Respiratory infections among kids in Mumbai: Paediatrician shares who is most at risk and how to protect your child

Following these doctor-approved tips can help keep children safe from respiratory infections and ensure they get the best possible care if they do get sick.

If your child shows signs of coughing, cold, fever, or wheezing, you should seek immediate medical attention. In an interview with HT Lifestyle, Dr Zahabiya M Bagwala, paediatric infectious disease specialist at Saifee Hospital, Mumbai, warns that lower respiratory infections among children in Mumbai have increased this season, largely due to the highly contagious Respiratory Syncytial Virus (RSV).

Understanding RSV

Dr Bagwala explained that it affects mostly young children under the age of two, and said it affects at least 90 percent of kids under two at least once in their lives. She said, “The virus mostly affects the lungs and is the most prevalent in young children below the age of two years. At least 90 percent of kids in this age bracket will develop RSV at least once in their lives, with two out of three children being infected concurrently.”

She said that RSV has been known to manifest in the form of cough, cold, fever and wheezing and can lead to hospitalisation and oxygen therapy in severe cases. “In extremely unfortunate events, the wheezing can develop to a point when the patient is hospitalised and oxygenised. Up to recently, they were only treated with humidified oxygen and nebulizations. Nonetheless, in 2023, a novel preventive choice, Nirsevimab, was approved in the US by the FDA,” Dr Bagwala said.

Respiratory Syncytial Virus can cause cough, cold, fever, and wheezing. (Freepik)

New preventive option

Nirsevimab is a monoclonal antibody that interferes with the transmission of RSV, she added. “A single dose covers the protection of a single RSV season. The vaccine is suggested for infants less than eight months, as well as for high-risk children between nine and 20 months. But this is only temporary and needs to be re-administered each season. The downside is that it is an expensive option – a single dose costs approximately 40,000. Though quite efficient, possible side effects associated with its use are allergies, anaphylaxis, fever, rashes and injection site pain,” Dr Bagwala said.

Who are the most vulnerable children?

She added that children below the age of five are the most susceptible to lower respiratory infections such as bronchiolitis and pneumonia. Immature immune systems, lack of exclusive breastfeeding, and partial vaccine immunisations increase vulnerability and environmental factors like air pollution contribute to the risk, Dr Bagwala explained.

She said, “Their immune systems are immature, most are not exclusively breastfed, and partial vaccine immunisations leave them more vulnerable. Environmental factors also contribute massively, as indoor and outdoor air pollution contributes to the load in a city like Mumbai.”

When to seek medical attention?

Identification early and early treatment are essential to avoiding complications, she said. “Parents are advised to seek immediate medical attention when the following signs are observed (worsening in the child): sleepiness, rapid breathing (more than 60 breaths per minute in the newest children, more than 50 in children between 2 months and 2 years, and more than 40 in children between 2 years and 5 years), low oxygen saturation, difficulty in the feeding process, and the minimal amount of urine and faecal outputs,” Dr Bagwala said.

In lower respiratory infections, awareness and action in a timely manner can save a serious situation caused by an RSV infection and others, she concluded.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.