Respiratory syncytial virus (RSV): What you need to know

Respiratory syncytial virus (RSV) is a common respiratory virus that causes cold-like symptoms in children and adults. Symptoms usually go away on their own in 1 or 2 weeks. 

Most children will get an RSV infection with mild symptoms by the time they are 2. But for some children under 1, RSV can develop into more serious conditions like bronchiolitis (swelling of the small airways in the lungs) or pneumonia (infection of the lungs). Here’s what you need to know.

In the winter of late 2020 into early 2021, there were almost no cases of RSV. Today, some children with RSV are becoming severely ill because they have little natural protection. That’s because their immunity has lessened, or they weren’t exposed to respiratory viruses before the pandemic.

No. Almost all children get an RSV infection by their second birthday.

Symptoms of RSV usually appear within 4 to 6 days after infection and include:

• Congested or runny nose
• Decreased appetite
• Coughing
• Sneezing
• Fever
• Moderate wheezing

In some cases, RSV can develop into more severe conditions like pneumonia. Symptoms to look out for include: 

• Severe wheezing
• Rapid breathing or respiratory distress
• Bluish skin or fingernails
• Refusal to drink liquids, breastfeed, or chestfeed
• Decreased number of wet diapers
• Extreme tiredness

If you’re worried your child is having a serious breathing problem or if they have bluish skin or fingernails, call 911 or go to your nearest emergency department. 

An RSV infection lasts about 3 to 7 days but coughing and wheezing can last for several weeks. 

RSV spreads through the air from droplets from coughing or sneezing. It can spread quickly in schools, child care centers, and other places where people are in close contact.

RSV can also survive for many hours on hard surfaces, such as toys or furniture. That’s why washing your hands regularly is important for preventing the spread of the virus.

Children who are most at risk of developing severe conditions include:

• Premature infants
• Young children with congenital (from birth) heart or chronic lung disease
• Young children with weakened immune systems 

If your child is at high risk, make sure they:

• Avoid close contact with sick people
• Wash their hands often with soap and water for at least 20 seconds
• Avoid touching their face with unwashed hands
• Limit the time they spend in child care or other crowded places
• Avoid exposure to people who are smoking 

Also, all eligible family members should get a flu shot and COVID-19 vaccination to protect children from complications.

• Manage your child’s fever and pain with over-the-counter medications, such as acetaminophen or ibuprofen. 
• Ensure your child is drinking lots of fluids to prevent dehydration. 
• If your child is too young to blow their nose, use nasal saline and a nasal aspirator or bulb syringe to remove sticky nasal fluids to help with comfort and breathing.

People infected with RSV are usually contagious for 3 to 8 days.

No vaccine is available at this time, but at least 2 candidates are in late-stage clinical trials. Pfizer is also developing an antiviral drug. Antibiotics are not used to treat RSV.

There are tests for RSV, but most people don’t need one unless there’s a risk they may need to be hospitalized if infected.

Most of the time, RSV is a mild, cold-like illness that lasts 1 to 2 weeks. However, according to the Centers for Disease Control and Prevention, 1 to 2 percent of children younger than 6 months may need to be hospitalized. Those who are hospitalized may need oxygen or help breathing. Most children can leave the hospital within a few days.

This flu season is being called a “tridemic” because there has been a fast rise in patients battling the flu, RSV, and/or COVID-19. All 3 viruses can lead to respiratory distress and hospitalization, especially in children under 1 or those with asthma or other health issues.