Respiratory Syncytial Virus (RSV)
Last updated November 3, 2022
What is respiratory syncytial virus or RSV? RSV is a very common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious especially for infants and older adults. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children younger than 1 year of age in the U.S.
How does RSV spread? RSV can spread when:
- An infected person coughs or sneezes
- You get virus droplets from a cough or sneeze in your eyes, nose, or mouth
- You touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands
- You have direct contact with the virus, like kissing the face of a child with RSV
People infected with RSV are usually contagious for 3 to 8 days, however some infants and people with weakened immune systems can continue to spread the virus even after they stop showing symptoms, for as long as 4 weeks. Children are often exposed to and infected with RSV outside the home, such as in schools or child-care centers. They can then transmit the virus to other members of the family.
RSV can survive for many hours on hard surfaces such as tables and crib rails. It typically lives on soft surfaces such as tissues and hands for shorter amounts of time.
Who typically gets RSV? People of any age can get RSV, but infections in adulthood are usually less severe. People at highest risk for severe disease include:
- Premature infants
- Young children with congenital heart or chronic lung disease
- Young children with compromised immune systems due to a medical condition or medical treatment
- Adults with compromised immune systems
- Older adults, especially those with underlying heart or lung disease
Some people with RSV infection, especially older adults and infants younger than 6 months of age, may need to be hospitalized if they are having trouble breathing or are dehydrated.
Is there a test to determine if you have RSV? A rapid test for RSV is available in our Urgent Care, however it is mostly used for vulnerable and/or immunocompromised patients. If you feel you need to be tested, you should contact your primary care provider.
If you have had RSV before, can you get it again? Yes.
What are the common symptoms of RSV? Individuals infected with RSV usually show symptoms within 4-6 days after getting infected. For most adults and older children, RSV causes typical common cold symptoms such as runny nose, nasal congestion, coughing, sneezing, fever, decreased appetite and/or wheezing. In very young infants, the only symptom may be irritability, decreased activity and breathing difficulties. For infants, preemies and those with high-risk conditions like asthma, RSV can create enough mucus and inflammation in the lungs to result in hospitalization to provide things like extra monitoring, breathing treatments, deep suctioning, supplemental oxygen, intravenous fluids and sometimes respiratory support in severe cases. For any age patient struggling to breathe, seek care immediately.
How do you treat RSV? There is no specific treatment for RSV once you are infected. Most RSV infections go away on their own in a week or two. Researchers are working to develop vaccines and antivirals (medicines that fight viruses,) but none are available yet. For parents, there are steps that can be taken to relieve your child’s symptoms:
- Manage fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. (Never give aspirin to children.)
- Drink enough fluids. It is important for people with RSV infection to drink enough fluids to prevent dehydration (loss of body fluids).
- Talk to your pediatrician or healthcare provider before giving your child non-prescription cold medicines. Some medicines contain ingredients that are not good for children.
- Nasal saline drops, humidifier and steamy bathroom treatments can be helpful to keep mucus thin and make it easier to breathe through the nose. For patients with asthma, nebulizers/inhalers may be helpful.
- For infants, preemies and those with high-risk conditions, RSV can create enough mucus and inflammation in the lungs to result in a need for hospitalization to provide things like breathing treatments, deep suctioning, supplemental oxygen, intravenous fluids and sometimes respiratory support in severe cases.
- There is a monthly, preventive treatment with a monoclonal antibody called palivizumab (Synagis) available to prevent severe RSV illness in certain high-risk infants and children. The drug can help prevent serious RSV disease, but it cannot help cure or treat children already suffering from serious RSV disease, and it cannot prevent infection with RSV. Because Synagis® is available to a very small population of high-risk infants and children, please check with your health insurance provider to determine coverage.
How can you prevent getting RSV? There are steps you can take to help prevent the spread of RSV.
- Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands.
- Wash your hands often with soap and water for at least 20 seconds.
- Avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others.
- Clean frequently-touched surfaces such as doorknobs and mobile devices.
- People with cold-like symptoms should not interact with children at high risk for severe RSV disease, including premature infants, children younger than 2 years of age with chronic lung or heart conditions, and children with weakened immune systems.
- If there is an outbreak of RSV at your school or daycare, it may be a good idea to keep your child home if possible, until the illnesses settle down. This is especially true if you have a very young child, a preemie, a child with an underlying health condition or if you have a high-risk person living in your home.
- High-quality masks are another tool that can help reduce the spread of germs if you are experiencing symptoms or just want to reduce the chances of being exposed if you are in an indoor or classroom setting.
- Handwashing is helpful. For younger children, a good practice is to wash hands, face and maybe even change into a clean shirt before interacting with other siblings when coming home after school.