Indolent Respiratory Viral Infections in Young Infants

Come Autum (October-November) and Winter (December -February) many paediatric hospitals and Paediatric practitioners see a rush of patients with upper and lower respiratory infections (URI/LRI). Out of every 10 patients with high-grade fever and flu-like symptoms, six to seven patients have viral fever, and the rest report a plummeting platelet count and are diagnosed with dengue and other vector-borne diseases including chikungunya. Multiple viral fevers are causing alarm among the public and health authorities, for most of the year, Rhinoviruses & RSV cause most acute viral URIs among young infants & under 5’s. National Program for Integrated management of Neonatal and childhood illnesses both at community and facilities (IMNCI & FIMNCI) guide the management. Individual practitioners follow academic and IAP guidelines, though there are marginal variations among guidelines. Use of antibiotics even in viral infections is a matter of concern. Basic Management practices include Symptom-based therapy as the mainstay Antimicrobial or antiviral therapy is appropriate in selected patients. Materials & Methods: This article is based on 3 such cases recently. It highlights the diagnosis & management of RV and RSV-related respiratory infections in young infants in India based on IMNCI guidelines and Practices in Paediatric hospitals in private sector. Conflict interest determines the overtreatment in private sector. Outcome: The first case of an unnamed baby in a district headquarters private facility though outcome was reverting to normal respiration in 5 days, but conflict of interest dominated the cost of management. The first and second cases of repeated URIs and respiratory distress are an example of need for assessing congenital heart diseases. Third case of normally mild Rhinovirus infection (common cold) leading to cerebrospinal fluid infection and Sudden Death Syndrome. Conclusion: Early detection, prevention, and ongoing research are vital to mitigating the impact of RV & RSV on vulnerable population. Vigilance is necessary in the infant’s environment, measures of hygiene, and protection by vaccinations be encouraged to reduce the risk of the Respiratory infections and SIDS in young infants.