Respiratory Syncytial Virus (RSV)

What Is Respiratory Syncytial Virus (RSV)?

Respiratory syncytial (sin-SISH-ul) virus (RSV) is a major cause of respiratory illness in children. The virus usually causes a common cold. But sometimes it infects the lungs and breathing passages and can cause breathing problems in infants and young children.

What Are the Signs & Symptoms of Respiratory Syncytial Virus (RSV) Infection?

Kids with RSV might have cold symptoms, such as:

• a stuffy or runny nose
• sore throat
• mild headache
• cough
• fever
• not eating or drinking well
• a general ill feeling

Sometimes, an RSV infection can lead to:

• bronchiolitis or pneumonia, especially in premature babies; infants younger than 1 year old; and kids with diseases that affect the lungs, heart, or immune system (such as asthma)
  
• dehydration

Respiratory Syncytial Virus (RSV) Infection: When Should I Call the Doctor?

Call your health care provider if your child:

• gets a fever after having a cold or has a high fever
• has a cough or other symptoms that get worse
• is wheezing
• has labored or fast breathing
• shows signs of dehydration, such as fewer wet diapers than usual

Also call if your infant is very cranky, or refuses to breastfeed or bottle-feed.

Get medical help right away if your child:

• is struggling to catch their breath
• is very drowsy
• has lips or fingernails that look blue

Is Respiratory Syncytial Virus (RSV) Contagious?

Respiratory syncytial virus is highly contagious. It spreads through droplets containing the virus when an infected person coughs or sneezes. It also can live on surfaces (like counters or doorknobs) and on hands and clothing. So people can get it if they touch something that's contaminated.

RSV can spread quickly through schools and childcare centers. Babies often get it when older kids carry the virus home from school and pass it to them. Almost all kids have had an RSV infection at least once by the time they're 2 years old.

RSV infections are most common from fall through spring. But during the COVID-19 pandemic, they began earlier and lasted longer. Respiratory illnesses caused by RSV — such as bronchiolitis or pneumonia — usually last about a week, but some symptoms, such as a cough, can last several weeks.

How Is Respiratory Syncytial Virus (RSV) Infection Diagnosed?

Health care providers usually diagnose a respiratory virus by taking a medical history and doing an exam. In many kids, they don't need to distinguish RSV Infection from a common cold.

But if a child has other health conditions or more serious symptoms, doctors might want to make a specific RSV diagnosis. In that case, they identify the virus by testing nasal fluids. The sample is collected either with a cotton swab or by suction through a bulb syringe.

How Is Respiratory Syncytial Virus (RSV) Infection Treated?

Most cases of respiratory syncytial virus infection are mild and don't need medical treatment. Antibiotics aren't used because RSV is a virus — antibiotics work only against bacteria.

RSV infection can be more serious in babies and toddlers, though. Some might need treatment in a hospital where they can be watched closely and get supportive treatment for any breathing problems or dehydration.

Home Care

At home:

• Make your child as comfortable as possible.
• Allow time for recovery.
• Provide plenty of fluids. Babies may not feel like drinking, so offer fluids in small amounts often.

Avoid hot-water and steam humidifiers, which can be hazardous and can scald skin. If you use a cool-mist humidifier, clean it daily to prevent mold and bacteria growth.

If your child is too young to blow their own nose, use saline (saltwater) nose spray or drops and a nasal aspirator (or bulb syringe) to remove sticky nasal fluids. Clearing a baby's nose before offering fluids can make it easier for them to drink.

Treat discomfort from a fever using a non-aspirin fever medicine like acetaminophen or, if your child is older than 6 months, ibuprofen. Do not give aspirin to children who have a viral illness. Such use is linked to Reye syndrome, which can be life-threatening. Do not use over-the-counter cold medicines, which can be dangerous for young children.

Can Respiratory Syncytial Virus (RSV) Infection Be Prevented?

Because RSV can spread easily by touching infected people or surfaces, washing hands well and often can help stop it. Wash your hands after being around someone who has cold symptoms. School-age kids who have a cold should keep away from younger siblings — especially babies — until their symptoms clear up.

An RSV vaccine is now recommended for all pregnant women at 32–36 weeks of their pregnancy if the baby will be born during RSV season (usually fall to spring in the U.S.). This vaccine can protect the newborn from severe RSV illness.

Doctors also can give babies a new type of shot that contains antibodies against RSV as another way to protect them. This shot works a little differently from routine vaccines. Its antibodies protect a baby from the virus for several months. It can be given to:

• babies younger than 8 months old during or right before RSV season
• babies 8–19 months old who are entering their second RSV season and are at higher risk of getting very sick if they get an RSV infection

If the RSV vaccine is given to the mother during pregnancy, the baby will likely not need the antibody shot. If a baby is born less than 2 weeks after the mother got the vaccine, the doctor might recommend the shot to make sure the baby is well protected.

In the past, high-risk infants younger than 2 years old could get a different type of RSV antibody shot, which they got monthly throughout RSV season. Children who got some doses of this shot, either in the previous year or the current year, can still get the newer antibody shot.

Ask your doctor if your child is considered high-risk, and which preventive shot is best for them. Some doctors will give the older shot, and others might give the newer one. They are equally safe and effective.

In kids, other respiratory viruses can cause symptoms similar to those from RSV. Health experts strongly recommend that all children 6 months and older get the yearly flu vaccine and an updated COVID-19 vaccine.