RSV: Symptoms, Treatment, and When to Worry

Children with respiratory syncytial virus, or RSV, have many of the same symptoms as the common cold – but RSV may come with some serious complications. Find out how to treat RSV and when you should worry.

Children with respiratory syncytial virus, or RSV, have many of the same symptoms as a bad cold but could be a serious condition. Find out how to treat RSV and when you should worry.

Respiratory syncytial virus (RSV) is a highly contagious virus that targets the lungs and respiratory system. It’s so common that almost every child is exposed to RSV before their second birthday. Most people don’t show symptoms, but for some young children – specifically babies born prematurely, and those suffering from heart, lung, or immune system deficiencies – RSV can cause complications like pneumonia. Here’s everything you need to know about the symptoms, prevention, and treatment of RSV.

What is RSV?

A highly contagious virus, RSV is spread through infected droplets from coughs and sneezes. The droplets can get on hard surfaces like countertops, toys, and door handles. Transmission occurs if a child comes into contact with these droplets, and then touches his mouth, nose, or eyes. “The real problem with this virus is that it can live on these surfaces for over 24 hours, which means it can be picked up by someone else’s hands and spread,” says Paul Checchia, M.D., medical director of the Cardiac Intensive Care Unit at Texas Children’s Hospital.

RSV usually pops up during the winter months, with peak outbreaks in January and February. Children exposed to many people – like those in daycare – tend to contract RSV more frequently, says Ben Z. Katz, M.D. attending physician at the Ann & Robert H. Lurie Children’s Hospital of Chicago who specializes in RSV.

RSV Symptoms

According to Dr. Katz, many people with RSV don't have any signs of infection. If symptoms do appear, they show up four-six days after exposure, then stick around for one or two weeks.

Symptoms of RSV in babies include:

Although most people are exposed to RSV before age 2, they won’t develop an immunity to the infection, says Dr. Checchia. Adults can also get the virus; symptoms usually imitate the common cold.

RSV is typically contagious for about a week – but infants and people with weakened immune systems can spread the virus for three or four weeks (even if they’re asymptomatic).

RSV Complications

RSV usually isn’t cause for concern, but it’s more serious in babies for a couple of reasons.“The first time you get an infection, it's usually the worst because you have no preexisting immunity,” says Dr. Katz. “Babies also have smaller airways, which makes symptoms worse.” Some people are also predisposed to complications from RSV, including premature infants and those with chronic lung disease, congenital heart disease, and immune system disorders.

Possible RSV complications include pneumonia (a lung infection) and bronchiolitis (an inflammation of airway passages in the lungs). In fact, RSV is the most common cause of pneumonia and bronchiolitis in children less than one, according to the Centers for Disease Control and Prevention (CDC). “About 1-2% of babies with RSV get admitted to the hospital. Once you're in the hospital, you have a chance of ending up in the ICU,” says Dr. Katz. He adds that about 100 babies die each year from RSV in America.

Visit a doctor if your child has:

  • Difficulty breathing

  • High fever

  • Cough producing yellow, gray, or green mucus

  • Signs of dehydration

  • Thick nasal mucus

Alena Stalmashonak/Shutterstock

RSV Treatment

RSV usually goes away without medical intervention. Antibiotics aren’t effective against the virus, says Dr. Checchia. At-home treatment and over-the-counter medications can reduce the severity of symptoms; check with your doctor before giving any medication to infants.

Hospitalization may be required if your baby has difficulty breathing, which often indicates pneumonia or bronchiolitis. In some cases, the infected person need fluids to combat dehydration, or extra oxygen to improve breathing. “There's a lot of junk in the airways with RSV,” says Dr. Katz. “The debris is making the airways smaller, and it can really get in the way. Sometimes children need oxygen.”

RSV Prevention

Since there’s no medication that treats the infection, “the most important thing to do is prevent the spread of RSV,” says Dr. Checchia. “The best prevention is hand washing during RSV season, which runs from October to April.” People should also practice good hygiene: cover your mouth when sneezing or coughing, clean hard surfaces often, and avoid close contact with others. Don’t let people with symptoms of the common cold handle your infant, especially if he’s premature or immunocompromised.  

A monthly medication (palivizumab) is available to the highest-risk infants with prematurity, lung, and heart disease. “The injection does not prevent RSV, but it does help prevent the most severe cases of RSV,” says Dr. Checchia. Palivizumab also doesn’t treat RSV symptoms. Although no RSV vaccine currently exists, Dr. Katz says one is currently in the works.

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