RSV (Respiratory syncytial virus)

What is RSV and how do I protect my Infant or Child?

Patti Pettis, APRN
Pediatric Nurse Practitioner

Respiratory syncytial virus (RSV) is a contagious virus that is usually mild and affects people of all ages, but can severely affect the lungs and respiratory airways in infants and young children leading to hospitalization. According to the U.S. Centers for Disease Control and Prevention (CDC), “Respiratory Syncytial Virus (RSV) is the leading cause of hospitalization in babies under age 1, and most parents have never heard of it”.

What You Need to Know

Here are some things you should know before your child does:

  • RSV is a highly contagious virus that can lead to respiratory illness in babies, including lung infections such as bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs).
  • RSV infections can go from mild symptoms to hospitalization in only a few days.
  • Mild symptoms may include a runny nose, sneezing, and coughing, while severe symptoms can include wheezing and difficulty breathing.
  • RSV is most common during the winter virus season (November – March) but can vary by local areas.
  • RSV spreads when droplets from a cough, sneeze, or infected surface get inside the eyes, nose, or mouth.
  • 2 out of 3 babies will get RSV by age 1.
  • Though hospitalization happens in only 1%-2% of RSV cases, no one can predict which baby will be hospitalized.
  • Babies are 16x more likely to be hospitalized with RSV than with the flu.

Symptoms to Look Out For

RSV can often mimic a cold or the flu. But as the infection becomes more severe so do the symptoms. Keep a close eye on your baby if you notice any of the following:

  • Coughing
  • Runny nose
  • Wheezing
  • Decreased appetite
  • Sneezing
  • Fever
  • Congestion

(In babies under 6 months, the only RSV symptoms they may show are irritability, decreased activity, decreased appetite, and difficulty breathing.)

When to Contact Their Healthcare Provider

If you notice any of the following in your baby, contact their Healthcare Provider right away:

    • Short, shallow, and abnormally fast breathing: Look for chest wall retractions (a “caving in” of the chest in between and under the ribs)
    • Your baby has a wheezy cough
    • Nasal flaring: your baby’s nostrils spread out and flare with every breath
    • Your baby is drinking/feeding poorly
    • Your baby is unusually tired or has a blue tint to their lips or fingernails
    • Your baby has a fever: 100.4° F or higher for a baby <3 months or 102.2°F or higher for a baby > 3 months

Most RSV infections in children go away on their own in 1-2 weeks. Those infected with RSV will show symptoms within 4-6 days of being exposed and are contagious for 3-8 days. While recovery times can vary from child to child, they can generally return to daycare, school after 8 days from the start of symptoms or after being fever free for 24 hours with other symptoms being mild. If your child is not eating, sleeping or playing well, better to keep them home until they feel better.

Healthy Habits

RSV spreads incredibly easily. To protect your infant/child, talk with your family and friends and practice the following healthy habits now and always:

  • Wash your hands often
  • Clean and disinfect surfaces, including your baby’s toys
  • Avoid close contact with anyone who has cold or flu-like symptoms
  • If you have cold or flu-like symptoms, avoid kissing or touching your baby
  • Cover your cough or sneezes
  • Avoid sharing utensils if you have cold or flu-like symptoms

There currently is no vaccine to prevent RSV infection, but scientists are working hard to develop one. There is a medicine that can help protect some babies at high risk for severe RSV disease. Healthcare providers usually give this medicine (called Palivizumab) to very premature infants and young children with certain heart and lung conditions as a series of monthly shots during RSV season. If you are concerned about your child’s risk for severe RSV infection, talk to your child’s healthcare provider.