RSV: Symptoms, Treatment and Prevention

Respiratory syncytial virus (RSV) is a common respiratory virus. It usually causes mild, cold-like symptoms, but it can cause serious lung infections, especially in infants, older adults and people with serious medical problems.

How it spreads

• through the air, by coughing and sneezing;
• by direct contact, such as kissing the face of a child who has RSV;
• by touching a contaminated object or surface and then the mouth, nose or eyes before washing hands.

People with RSV are usually contagious for 3 to 8 days, but infants and people with weakened immune systems can keep spreading it for as long as 4 weeks.

Who gets it

RSV affects all ages, and nearly all children have had it by age 2. In the United States it circulates mainly during RSV season, usually fall through spring. The risk of severe infection is higher for:

• infants;
• older adults, especially those 65 and older;
• people with chronic heart or lung disease;
• people with weakened immune systems.

Symptoms

Symptoms usually start 4 to 6 days after infection and tend to come in stages: runny nose, less appetite, cough, sneezing, fever and wheezing. In very young infants the only signs may be irritability, reduced activity and trouble breathing.

RSV can also cause more serious illness, especially in high-risk people: bronchiolitis, inflammation of the small airways of the lungs, and pneumonia, a lung infection.

Diagnosis

A provider takes a history and does a physical exam. A lab test of nasal fluid or another respiratory sample, usually done for severe illness, can confirm RSV; people with severe infection may also need a chest X-ray and blood and urine tests to check for complications.

Treatment

There is no specific treatment; most infections clear on their own in a week or two.

• Over-the-counter pain relievers can ease fever and pain, but don't give aspirin to children, and don't give cough medicine to children under 4.
• Drink enough fluids to avoid dehydration.
• Some people with severe infection need hospital care, where they may get oxygen, a breathing tube or a ventilator.

Prevention

Vaccines:

• Two RSV vaccines are for people 60 and older; ask a provider whether one is right for you.
• A vaccine can be given during pregnancy, between 32 and 36 weeks, to protect the newborn for its first 6 months.

Medicines for babies and young children, given by injection, can help prevent severe RSV illness, though they cannot treat or cure it or prevent infection:

• one is given to infants under 8 months during their first RSV season, including those born during the season, and to some children aged 8 to 19 months at high risk, for example because they were born prematurely or have congenital heart disease, chronic lung disease or a weakened immune system;
• the other is given monthly during RSV season to high-risk children under 24 months.

Everyday steps: wash hands often with soap and water for at least 20 seconds; avoid touching the face with unwashed hands; avoid close contact such as kissing, shaking hands and sharing cups or utensils when you or others are sick; clean and disinfect often-touched surfaces; cover coughs and sneezes with a tissue, throw it away and wash your hands; and stay home when sick.

Sources

• MedlinePlus, produced by the U.S. National Library of Medicine, "Respiratory Syncytial Virus Infections": https://medlineplus.gov/respiratorysyncytialvirusinfections.html — drawing on the Centers for Disease Control and Prevention.