Respiratory syncytial (pronounced sin-SISH-uhl) virus affects the lungs and breathing passages. RSV, which is highly contagious, causes upper respiratory infectionssimilar to the common coldand can lead to lower respiratory infections, like pneumonia and bronchiolitis (inflammation of the small airways of the lungs).
In people who are otherwise healthy, RSV infection usually resolves in 1 or 2 weeks without medical treatment. However, in high-risk populationsincluding infants and young children and older adults with certain chronic medical conditionsthe virus can cause serious illness.
RSV is the most common cause for bronchiolitis in babies under the age of 1 year, and is a major cause for pneumonia and other serious respiratory infections in older adults. Premature infants and children and adults with lung disease (including asthma), heart disease, a weakened immune system, or other chronic conditions are at increased risk for severe RSV infection.
Incidence and Prevalence of RSV
According to the Centers for Disease Control and Prevention (CDC), most people in the United States contract RSV before the age of 2. RSV infections are more common during cold and flu seasonin the late fall, winter and early spring.
A person can contract RSV more than once, but subsequent infections usually are less severe. The CDC reports that 2540 percent of young children with RSV develop bronchiolitis or pneumonia, and about 0.52 percent (commonly babies under the age of 6 months) require hospitalization. Older children and adults with certain chronic medical conditions may continue to be at high risk for severe RSV infection.
Transmission of RSV
RSV is a very common, highly-contagious virus. It spreads through the airwhen an infected person coughs or sneezesand through contact with infected nasal or oral secretions. RSV can survive on hard surfaces, such as doorknobs, telephones, computer keyboards, remote controls, tables and crib railings for several hours, and on soft surfaces, like tissues, stuffed animals and towels, for shorter periods.
RSV can spread quickly through daycare centers and schools and the virus is easily transmitted to other family members. The virus can enter the body through the nose, mouth or eyes and cause infection. Symptoms of RSV usually develop within 4 to 6 days of exposure.
A person who contracts RSV usually is contagious for about 3 to 8 days. However, babies and children and adults with weakened immune systems may be contagious for as long as 4 weeks after contracting the virus.
At this time, there’s no vaccine to prevent RSV infection. Protective measures are similar to those that help stop the spread of other respiratory infections like the common coldsuch as frequent hand washing. Important Tip: Remember to wash your hands before providing infant/young child careespecially if you have cold symptoms.
Other ways to help reduce RSV transmission include the following:
- Avoid sharing cups, dishes and eating utensils.
- Cover your mouth and nose when coughing or sneezing.
- Keep your child home from daycare or school if he or she has cold symptoms.
- Limit contact with high-risk children and adults during RSV season, especially if you have cold symptoms.
If your child is at high risk for severe RSV infection, talk to your health care provider about a drug called palivizumab. This medication cannot prevent, cure, or treat RSV, but it may help reduce the risk for serious illness and complications.
Signs and Symptoms of RSV
The first symptoms of RSV infection typically include runny nose and decreased appetitefollowed by fever, cough, wheezing and other cold symptoms (headache, sneezing, sore throat, fatigue, malaise). Infants may be irritable and become less active.
Here is some additional information about RSV and asthma risk.
Contact your health care provider immediately or call 9-1-1 if any of the following symptoms develop:
- Dehydration (dry mouth, inability to produce tears, dark urine, dry skin, dizziness, sunken eyes or soft spot in infants)
- Difficulty breathing, rapid breathing
- Bluish tint to lips or nail beds
- High fever
- Thick nasal discharge
- Worsening cough, productive cough
Call your health care provider if symptoms of RSV developespecially in a young child or an older child/adult at high risk for complications. It's important to assess the severity of the illness and detect breathing problems quickly.
RSV diagnosis may involve a physical exam, pulse oximetry, chest x-rays, and laboratory tests (e.g., nasal swab, blood test) to detect the virus.
RSV usually resolves without medical treatment. Talk to your health care provider about supportive care. Measures that may help relieve symptoms and prevent complications include:
- Plenty of rest
- Plenty of fluids (try small amounts in frequent intervals)
- Cool mist vaporizer (follow instructions for proper use and cleaning)
- Over-the-counter (OTC) pain relievers/fever reducers (e.g., acetaminophen, ibuprofen)Due to the risk for a serious condition called Reye's syndrome, do not use aspirin in children younger than 18 years of age.
Your health care provider may prescribe a bronchodilator (e.g., albuterol), administered through a nebulizer or inhaler, to help open the airways. If a secondary bacterial infection (e.g., ear infection) develops, antibiotics may be prescribed.
In severe cases, and when serious complications of RSV develop, hospitalization and treatmentincluding IV fluids, supplemental oxygen, suctioning of the airways, and/or a breathing tube (intubation with mechanical ventilation)may be necessary.
Sources: Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH)