#HEALTH: RSV - premature babies at high risk

Nursyahirah Wan Ab Hafiz knows the inside of a hospital better than most people.

As a parent of a premature baby, she has spent hours pacing the wards and worrying over her child's condition.

Her daughter, Wan Nur Afeeya, was born at just 25 weeks, weighing only 700 grams.

She was in an incubator for six months and even after being discharged, needed to be warded almost every month due to her susceptibility to infections.

This year, the child contracted RSV or respiratory syncytial virus, a common and contagious virus that infects the nose, throat and lungs, making it hard to breathe.

While all babies can pick up RSV, in high risk infants, such as those born premature (less than 37 weeks in the womb), it can cause a serious infection that requires hospitalisation.

Nursyahirah's life revolves around ensuring her vulnerable child is not exposed to infections.

"Hygiene is crucial. We have to always wash our hands before touching her and we avoid crowded places," she says.

She and her husband take turns to care for Afeeya whenever she's warded while managing their older child who's schooling, a routine that can be draining, both mentally and physically.

It's a routine that Norazleena Yaha can relate to as well, having had three children born premature.

Almost every month one of her children would be warded, usually with lung infections. At one time, all three were in hospital.

She says people assume RSV is a mild disease like the flu or common cold but it's not that way for children born premature.

"It requires great mental strength to handle this. There's the financial aspect and the hecticness of your routine when a child falls ill. As mums, we don't have options or excuses. We do it for our children," says Norazleena who's also the founder of a support group for parents of premature babies.

Nur Suhana Abd Shukor has had similar experiences with her son. Her child was born at just 27 weeks and spent 88 days in hospital immediately after birth and has been admitted to hospital multiple times since.

Many parents of premature babies are not aware of RSV and how dangerous it can be for high risk children, and greater awareness is needed, she says.


RSV actually infects almost all children by age two and is the most common cause of childhood illness explains UKM Children's Specialist Hospital head of immunology and rheumatology services, Associate Professor Dr Adli Ali.

RSV is a seasonal virus that affects the airways and usually causes mild, cold-like symptoms.

However, in some cases, it can lead to other problems such as bronchiolitis (lung inflammation), pneumonia or croup. In severe cases, children may need to be hospitalised.

"All of us can get RSV and we can get it multiple times, but the high risk groups are those aged below three and over 65," says Dr Adli.

Those who are in the very high risk group, with chances of developing severe RSV include preterm babies, those born with congenital heart problems, children with neuromuscular impairment, immunodeficiency and those with Down syndrome.

"RSV is the most common cause of hospitalisation during the first year of life," he says.

Hospitalisation rates are higher among high risk groups and nearly 50 per cent of deaths occur in infants less than 6 months old.

When the pandemic happened, RSV cases were nearly undetectable. Dr Adli says this was mainly due to children being kept indoors during lockdowns and the wearing of face masks.

This is not a new disease, he stresses, but it is causing significant problems and many people are not aware of it. In some children it is causing severe disease and hospitalisation.

University Malaya Medical Centre consultant neonatologist and paediatrician, Associate Professor Dr Choo Yao Mun says the key is prevention rather than just treating the disease.

Since RSV can be spread by touching something that has the virus on it, person-to-person contact, and through droplets from coughs and sneezes, prevention methods include hand washing, avoiding crowds or other younger children, especially those who have a fever or cough, and keeping toys, clothes, blankets and sheets clean.

Smoking should also be avoided within the home or even nearby.

RSV - Mild Symptoms

*Low-grade fever, less than 38.3°C

*Runny/stuffy nose

*Dry cough

*Sore throat

RSV - Severe Symptoms

*High-grade fever over 39.4°C

*Unusually tired

*Refuses to eat or drink

*Trouble breathing or is breathing fast or irregularly

*Blue colour to the skin/lips, or they become very pale

*Noisy breathing when not crying (wheezing, rattling, whistling sounds)

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