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RSV (Respiratory Syncytial Virus)

RSV (Respiratory Syncytial Virus)

​RSV is a common respiratory virus that usually causes mild, cold-like symptoms, but may cause severe disease in infants and older adults.

Baby in crib

What is RSV?

Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can cause severe infection in infants and older adults. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States. Almost all children get RSV at least once before they are two years of age. 

Symptoms

People with RSV infection typically have;

  • Fever

  • Cough

  • Runny nose

  • Wheezing  

  • In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties.

Caring For Your Child at Home 

There is no cure for respiratory viruses, but some medications can reduce disease severity in certain situations. For mild symptoms, follow these tips to help ease discomfort: 

  • Reduce congestion with nasal saline with gentle suctioning. Patients should sit or lie upright when possible. Cool-mist humidification also helps to clear the congestion and make people feel better. 

  • Make sure your loved ones get plenty of rest and drinks clear fluids such as water, broth or sports drinks to prevent dehydration. For infants, use electrolyte beverages such as Pedialyte. Healthy snacks and small meals are also recommended. 

  • If your child has a fever (100 degrees or higher), acetaminophen and ibuprofen can be given to children 6 months of age and older. Infants and children should not be given aspirin as this can cause a rare but serious illness called Reye's syndrome. Only use other medications or medications for infants less than 6 months old under the guidance of your health care provider. 

  • Follow dosing instructions listed on the back of the medication or from your health care provider. 

  • Stay home at least 24 hours after there is no longer a fever or signs of a fever (without the use of fever-reducing medicine). 

When to Seek Care 

Most childhood respiratory illnesses are mild and resolve on their own without the need for emergency care or hospitalization. Understanding when to see a doctor or go to the hospital ensures that children receive the right care. Call ahead to get medical advice and see what you can do at home and when it is best to come in to be examined. Seek evaluation right away if your child has the following symptoms: 

  • Difficulty breathing (for example fast breathing, flaring nostrils, head bobbing, grunting, or wheezing while breathing; belly breathing; pauses in breathing)  

  • Are not able to drink enough fluids and having symptoms of dehydration 

  • Gray or blue color to tongue, lips or skin 

  • Significantly decreased activity and alertness 

  • Fever in those under 3 months of age (12 weeks) 

  • Fever above 104°F repeatedly for a child of any age 

  • Poor sleep or fussiness, chest pain, ear tugging or ear drainage 

  • If symptoms worsen or do not improve after 7 days.   

Is Your Child at Higher Risk for Severe RSV? 

Early evaluation and treatment by a health care professional can ensure the best possible outcomes for children who are at a higher risk of severe disease. Children who are at higher risk of severe disease include: 

  • Younger children, particularly 6 months old or younger 

  • Premature or low-birth weight infants 

  • Children with chronic medical conditions, including chronic lung diseases, heart disease, disorders weakening the immune system, or neuromuscular disorders 

Prevention 

While there is currently no vaccine to prevent RSV, other prevention measures are available and are strongly recommended to help stop the spread of RSV. Actions you can take to slow the spread of RSV and other respiratory viruses include: 

  • Wear a mask in indoor public or crowded spaces. Wearing a mask can protect babies and young children who do not yet have immunity and are too young to wear a mask themselves. 

  • Wash hands frequently and thoroughly with soap and warm water or use an alcohol-based hand sanitizer. 

  • Cough or sneeze into your elbow, arm, or disposable tissue. If disposable tissue is used, use hand sanitizer or wash hands afterwards. 

  • Avoid touching your eyes, nose, and mouth. 

  • Stay away from people who are sick. 

  • Stay home when sick.  Return to school or childcare should be based on symptoms; generally children with respiratory symptoms should not return to childcare or school until symptoms are resolved or at least mild and improving. Testing for RSV is not necessary for return. 

  • Individuals may return to work/school/childcare after symptoms have resolved, including waiting at least 24 hours since resolution of fever without the use of fever-reducing medications. Return should be based on symptoms and generally children with respiratory symptoms should not return to childcare or school until symptoms are resolved or at least mild and improving. Testing for RSV is not necessary to return. 

Prevention in high-risk infants 

There is a medicine called palivizumab (Synagis®) that can help prevent serious infection in babies at high risk for severe RSV disease. The American Academy of Pediatrics (AAP) recommends  preventive use of this medicine for infants at high risk for severe RSV.

Healthcare providers may prescribe palivizumab to very premature infants and infants 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 for more information. As of 11/17/22, the AAP recommends considering using this medicine for longer than usual if high RSV levels continue in the region where the high-risk infant lives. 

Information for Healthcare Providers 


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