Respiratory Syncytial Virus (RSV)
Respiratory syncytial virus, commonly known as RSV, is a common respiratory infection that affects children and adults. Most children contract RSV before the age of 2. RSV is not usually a serious condition; however, high risk groups — especially infants — can develop serious cases and require a hospital visit.
Dr. Joseph Collaco, an associate professor of pediatrics at the Johns Hopkins Children's Center, offers his insight on preventing and treating this infection.
What is RSV?
RSV is a viral infection that can lead to inflammation of the respiratory tract and lungs. The peak time for RSV to spread is during fall and winter. Most children and adults with RSV will have mild symptoms similar to the common cold and recover in one to two weeks. In children younger than 1 year, RSV is the most common cause of inflammation of the lungs, such as bronchiolitis and pneumonia.
Who is at Risk for RSV?
People of any age can contract RSV, but those at the highest risk of complications include:
- Premature infants and children under age 2
- Infants under the age of 6 months
- Children under age 2 with chronic lung diseases, such as asthma
- Children under age 2 with congenital (from birth) heart problems
- Children with neuromuscular disorders that cause difficulty in clearing mucus secretions or swallowing
- Adults and children with weakened immune systems due to illnesses or medical conditions
- Older adults with heart or lung problems
RSV Causes and Spread
RSV is highly contagious. It can be spread by coming into contact with fluids from an infected person’s nose or mouth. This can happen by inhaling the droplets of the person’s cough or sneeze, or by touching a contaminated surface before touching the nose, eyes or mouth. Outbreaks often occur in classrooms, community centers and child care centers.
In most cases, people with RSV are contagious for three to eight days after their first exposure. However, if an infant or someone with a weak immune system contracts the disease, they may be contagious for up to four weeks.
Typically, symptoms of RSV start within four to six days after exposure. The early symptoms are often mild, and similar to those of a common cold. Common symptoms may include:
- Runny nose
- Decreased appetite
- Low fever
In some cases, the infection will lead to severe respiratory disease in infants. Contact a doctor if you notice:
- High fever
- Worsening cough
- Nostril flaring or chest muscles visibly pulling in and out, signaling breathing issues
- Irregular or rapid breathing
- Blue coloring of skin (lips and fingers)
- Trouble eating, drinking or swallowing
RSV can be diagnosed by a doctor after viewing symptoms and findings from a physical exam. Additional tests, such as nasal swab or nasal wash may also be used to diagnose.
For those with mild symptoms, no specific treatment is necessary. Over-the-counter pain relievers or fever reducers can help manage symptoms. Aspirin should NOT be given to children or teenagers during viral illnesses.
People with RSV should drink plenty of fluids to avoid dehydration.
Children with severe symptoms may require a hospital visit to receive more fluids, oxygen therapy or use of a ventilator breathing machine. Antiviral medications may be used in the treatment of some patients with severe cases in the hospital.
RSV easily spreads from person to person. The proper steps to take to avoid the spread of RSV, especially if experiencing cold-like symptoms are:
- Wash your hands for at least 20 seconds.
- Avoid touching your face with unwashed hands.
- Avoid close contact with others (especially sick people), such as shaking hands, sharing eating or drinking utensils, and kissing.
RSV Prevention for Babies
The following steps are recommended by doctors to prevent RSV in babies and infants, especially among high-risk children:
- Wash their hands for at least 20 seconds.
- Disinfect surfaces that people come into contact with regularly, such as door knobs, handles and countertops.
- Cover the mouth and nose while coughing.
- Avoid exposure to tobacco smoke.
- When possible, avoid or restrict group settings during RSV season.
Your child may be prescribed a medication known as palivizumab to minimize or prevent serious RSV disease among high-risk infants and children less than 2 years of age. If prescribed, palivizumab is given by injection monthly during the RSV season. Palivizumab is not a vaccine, but protects against RSV using virus-fighting antibodies. Talk with your child’s doctors to determine if they would be a candidate for this therapy.