RSV stands for Respiratory Syncytial Virus. It is a common, contagious virus which affects the lungs. It circulates seasonally in our population but is most common during the winter months of the year. It causes symptoms similar to the cold and other respiratory viruses, like fever, sore throat, nasal congestion, runny nose and cough. However, symptoms tend to be more severe and last longer than the common cold. Doctors refer to the nose and throat as the upper respiratory tract. Rarely, RSV can cause severe disease in the lungs or lower respiratory tract, including bronchiolitis and pneumonia. Most individuals have had an RSV infection at some point in their life or even multiple times. It is more likely to cause severe disease in the very young, elderly, and those with underlying medical conditions, especially lung conditions.
In most cases, RSV is uncomfortable but not dangerous. For most individuals, including children, RSV causes cold like symptoms and is managed exactly like a cold. Almost all children are infected by the age of 3, and because humans do not develop long term immunity to the virus, we continue to get infected multiple times throughout childhood and adulthood. Most people with RSV will have mild to moderate symptoms and recover completely. But the virus can be very dangerous to certain populations including the elderly and newborns (under 1-2 years old), also known as neonates. This is especially true if the individual has underlying medical issues of the lung or heart from being born too early. Infants with a history of prematurity can be particularly at risk if their lungs did not develop fully before they were born.
It’s very difficult to avoid RSV since it widely circulates in our communities year-round. The virus easily spreads in crowded places, so there are frequent outbreaks in daycares, schools, and households. Since it is a respiratory virus which is spread by contact with contaminated surfaces (like your hands) or from breathing in droplets produced by infected people coughing, sneezing or simply breathing, you can lessen your exposure by using common sense measures such as avoiding crowded places, washing your hands frequently, social distancing, and avoid being around sick people. During COVID, when we were wearing masks, we saw less RSV circulating in our communities, so mask wearing is also likely an effective tool to avoid exposure.
Unfortunately, there is no specific treatment for RSV just like there is no treatment for the common cold. Treatment for RSV is what we call “supportive care,” which is management of the symptoms while the virus runs its course over 7-10 days. This includes acetaminophen or ibuprofen for fever or discomfort, increased fluids, saline and bulb suction for infants with nasal congestion, and over-the-counter cough and cold medications for older children and adults. Some also find that added humidity helps. Antibiotics are not effective against RSV and would only be needed if a secondary bacterial infection were to develop, like bacterial pneumonia, which is uncommon.
Most babies and children can recover from RSV at home since the majority of cases of RSV will only cause cold like symptoms. If the child is alert, able to drink fluids, and not having breathing difficulties, they can most likely be managed at home. However, if your child is difficult to awaken, having severe difficulties breathing such as their nostrils flaring, their skin being pulled in between their ribs when they breathe in, very fast breathing, or blueness around the lips or on the fingers (cyanosis); seeking medical assistance is advised. This can include calling their pediatrician, calling the nurse line, seeking an urgent virtual visit with a healthcare provider, going to urgent care, or in severe cases going to the emergency department or calling 911.
Parents should understand the usual course of the illness and only bring their child to urgent care or the ER if the illness falls outside the normal range. For example, fever for 3-4 days is common in infants and children with RSV. The cough and nasal congestion from RSV is usually worst on day 4 of the illness, improving over 7-10 days, with symptoms dragging on for 2-3 weeks. If your child’s illness falls into this pattern, they can be treated supportively at home. However, if the fever lasts longer than 4 days, the cough is worse instead of better after 7-10 days, or there is significant pain or discomfort, a visit to a pediatrician or urgent care is recommended. Additionally, if your child starts having severe respiratory distress or blue lips, they should go to the emergency room.
- Myth 1: There is a specific treatment for RSV.
- Research has not yet been able to find an intervention which definitively treats RSV.
- Myth 2: If you’ve had RSV you cannot catch it again.
- This is unfortunately not true. It is possible to catch RSV again and sometimes in the same season.
- Myth 3: RSV is only around in the winter.
- While winter is the most prominent season for RSV, it can actually be caught at any time of the year.
- Myth 4: The only way to know your child has RSV is to bring them in and get them tested.
- RSV is a common respiratory virus that causes common cold symptoms in most people, but it does not generally require a test to confirm the diagnosis. In addition, not only does a positive test not change the management of the illness, bringing an infected child around other people, even in a doctor’s office, can spread the infection to others.
Most individuals do fine with RSV, so if your child is diagnosed with RSV, do not panic. Monitor your child’s progress, keep them comfortable and know that we’re here if you have any questions or need your child to be seen virtually or in person.