Respiratory syncytial virus or RSV is a common virus that affects the airway and lungs. Most people develop mild cold-like symptoms and get better in a few weeks. For some people, though, RSV can cause serious illness. The infection is especially dangerous for the very old and young.

Older Children and Adults

In older children and adults, respiratory syncytial virus may not have any symptoms. If any do appear, they resemble those of common cold, including cough, fever, congestion, and fatigue. The illness usually clears up on its own in less than a week. That said, symptoms can sometimes be more severe and resemble pneumonia.

Infants and Young Children

Respiratory syncytial virus can be severe in infants and young children. Most of the time, the symptoms are mild, but it can progress to more complicated respiratory infections like pneumonia or bronchiolitis. One to 2% of infants under six months old who develop RSV require hospitalization. The virus hits newborns and young infants particularly hard and is the number one cause of lower respiratory illnesses.

Populations Most At Risk

Respiratory syncytial virus can also cause severe disease in other at-risk pediatric populations, especially those with underlying conditions that compromise lung function. These include premature infants, children less than two years old with heart or lung disease, and those with neuromuscular disorders that cause difficulty swallowing or clearing secretions. RSV is also particularly dangerous for children with compromised immune systems.

Spread of RSV

Respiratory syncytial virus spreads from person to person through respiratory droplets. Someone with RSV is most contagious within the first few days of infection but may be able to spread the disease for as long as four weeks. The virus spreads through coughing, sneezing, or direct contact, such as touching an object with the virus and then touching the mouth, nose, or eyes.

Prevention

There is no vaccine for respiratory syncytial virus. The best prevention is to take precautions to prevent spread by frequently washing the hands, keeping surfaces clean, not sharing glasses, and throwing away used tissues right away. Parents with infants and young children should not smoke in the home, as exposure to tobacco smoke increases the risk of infection and severe symptoms.

Diagnosis

Doctors do not have to positively diagnose respiratory syncytial virus to begin treating the symptoms, but it helps in the hospital setting, as patients with the same virus can be placed together. Rapid antigen testing is more accurate with children than adults. Labs and imaging aren’t usually needed unless complications arise. A chest x-ray can diagnose inflammation, and pulse oximetry monitors the oxygen levels in the blood.

Treatment

In most cases, reatment for respiratory syncytial virus focuses on comfort. Over-the-counter medications can reduce fever, and nasal drops or sprays can help alleviate congestion. Hydration is important, especially for young infants and children who can dehydrate quickly. If the infection is severe, the patient may need hospitalization. Interventions include IV fluids, supplemental oxygen, and mechanical ventilation.

Treatment at Home

When treating respiratory syncytial virus at home, a cool-mist humidifier can moisten the air, which helps thin secretions, so they clear more easily. A bulb syringe can be used for infants to clear secretions from the nose. Warm fluids can also ease symptoms. Parents should bottle- or breastfeed infants as usual, but keep a close eye on their urine output to make sure they are eating enough.

RSV Season

Respiratory syncytial virus activity is tracked and analyzed by the Centers for Disease Control and follows a pretty predictable pattern. RSV season usually starts around the middle of September and lasts until April or May. It peaks between late December and mid-February. The only exception is Florida, which usually has a longer RSV season that starts earlier and lasts longer.

Medication and Vaccines

There are no antiviral medications for respiratory syncytial virus. For prevention, the American Academy of Pediatrics recommends a special monoclonal antibody injection once a month during RSV season for some individuals, including those who are very young or have an underlying medical issue that makes them more likely to develop a severe RSV infection.