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Respiratory syncytial virus or RSV

Respiratory syncytial virus (or RSV) infects the lungs and airways. RSV can affect anyone of any age, but it's most common in infants and young children. In fact, it's so common that almost all children have been infected with RSV by the age of three.

Outbreaks of RSV usually start in late fall through early spring, peaking during the winter months. 

RSV can infect the same person more than once throughout their lifetime. Symptoms are usually less severe after the first RSV infection. Symptoms for older children and adults are more like cold symptoms.

RSV can cause serious illness

RSV is usually a mild disease that goes away on its own.

Infants or young children who have RSV for the first time may get a serious infection in their lower respiratory tract, like bronchiolitis or pneumonia. They will need to be treated in hospital. Most children with RSV who are sick enough to go to the hospital are either very young (infants) or have an underlying health condition, like heart or lung disease. RSV can also be more serious in premature and newborn babies.

RSV usually goes away on its own and does not require a hospital visit or specific medical treatment. Symptoms may last for one to two weeks, and a cough may last for two weeks or more. Symptoms in older children and adults are usually milder.

In most children, RSV usually causes symptoms similar to the common cold:

  • stuffy or runny nose
  • cough
  • ear infections (sometimes)
  • low-grade fever
  • sore throat

When should I call my healthcare provider?

Get emergency help if your child has warning signs of a serious RSV infection (see below). As in any case of illness, you should call your healthcare provider if you are worried about your child. Your child's doctor can best decide with you whether the symptoms and behavious you describe need medical treatment. When in doubt, call for advice.

Warning signs of a serious RSV infection

Get emergency help right away if your child has:

  • trouble breathing
  • fast, rapid breathing
  • wheezing
  • deeper and more frequent coughing
  • blue lips or fingernails
  • dehydration
  • difficulty breast feeding or bottle-feeding

In most cases, RSV infection will go away on its own, without any special treatment. For a few children, having RSV will make them more prone to other lung and breathing problems later on, although these problems could be caused by an underlying medical condition or allergy, and not RSV. 

There are many things you can do at home to help a child with a mild case of RSV feel better:

  • Give them plenty of clear fluids to prevent dehydration: diluted juice, water and popsicles, Pedialyte or another electrolyte drink for children. 
  • Use a cool-mist vaporizer to humidify the air, soothe irritated breathing passages and relieve coughing.
  • Use saline (salt water) nose drops to loosen mucus in the nose. You can buy this over the counter at the drugstore. 
  • For children who are too young to blow their nose, use a nasal aspirator to remove sticky nasal fluids.
  • Treat fever using a non-Aspirin fever medicine like acetaminophen (for example, children's Tylenol or Tempra). Never give a child or teen acetylsalicylic acid (also called ASA or Aspirin).

RSV infection is not treated with antibiotics because antibiotics do not work against viruses. But if your child gets an ear infection associated with RSV, the doctor may prescribe antibiotics.

Younger children, especially infants, who have severe RSV-related pneumonia or bronchiolitis may need to be treated in hospital. They may be given oxygen with mist and medicines to open up their airways.

RSV is an especially contagious virus because it can live on surfaces for hours, and is easily passed from person to person. Children in daycare centres and preschools are at greatest risk for RSV. Infants are at greater risk if they have an older brother or sister in school.

Because RSV occurs in sudden, large outbreaks throughout the year, it is hard to prevent your child from being exposed to the virus.

Still, there are many things you can do to reduce your child's risk of getting RSV:

  • Wash your child's hands with soap and water. Good and frequent hand-washing is the best way to prevent RSV infection.
  • Throw used tissues in the garbage.
  • Avoid people who are sick.
  • If your older child comes down with a cold, keep them away from an infant sibling until the symptoms pass.
  • Don't let your child share things that could easily pass germs, like cups, spoons or pillows.

Is there a vaccine for RSV?

Arexvy is an RSV vaccine that has been approved for adults 60 years old and older. There is a monoclonal antibody (palivizumab or PVZ) in use to prevent RSV in certain populations of children. PVZ is not a vaccine.