Helen Dandurand (Host): Welcome back to the Well Within Reach podcast. I'm your host, Helen Dandurand and today I'm going to be joined by Dr. Ramanpreet Grewal family medicine provider at Riverside's Watseka campus to give us some important information about RSV

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Helen Dandurand (Host): And we're back with Dr. Ramenpreet Grewal. Thanks for being here. .

Dr Ramanpreet Grewal: Thank you for having me, Helen. Good to be back.

Helen Dandurand (Host): Yeah, I know we've done this before, so it's definitely fun, fun to keep going and learning new things together. Yes, of course. So can you, for the people who don't know who you are, can you give us a little bit about your background?

Dr Ramanpreet Grewal: Yes, Helen, for sure. Hello everyone. I'm Dr. Grewal. I'm a board certified family medicine physician. My primary area of focus is providing preventative care to the population in Watseka. I work as a primary care provider at the Riverside campus. Like I said I did my residency with just recently from a community hospital in Pontiac, and here I am a year later, maybe a little bit wiser. Yes. Hopefully . Yeah.

Helen Dandurand (Host): Awesome. Well, great. So like I said, today we're gonna be talking about RSV which we hear a lot about these days on social media and in the news. A lot going on. So can we start with you like telling us a little bit about what RSV is?

Dr Ramanpreet Grewal: So RSV is a very common respiratory virus that usually Spreads around wintertime. RSV stands for respiratory Sensitele virus. It normally only causes mild symptoms like cold like symptoms some cough congestion, but sometimes it can also cause serious infections that may lead to hospitalizations and even ICU admissions. You must have been seeing that on the news these days. Yeah. That it's kind of spread. Yeah.

Helen Dandurand (Host): Yeah. Okay. We'll get into some of that a little later, but going like into the basics, like how do people get infected with this? Is it like any other virus?

Dr Ramanpreet Grewal: So, RSV can spread easily from a person to person. This virus lives in the droplets that go into the air. When a sick person coughs or sneezes. One can also get it from direct exposure to the virus droplets. Like for example, if you're infected with it and you might just have some mild symptoms, but if you go and let's say you're visiting a newborn and you go kiss that child on their cheek, You might give it to them. Other ways are that if you cough on your hand and then you touch a doorknob, you open the faucet or you just kind of touch your clothes. The RSV can also kind of live on hard surfaces or common surfaces for a very long time. So if somebody touches the same things again, and they don't sanitize their hands and then they touch their nose or their face, they can give it to themselves.

Helen Dandurand (Host): Okay. That makes sense. That's kind of what you normally, try not to do with other sicknesses too. So that's good that it's like the basics. So what are the symptoms to look for, I guess, specifically in children, since we know that that's who it can be kind of worse for, and how do those differ from other common, like colds or things like.

Dr Ramanpreet Grewal: So RSV usually begins like a regular cold and most commonly causes bronchiolitis in children. Some children may just, Have like a stuffy nose, mild cough, fever. Fever is defined as temperature that's more than 100.4 degree Farenheit and some decreased appetite. Now the bronchiolitis can also progress and cause other symptoms like faster breathing, pauses between breaths, wheezing. A severe cough that may last for 14 days or longer. Some trouble eating and drinking. So, if your nose is stuffed the child might not want to eat as much because, they, it's hard to catch a breath and just kind of things like that.

So the flu, Covid 19. RSV. and there's another virus that's usually only causes common cold, is what we call it. Okay. In layman terms. It's called adenovirus. So they all spread through the air. They're present in the droplets. Now, flu itself is caused by the influenza virus. The covid 19, as we all know, is caused by Sars COVI2 virus and RSV being caused by the virus itself. Yeah. Respiratory, sincere virus. Now it's also possible that one person may be infected with multiple viruses at the same time, just kind of depending on their immunity or their exposure and things like that. Now the biggest difference. It between flu and RSV would be that flu usually starts with like a high fever and it's associated with aches and pains.

That along with COVID can also have other GI effects, like you might have some diarrhea, some nausea. COVID. In general may also cause some sore throat and the most common would being difficulty tasting or smelling. Yeah. So that's kind of like a broad differentiation. But yeah, testing is the key to identifying viruses. So you know, with symptoms of flu, covid, rsv, they're all similar kind of, and it's like a perfect storm of all of these three viruses kind of circulating. Yeah. In the environment right now. And the only way to know for sure which virus you have is to get tested. So they're we do rapid antigen tests.

We also do ps Those are two most common tests that are used. Yeah. Gold standard would be viral culture, which we don't do because it takes a lot of time. By the time patients normally also recover . By the time you get the results. Now why would you wanna get tested? Because with Covid you have to isolate. You have to make sure that we are not giving it to other peopl . you haveE to wear a mask. So just what to do after you have these symptoms just kind of depends on which virus you have.

Helen Dandurand (Host): That makes sense. So for RSV specifically, how long does that typically last?

Dr Ramanpreet Grewal: So RSV typically lasts for a week or two. Most kids get better on their own. And like I said, some people. Might end up having like a longer infection, which would be in people who have weakened immune systems that then they can maybe be ill for a month or maybe eight weeks, things like that. And people with RSV are contagious for about three to eight days.

Helen Dandurand (Host): All right. We're going to take a quick break to talk about finding a primary care provider. Riverside knows that your health is your greatest asset and that your primary care provider is your partner. So you can find a primary care provider that fits your needs at riversidehealthcare.org/primarycare. All right, and we're back here. We're going to go into like, why is it considered to be so serious when a young child like an infant is diagnosed?

Dr Ramanpreet Grewal: So, mainly for young children and infants is because they don't have the immunity. That's the best explained. Now RSV this virus kind of, let's talk about how and what it does when it enters your body. So if you inhale it or if you somehow somebody sneezes into your mouth. So at the back of your throat or back of your nose, that's where the virus kind of replicates. And then it goes further down into your windpipe through the trachea. It goes into the bronchials, hence the name bronchiolitis. So when it enters the bronchials, it causes like a lot of inflammation over there, which leads to like, lots of secretions and they kind of start to block the airways.

So this makes it hard to breathe. And especially in preterm infants because their lungs are not as developed or in patients or people who are more than 65 years of age, and they have other lung issues like asthma or COPD or even if they're chronic smokers they develop severe infections like that. Now RSV can also cause lower respiratory tract diseases. Like I said, bronchitis can cause some bronco spasm, pneumonia, and acute respiratory failure in children. It also causes apnea.

Helen Dandurand (Host): Gotcha. Okay, that makes sense. So what kind of, then, I guess you're saying like it would restrict like kind of airways and airflow and things like that. So obviously like just hearing that sounds like it could be life threatening, but like it definitely could be right for people, the right person?

Dr Ramanpreet Grewal: Correct. Yes. Yes. So it's very important to just kind of identify when is it time to go to a doctor or when is the time to go to the ER? Yeah.

Helen Dandurand (Host): What would you say? Like what if, I guess if your kid is just sick, then you would say, I mean, you need to go figure out what that is. And then from there, like when would it be time if you know they have RSV but aren't doing well to go to like the ED?

Dr Ramanpreet Grewal: Yep. to warrant a visit to see a doctor would be if the symptoms are either getting worse or if they're not improving after seven days. If we were off a hundred 100.4 or higher. Okay. Or if The symptoms develop in a child who's younger than three months of age. For the ER immediately head to the er. If your baby exhibits any signs of dehydration, that is, if you know, you feel like their tongue is dry, they're not making as many tears when they're crying or there's a decrease in the wet diapers if you see that they're doing belly breathing or using muscles of their ribs or necks.

So you'll literally see some retractions between the ribs, or you'll see that their neck muscles are kind of getting hard or in spasm. Is how you can kind of relate to it. You can, if you notice that your child has some flaring nostrils or if their head is bobbing with breathing or if they have like a really high fever.

Helen Dandurand (Host): Got it. That makes sense. So once they go, say they go to a doctor how would RSV be treated? Is there medication?

Dr Ramanpreet Grewal: So for RSV now let's talk about when a child is otherwise doing okay. There's no antibiotics because it's a viral infection. Okay. You know, Sometimes we have patients walk in with the expectation of an antibiotic. So there's no antibiotic.

Helen Dandurand (Host): Me. I'm like, please gimme something. help me out here.

Dr Ramanpreet Grewal: Yeah. And for children especially, Antibiotics, cough, medicines, decongestants and sedatives are not recommended. Cough medicines and decongestants have not been proven to be helpful at all and are not safe to use in young children, especially children who are less than two years of age. And a sedative can basically mask symptoms of low blood oxygen, and difficulty breathing. So obviously that's not recommended. Otherwise there are a few things that you can do at home and that's what we always kind of recommend to our, the parents of our patients, would be to just kind of make sure that your child gets enough fluids.

Use a humidifier in the room where your child sleeps. If you feel like your child is uncomfortable because of fever, you can give some over the counter medications. Acetaminophen or brand name, Tylenol or Ibuprofen, brand name Advil or Motrin. , but be sure to read the instructions carefully. Never give them aspirin. So any child younger than 18 years old should not be using aspirin. You may remove the mucus from your child's nose with a suction bulb. If a child is older than one, then feed them warm, clear liquids to just soothe their throat and help them loosen their mucus.

Sleep in the same room as your child so that if anything happens overnight, you're right, available right away, and you can help them. And the last, but not the least would be do not allow anyone else to smoke near your child.

Helen Dandurand (Host): All right. That makes sense. I really, I thought that there was medication, so I'm really , I'm really coming at this with no info. I guess I don't have children, so I haven't looked into it before, but that's really good to know. So it's a lot of things that you, you will be doing at home to help your child. So to like, wrap this all up? How would you recommend we work to prevent this and to like stop the spike of people getting infected with this, like right now in this season? .

Dr Ramanpreet Grewal: Well, Helen as there's no vaccine for RSV. There are five different types of RSV vaccines that are understudy at this time, but maybe we'll have a vaccine in two or three years. T hey're kind of doing studies on them. Wow. But most likely it won't be something that would be given to. Like all of us, maybe it'll be only for kids or older adults who the virus would impact the most. So depends on us to make sure that the virus does not spread. So, basic hygiene, like wash your hands and your child's hands but often with kind of soap and water or use alcohol based sanitizer.

Teach your child to cover their mouth when they cough or have them cough into their elbow. Don't share glasses. Cups are utensils. Clean things that are touched a lot like counters, sinks, faucets, doorknobs, phones, remotes, and light switches. Stay away from people who are sick. Yeah, that makes sense. and make sure your child gets all of the recommended vaccines, including those of flu and covid 19.

Helen Dandurand (Host): Great. That's awesome. I've never really, I mean, don't get me wrong, I clean my phone sometimes, but I should probably, all the places that it goes every day. Probably should clean that a little bit more. Yeah. So, no, that's, that's really great. Sounds good. Well, I think we covered a lot here, and I hope that this is helpful to someone. But thank you for joining us today, Dr. Grewal.

Dr Ramanpreet Grewal: Thank you.

Helen Dandurand (Host): And thank you listeners for tuning in to the Well Within Reach podcast brought to you by Riverside Healthcare. For more information, visit riversidehealthcare.org.