Respiratory Syncytial Virus (RSV)

Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms. However, it can sometimes cause serious breathing problems.

At Banner Health, our goal is to help you understand RSV and how to keep yourself and your family safe. Whether you’re seeking information for yourself or a family member, we have you covered.

What is RSV?

RSV is a common infection of the lungs and breathing passages, known as the respiratory tract. It can cause mild, cold-like symptoms but can be serious for infants, some young children and older adults.

When you have RSV, the virus enters your respiratory tract and causes swelling and inflammation in your lungs. This inflammation can make it harder for air to flow in and out of your lungs. 

RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lungs) and pneumonia (infection of the lungs) in children under age 1. These conditions can cause difficulty breathing, wheezing and decreased oxygen levels. They may also require medical attention and hospitalization.

Who is most at risk for RSV?

While anyone can get RSV, certain groups are at higher risk for severe illness:

• Infants and young children: Especially those under six months old or with conditions like premature birth, congenital heart disease, asthma or chronic lung disease.
• Older adults: Especially those over 65 or with underlying health conditions like chronic obstructive pulmonary disease (COPD), diabetes and heart disease.
• People with weakened immune systems: Including those undergoing chemotherapy or other conditions that weaken the immune system. 

How does RSV spread?

RSV is very contagious. You can easily spread the virus while you have symptoms, about three to eight days after symptoms develop.

RSV spreads through droplets when an infected person coughs or sneezes. Touching someone who has RSV, such as shaking hands and hugging, can spread the virus. You can also get it by touching a surface that has the virus on it and then touching your face, especially your eyes, nose and mouth. 

RSV season occurs in the fall and winter months but can be seen year-round. Because it is very contagious, RSV can spread quickly in places like childcare centers and schools.

Symptoms of RSV

RSV symptoms usually appear four to six days after exposure to the virus and may last one to two weeks. These symptoms can vary and may include:

• Runny nose
• Sore throat
• Cough (might sound tight or like a seal barking)
• Sneezing
• Fever
• Decrease in hunger or appetite (for breastfed children: refusing to breastfeed or bottle feed)
• Lack of energy

When to seek medical attention

Most RSV infections are mild and can be treated at home. However, seek medical attention from an urgent care or emergency department if you or your child experience:

• Trouble breathing: Whistling or wheezing noise, flaring of the nostrils while breathing; blue or gray skin , lips and/or fingernails; short, shallow or fast breaths or pauses in breathing.
• Dehydration: Signs include dry mouth, lack of tears when crying and fewer than one wet diaper every eight hours.
• High fever: Fever is a problem if it is very high or does not go down with medication. For babies under three months old, a high fever is a temperature greater than 100.4°F (38°C). And for anyone at any age, a high fever is a temperature greater than 103°F (39.4°C).
• Worsening symptoms: If symptoms worsen or do not improve after a few days.

How is RSV diagnosed?

If you suspect you or your child has RSV, it is important to see a health care provider. They can diagnose RSV through a physical exam and by listening to the lungs. In some cases, they may perform tests such as:

• Nasal swab test to check your mucus for RSV
• Pulse oximetry to check blood oxygen levels 
• Chest X-ray to look for lung congestion

How is RSV treated?

There is no specific treatment for RSV. Most cases are mild and can be treated at home. Here are some ways to help ease symptoms:

• Rest and drink lots of fluids to avoid dehydration.
• Take over-the-counter (OTC) medications to help reduce fever and ease pain. Always speak with a health care provider before giving any medication to young children. 
• Use a cool mist vaporizer or humidifier to make breathing easier and reduce coughing.
• Use saline nasal drops or sprays to loosen a stuffy nose.
• Use gentle suctioning to help clear mucus from the baby’s nose before feedings.

For severe cases, hospitalization may be required. This may include oxygen therapy, IV fluids and a breathing machine (ventilator). In some cases, medicines may be given to help open air passages in the lungs (bronchodilators) or kill infections caused by viruses (antiviral medication).

Complications of RSV

While most people recover fully from RSV, it can lead to severe complications in high-risk groups. These complications may include:

• Bronchiolitis: Inflammation of the small airways in the lungs that can cause severe breathing problems.
• Pneumonia: An infection of the lungs that can be serious and require hospitalization.
• Middle ear infection: RSV can lead to ear infections, especially in babies and young children.
• Asthma: Severe RSV in early childhood may be linked to an increased risk of developing asthma later in life. 

How to protect yourself from RSV

While RSV often causes mild, cold-like symptoms, it can cause severe lung infections in some groups of people. Here are some ways to protect yourself and your loved ones from RSV:

• Wash your hands: Use soap and water and wash for at least 20 seconds.
• Cover coughs and sneezes: Use a tissue or your elbow when you cough or sneeze to stop the spread of germs.
• Clean regularly touched surfaces: Clean and disinfect surfaces that are touched often, like doorknobs, toys and remote controls. 
• Avoid close contact with sick people: If someone is sick, keep a safe distance. If you are sick, stay home and avoid close contact with others.
• Don’t share personal items: Do not share cups, utensils or towels with others, especially if someone is sick.
• Avoid smoking and secondhand smoke: Avoid smoking or being around smoke to keep your lungs healthy and reduce your risk of infections like RSV.
• Get vaccinated: Vaccinations help prevent RSV and other viruses like the flu (influenza), whooping cough and COVID-19. Stay up-to-date on your immunizations, especially if you or your loved ones are high-risk. 

There’s currently a vaccine for RSV for adults over 60 and pregnant people and a monoclonal antibody to protect infants and young children. Here’s what to know:

• Adults ages 60 and older: The Centers for Disease Control and Prevention (CDC) recommends an RSV vaccine for everyone 75 and older and adults 60 to 74 who are at an increased risk for severe infection. 
• Pregnant people: The CDC recommends an RSV vaccine (Abrysvo) between 32 and 36 weeks of pregnancy. Your protection is passed to your baby during the first six months of life.
• Babies up to 8 months old: The CDC recommends a monoclonal antibody product (nirsevimab) to help protect against severe RSV infections. These antibodies are not vaccines but help fight RSV infections. A second dose is also recommended for children age 8 to 19 months if they are high-risk.

There is another monoclonal antibody (palivizumab) that is limited to children younger than 2 years old with certain conditions that put them at greater risk for severe infection. 

Talk to your health care provider about what is best for you and your family.