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Peer Responses:Length: A minimum of 180 words per post, not including referencesCitations: At least two high-level scholarly reference in APA per post from within the last 5 yearsFor peer posts and subsequent posts under the initial discussion board thread add in second and third line treatments and additional considerations (250 word maximum for responses). Example requirement, only evidence-based sources, such as AAFP, CDC, IDSA, ADA, JNC 8 etc. (textbook resources and internet sites affiliated with medical associations are considered credible sources to obtain the information on the most up to date guidelines). Add in the link to the guideline(s) within the discussion board for further reading by your peers.A Quick Overview of Pediatric Respiratory Syncytial VirusIntroductionHuman respiratory syncytial virus (RSV) is the cause of complications in younger children; it is a common virus as an upper respiratory infection; however, in infants, it could escalate as bronchiolitis, and more so in preterm and immunocompromised children, affecting the lower respiratory tract illness (Barr & Barney, 2024).EtiologyRSV is a common respiratory virus, typically occurring during the influenza season from October through May. It could lead to complications of lower respiratory infections known as bronchiolitis, which is most common in infants under five months, and have high rates of hospitalizations (AAFP, 2023).EpidemiologyRSV is a mucosal-restricted pathogen that spreads through respiratory through droplets, and fomites. It primarily affects children under the age of two, premature infants and children with underlying medical conditions have high risk of severe complications (Cash, 2023). PathophysiologyRSV replicates and binds in the mucosa of nasal cavities, eyes, and mouth epithelium forming a syncytium leading to proliferation in the bronchioles and mucus secretion (Cash, 2023). This causes mild cold-like symptoms to bronchiolitis, pneumonia, or bronchitis.Clinical ManifestationsAccording to Cash (2023), clinical manifestations occur repeatedly in healthy children; however, lower respiratory infections occur with repeated infections in patients with lung involvement, immunocompromise, and low birth weight babies. Common symptoms include nasal congestion, cough, dyspnea, low-grade fever, and wheezing. Infants often present as fussy and poor feeding, with nasal flaring, chest retractions, labored breathing, and nasal flaring. DiagnosisMild cases might be clinical diagnosis if younger than 24 months, in the winter season, and presents with wheezing and respiratory distress. If moderate symptoms, a respiratory viral panel, or an RSV-specific polymerase chain reaction (PCR) will confirm or rule out RSV or other pathogens with results in < 3 hours. An alternative is a rapid antigen detection test (RAD) that yields results in 30 minutes. (Barr & Barney, 2024). Pharmacological and Non-Pharmacological ManagementThe first line of intervention is to reduce the fever with over-the-counter acetaminophen for > three months infants, and Ibuprofen for > six months infants (Pappas, 2024). Most cases of are mild and addressed with supportive, including adequate nutrition and hydration, and manual nasal suctioning bulbs. Barr and Barney (2024) recommend prophylactic treatment of palivizumab and nirsevimab for high-risk children.EducationPreventive measures include avoiding close contact with sick people and large crowds, maintaining a clean environment, and washing hands. Parents need to be educated about respiratory symptoms of distress and recognize the need for medical attention (AAFP, 2023). Follow-upThe provider will contact caregiver within 12-24 hours to assess child’s condition. Cash (2023) specified that recovery might take 1-2 weeks. A follow-up appointment is recommended within 2-4 weeks, but sooner if the treatment does not relieve symptoms or if it is getting worse. Additionally, admitting the child to the emergency department if respiratory distress.ReferencesAmerican Academy of Family Physicians (AAFP). (2023). Respiratory syncytial virus infection. American Academy of Family Physician, 108(1). https://www.aafp.org/pubs/afp/issues/2023/0700/patient-information-respiratory-syncytial-virus-infection.html Barr, F. E., & Barney, S. G. (2024). Respiratory Syncytial virus infection: Treatment in infants and children. UpToDate. https://www.uptodate.com/contents/respiratory-syncytial-virus-infection-treatment-in-infants-and-children Cash, J. (2023). Family Practice Guidelines. (6th ed). Springer Publishing.Pappas, D. E. (2024). The common cold in children: Management and prevention. UpToDate. https://www.uptodate.com/contents/the-common-cold-in-children-management-and-prevention
