in the fact that ECE services have health and hygiene policies in place to safeguard our children as they learn, play and mingle, and we all play a part in staying healthy as a child care community.

Good luck!

Further reading

Immunity boosters for kids in care

Hand, foot and mouth disease and how it affects youngsters

Gastro prevention in child care