Respiratory syncytial virus infection, usually called RSV, is a lot like a bad cold. It causes the same symptoms. And like a cold, it is very common and very contagious. Most children have had it at least once by age 2.
RSV is usually not something to worry about. But it can lead to pneumonia or other problems in some people, especially babies. So it's important to watch the symptoms and call your doctor if they get worse.
A virus causes RSV infection. Like a cold virus, RSV attacks your nose, eyes, throat, and lungs. It spreads like a cold too, when you cough, sneeze, or share food or drinks.
There are many kinds of RSV, so your body never becomes immune to it. You can get it again and again throughout your life, sometimes during the same season.
RSV usually causes the same symptoms as a bad cold, such as:
Babies with RSV may also:
Some children have more serious symptoms, like wheezing. Call your doctor if your child is wheezing or having trouble breathing.
Doctors usually diagnose RSV by asking about your or your child's symptoms and by knowing whether there is an outbreak of the infection in your area.
There are tests for RSV, but they aren't usually needed. Your doctor may want to do testing if you or your child may be likely to have other problems. The most common test uses a sample of the drainage from your nose.
RSV usually goes away on its own. For most people, home treatment is all that is needed. If your child has RSV:
When a person with RSV is otherwise healthy, symptoms usually get better in a week or two.
RSV can be serious when the symptoms are very bad or when it leads to other problems, like pneumonia. Certain people are more likely to have problems with RSV:
These people sometimes need treatment in a hospital. So it's important to watch the symptoms and call your doctor if they get worse.
It's very hard to keep from catching RSV, just like it's hard to keep from catching a cold. But you can lower the chances by practicing good health habits. Wash your hands often, and teach your child to do the same. See that your child gets all the vaccines your doctor recommends.
Medicines to prevent RSV may be given to babies and children who are more likely to have problems with the infection. Sometimes these medicines don't prevent RSV, but they may keep symptoms from getting serious.
Respiratory syncytial virus (RSV) is highly contagious, meaning it spreads easily from person to person. There are two main types of RSV and many subtypes (strains). For this reason, you cannot have full immunity to the virus. And you may have many RSV infections throughout life.
People with RSV infection may spread the virus through their secretions (saliva or mucus) when they cough, sneeze, or talk. You can catch the virus by:
The virus spreads easily in crowded settings, such as child care facilities, preschools, and nursing homes. Children attending school often spread the virus to their parents and siblings. The incubation period—the time from exposure to RSV until you have symptoms—ranges from 2 to 8 days but usually is 4 to 6 days.footnote 1
You are most likely to spread the virus within the first several days after symptoms of RSV infection begin. You remain contagious for up to 8 days. Babies and young children may spread the virus for at least 3 to 4 weeks.
Many different viruses can cause lower respiratory tract infections in children. These viruses can cause symptoms that are similar to an RSV infection.
When a respiratory syncytial virus (RSV) infection affects the nose and throat (upper respiratory system), symptoms are usually mild and resemble those of the common cold. They include:
Babies may have additional symptoms, including:
It is hard to distinguish between a common cold and RSV infection. But unless you or your child has an increased risk of complications from RSV, it usually is not important to know which virus causes symptoms.
Symptoms of these complications include:
In healthy children, respiratory syncytial virus (RSV) infections tend to be mild and resemble a cold. Children who have only upper respiratory system symptoms, such as a sore throat or a runny nose, usually recover in about 10 to 14 days.
Two different types and many different subtypes (strains) of RSV exist. For this reason, you cannot have full immunity to the virus and may have many RSV infections throughout your life. A child's first RSV infection, which almost always occurs by age 2, usually is the most severe. Certain babies and children have an increased risk of complications from an RSV infection because of a health condition or another problem. Also, babies have narrow breathing tubes that can clog easily, making breathing hard. The most common complications for young children are bronchiolitis and pneumonia, which are lower respiratory tract infections.
Adults older than 65 have an increased risk of complications following infection with RSV. Pneumonia is a particular risk, especially if other health problems exist, such as chronic obstructive pulmonary disease (COPD) or heart failure.
It may take older adults longer to recover from RSV infection and its complications than people in other age groups.
Respiratory syncytial virus (RSV) infects almost all children by the age of 2, and reinfection throughout life is common. The virus spreads easily and is extremely difficult to completely avoid. Babies and young children who are in day care centers or frequently in public places are most likely to become infected, especially during the peak season.
Older brothers and sisters in school often become infected with the virus and spread it to other household members, including babies and preschoolers. Sharing food, touching objects that are contaminated with the virus, and not washing hands can lead to RSV infection. Older adults living in nursing homes or other group environments also have a higher risk of becoming infected with RSV.
Babies ages 2 to 7 months of age have the highest incidence of RSV infection affecting the lower respiratory tract. Reinfection with another type or strain of RSV can occur within weeks. But later infections are usually less severe.
With RSV infections, there is an increased risk of having complications, especially in certain babies and young children and adults older than 65.
Call 911 or other emergency services immediately if:
Call your doctor now if your baby or child has moderate trouble breathing.
Call a doctor if your child:
For an otherwise healthy child who has symptoms of an upper respiratory infection, such as a cough or runny nose, home treatment usually is all that is needed. But it's important to watch for signs of complications, such as dehydration.
Watchful waiting may not be a good choice when your child with an upper respiratory infection has an increased risk for complications. Watch your child closely if there are symptoms of an upper respiratory infection. If symptoms get worse or new symptoms develop, see a doctor right away.
In otherwise healthy people, it is not usually necessary to distinguish respiratory syncytial virus (RSV) infection from a common cold. A doctor may suspect RSV infection as the cause of symptoms when there is evidence of a recent community outbreak. It is generally not necessary to confirm RSV infection with lab tests. But a medical history and physical exam may be done to evaluate symptoms.
A viral detection test may be done to confirm a diagnosis of RSV in symptomatic children and adults older than 65 who are at an increased risk for a severe infection or for complications. The test involves lab analysis of nasal drainage, obtained with a cotton swab or nasal wash. Testing may also be recommended for people who are hospitalized if the cause of symptoms has not already been determined and they have a high risk of developing complications.
The results of viral detection tests help determine whether precautions are needed to prevent the spread of infection. For children who are at risk for getting severe infections or complications of RSV infections, the results of these tests may help guide treatment, such as the need for medicines.
Respiratory syncytial virus (RSV) infections are usually mild and seem like a common cold. In most cases, RSV infections go away on their own in about 10 to 14 days. Home treatment to ease symptoms and prevent complications is usually all that is needed.
Children who develop lower respiratory infections, especially bronchiolitis, may need medicines in addition to home treatment. Antibiotics may be used to treat a bacterial infection (such as pneumonia) that develops as a complication. But antibiotics don't treat RSV or any other viral infection.
When complications develop in otherwise healthy children, corticosteroid medicines sometimes are used. But more study is needed before corticosteroids are routinely recommended for this purpose.
A child who is having difficulty breathing or is dehydrated may need to be cared for in a hospital. The child may need respiratory and other medical treatments. In very rare cases, some children receive the antiviral medicine ribavirin while they are in the hospital.
Respiratory syncytial virus (RSV) infection is easy to catch (highly contagious). It is common for children to get viral infections such as RSV if they are often exposed to infected people and have not built up immunity. There is no sure way to prevent respiratory illnesses in babies and children.
Sometimes medicines are used to help prevent RSV infection in babies and children who are at risk for complications from RSV. Even if RSV infection develops, use of these medicines may result in a less severe infection.
Monoclonal antibodies, such as palivizumab (Synagis), may be used to help prevent or reduce the severity of RSV infection.
The following may help reduce your child's risk of respiratory problems:
Outbreaks of RSV often occur between late fall and early spring. To keep from catching the virus during this time, limit your exposure to RSV. This is most critical for babies and children who are at risk for serious RSV infections. Try to avoid:
Most mild to moderate respiratory syncytial virus (RSV) infections in otherwise healthy people are like the common cold and can be treated at home. If your child is older than 12 months of age and is not at risk for complications from RSV infection, try home treatment. But RSV infections in people with an increased risk of complications need close monitoring.
People who have impaired immune systems need to see a doctor for cold symptoms because of the increased risk for complications. Also, babies and children—and older adults—who have health problems and other risk factors should see a doctor at the first sign of RSV.
Most respiratory syncytial viral (RSV) infections do not require prescription medicines. But medicines may be recommended for certain people to help:
A medicine may be given to infants and children at high risk for complications of RSV to prevent the infection or reduce its severity. Monoclonal antibodies, such as palivizumab (Synagis), are usually given in monthly doses for up to 5 months. This medicine can stop RSV from multiplying.
Medicines to help treat complications of RSV infection include:
- American Academy of Pediatrics (2015). Respiratory syncytial virus. In DW Kimberlin et al., eds., Red Book: 2015 Report of the Committee on Infectious Diseases, 30th ed., pp. 667–676. Elk Grove Village, IL: America Academy of Pediatrics.
- Hall CB, Walsh EE (2009). Respiratory syncytial virus. In RD Feigin et al., eds., Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed., vol. 2, pp. 2462–2487. Philadelphia: Saunders Elsevier.
Other Works Consulted
- Committee on Infectious Diseases, Bronchiolitis Guidelines Committee (2014). Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics, published online July 28, 2014. DOI: 10.1542/peds.2014-1666. Accessed August 1, 2014.
- Honegger JR, Brady MT (2011). Viral respiratory infections including influenza. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 961–970. New York: McGraw-Hill.
- Levin M, et al. (2014). Infections: Viral and rickettsial. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 22nd ed., pp. 1227–1270. New York: McGraw-Hill.
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