According to the Centers for Disease Control and Prevention (CDC), respiratory syncytial (sin-SISH-uhl) virus, or RSV, is one of the most common causes of respiratory illness in young children. RSV cases typically increase in the late fall and taper off in early spring, peaking in December or January. By age 2, nearly all children have had the virus at least once.
RSV affects the airways in the nose, throat and lungs. In most healthy people, an RSV infection can feel like a mild cold. However, in more vulnerable populations, such as young children and the elderly, RSV can be much more serious and lead to infection of the lower airways (bronchiolitis) and lungs (pneumonia), which may require medical intervention.
Signs and Symptoms of RSV
Symptoms of RSV are like that of a mild cold. They typically start to show around four to six days after infection and appear in stages, not all at once. Look for:
- Stuffy or runny nose
- Sneezing
- Coughing
- Fever (a temperature of 100.4 or higher)
- A decrease in appetite
- Fussiness and poor feeding in infants
In very young infants, symptoms may only include irritability, decreased activity and difficulty breathing.
Severe RSV is indicated by worsening cough and wheezing, which are some of the first signs that RSV is infecting the lower respiratory system.
To diagnose RSV, the child’s health care provider can perform lab tests; however, in mild cases not requiring hospitalization, these tests are not needed for diagnosis and treatment.
When to Seek Emergency Care
While mild RSV can usually be treated at home, a sick child needs to be taken to their pediatrician or the emergency department if:
- They are having difficulty breathing
- They are not drinking enough fluids
- Their symptoms are getting worse
- They are at high risk for severe RSV
Children at Greater Risk for Severe RSV
Those at greater risk for severe illness from RSV include:
- Infants and young children (the younger they are, the higher the risk)
- Infants who were born prematurely
- American Indian and Alaska Native children
- Children with chronic lung diseases or congenital heart disease
- Children with compromised immune systems
- Children with cystic fibrosis
- Children with a neuromuscular disorder that causes them to have trouble swallowing or clearing mucus
Treatment for RSV
Most RSV infections get better on their own within a week or two. People with mild cases of RSV can be cared for at home and can take over-the-counter medications, like fever reducers, as needed. Since RSV is a virus, antibiotics will not help, and antiviral medications are not recommended as a treatment option. Help the child rest comfortably and stay hydrated. Check with their pediatrician before giving the child over-the-counter cold medicines; some contain ingredients that can be harmful to children.
According to the CDC, as many as 2 to 3 out of every 100 infants under 6 months old are hospitalized with RSV every year. They require treatments such as oxygen, intubation or mechanical ventilation. The child might also receive IV fluids to help with hydration.
Fortunately, there are now preventive vaccines that help protect infants and young children who are at high risk of developing severe illness from RSV.
Vaccines: Frontline Protection Against RSV
CDC guidance recommends that all babies be protected from severe RSV by either a maternal RSV vaccine or an antibody given directly to the baby.
Maternal RSV Vaccine
If a mother is between 32 and 36 weeks of pregnancy during the months of September through January in the U.S., the CDC recommends that she get the maternal RSV vaccine. This vaccine teaches the immune system to fight RSV, and this protection is passed along to the baby. It takes two weeks from the time the vaccine is given to develop the antibodies that protect the mother and her baby. That protection will last through the baby’s first six months, which is when they are most at risk of getting severe RSV.
If the mother received a maternal RSV vaccine during a previous pregnancy, she does not need to get another RSV vaccination during any other pregnancies. Those babies should receive the RSV antibody instead.
RSV Antibody for Babies
All babies under 8 months of age born to mothers who did not receive the maternal RSV vaccine during their pregnancy should receive the RSV antibody. The dose should be given shortly before the RSV season or within one week of birth if they are born between October and March in most of the U.S.
The RSV antibody is also recommended for some young children ages 8 through 19 months who have a higher risk for severe RSV, including:
- Children who were born prematurely and have chronic lung disease
- Children who are severely immunocompromised
- Children with cystic fibrosis
- American Indian and Alaska Native children
These children should receive their second dose of the RSV antibody shortly before the child’s second RSV season.
Protection Through Prevention
RSV is highly contagious and spreads through the air in water droplets from coughs or sneezes. RSV can also be passed along by contact with infected people and contaminated objects. To prevent infection, people should wash their hands often and avoid touching their face. They should also try to stay away from people who are sick.
If someone is ill, they can help control the spread by:
- Staying home as much as possible
- Not sharing cups, utensils or toys
- Cleaning surfaces, doorknobs, light switches, toys and other high-touch objects often
- Avoiding close contact with others, such as kissing and shaking hands
- Covering coughs and sneezes
Since RSV runs rampant during the winter, it overlaps with the holiday season, which means potential exposure among family members and friends. This is particularly concerning for older adults, who are at high risk for serious infections if they catch RSV. In addition to following the tips above, adults 60 and older may benefit from one of the new RSV vaccines designed to protect seniors against serious illness. They should talk to their medical provider to discuss their options.
More to Read
- Not Just for Kids: What to Know About RSV in Adults
- Pneumonia Treatment: What Does It Take to Feel Better?
- Wondering What to Eat When You’re Sick? Try These Comforting Foods.
- Should I Take My Child to the Emergency Room?
Medically reviewed by Andrea Berry, MD. Â
Updated 11/22/2024
