Respiratory syncytial virus (RSV) causes coldlike symptoms, but this common virus is more dangerous for a baby or young child. Learn what it is, identify warning signs that your child has a more serious infection, and get prevention strategies.
What is RSV?
RSV is the abbreviation for respiratory syncytial (sin-SISH-uhl) virus (RSV). This respiratory virus typically causes mild, coldlike symptoms in older children and adults, but it can lead to more serious problems in babies and young children.
RSV is the most common cause of lower respiratory tract infections in children younger than 1 year old. Most children get infected with RSV at least once before age 2.
In what months does RSV most commonly occur?
Outbreaks of RSV are most common from October or November to April or May, with a peak in January and February. Children (and adults) can get RSV more than once in a season. Repeat infections are usually less severe than the first one, though.
How does RSV spread?
RSV spreads easily through droplets in the air or from contact with a contaminated surface. A child can pick up RSV when an infected person sneezes or coughs nearby, or by touching a contaminated surface, like a toy, and then putting his fingers in or near his mouth, nose, or eyes.
The virus can live on hard surfaces – such as doorknobs, countertops, and toys – for up to six hours, and on soft surfaces – like hands or tissues – for 30 minutes or more.
People with RSV are usually contagious for three to eight days.
What are the symptoms of RSV in a child?
Mild RSV symptoms are similar to upper respiratory tract infections, like the common cold. They include:
- Runny nose
- Fever (not always)
- Poor appetite
- Irritability and restlessness
Can RSV become a more serious illness?
Yes. In children, RSV is the most common cause of bronchiolitis and pneumonia. At least a quarter of children have signs of one of these lung disorders when they contract RSV for the first time.
- Bronchiolitis causes the small airways in the lungs to swell and fill with mucus, restricting air flow.
- Pneumonia is an infection in one or both sides of the lungs.
Symptoms of bronchiolitis and pneumonia include:
- Fast breathing
- Labored breathing (flaring of nostrils, grunting, head bobbing, or tugging between ribs or lower neck while breathing)
- Extreme fatigue
- Bluish or gray lips and fingernails (because of decreased oxygen in the bloodstream)
When should I call the doctor?
Call the doctor if your child has coldlike symptoms and:
- Has any symptom of bronchiolitis or pneumonia (see "Can RSV become a more serious illness?")
- Is younger than 3 months old
- Was born premature and is younger than 2 years old
- Is between 3 months and 6 months old and has a fever of 101 degrees F or higher
- Is older than 6 months and has a temperature of 103 degrees F or higher
- Has lung or heart problems
- Has a weakened immune system
Seek immediate medical attention if your child of any age has RSV symptoms and signs of dehydration.
Signs of dehydration include:
- Dark, strong-smelling urine
- More than six hours without urinating
- Dry, parched mouth and lips
- No tears while crying
- Sunken eyes
- Hands and feet that feel cold and look splotchy
- Lightheadedness, dizziness, or delirium
- Excessive sleepiness or fussiness
Is my child at a higher risk of developing a more serious RSV infection?
Although most children recover from RSV without any complications, some are at a higher risk of developing a more serious infection, which may require treatment in the hospital.
Children at the highest risk include:
- Premature babies
- Babies 6 months and younger
- Children younger than 2 years old with congenital heart defects or chronic lung disease
- Children with a weakened immune system
- Children with neuromuscular disorders (especially those who have difficulty swallowing or clearing mucus secretions)
How is RSV diagnosed?
During an office visit, your child's doctor can diagnose RSV using a rapid RSV test, which can give the result in about 10 minutes. (This involves suctioning nasal secretions or swabbing your child's nose.) If a rapid RSV test isn't an option, the sample may go to a lab for analysis.
The doctor will also do a physical exam and may use a pulse oximeter to test the level of oxygen in your child's blood (with a sensor painlessly attached to a finger or toe) to make sure that your child is getting enough oxygen.
To check for lung congestion, the doctor may order a chest X-ray, although this usually isn't necessary.
Babies who are at least 3 months old and otherwise healthy don't need to see a doctor just to get a definite RSV diagnosis.
What is the treatment for RSV?
Like the common cold, there's no cure for RSV. Mild symptoms may simply go away on their own in a week or two. The cough may linger. Symptoms are usually worst on days three through five.
If your child develops pneumonia as a complication of RSV, he may be prescribed antibiotics to treat a bacterial infection. (Antibiotics won't work to treat RSV on its own because it's a virus.)
An estimated 1 to 3 percent of children who get RSV need to stay in the hospital to receive oxygen treatments and IV fluids. Most are younger than 6 months. But in most cases, children stay in the hospital for only a few days and usually recover completely within two weeks.
How can I make my child with RSV more comfortable?
- Offer plenty of fluids to keep your child well hydrated. If she's breastfeeding, nurse often.
- Use nasal saline solution (available over the counter at the drugstore). Put a few drops into his nose to loosen any mucus, then use a bulb syringe or nasal aspirator to suction it out.
- Use a cool-mist vaporizer to moisten your child's airways, which makes it easier to breathe. Follow the manufacturer's directions for keeping it clean because it can spread germs through the air if it's dirty.
- Keep your child away from irritating fumes, such as cigarette smoke, fresh-paint fumes, and wood smoke, which can make breathing more difficult. Exposure to tobacco smoke puts a child at a higher risk of suffering a serious RSV infection or another respiratory virus.
- Give age-appropriate doses of acetaminophen or ibuprofen. If your baby is younger than 3 months old, check with her doctor to see if it's okay to give her infants' acetaminophen to relieve discomfort. Once she's 3 months old, you can give her the proper dose of children's acetaminophen. When she's at least 6 months old, you can give her the proper dose of children's acetaminophen or ibuprofen (learn more about the difference).
- Don't give your child an over-the-counter cold remedy unless the doctor says to. These remedies may seem to work in the short run, but they can make the problem worse and can have serious side effects.
How can I prevent RSV in my child?
These precautions can help prevent respiratory infections, including RSV. They're good practices for all families but are especially important if your child is at a higher risk of developing a more serious RSV infection (see “Is my child at a higher risk of developing a more serious infection?”).
- Wash your hands and your child's hands often. Remind your child's caregivers to be conscientious about doing it too. At home, ask all visitors to wash their hands before handling your baby.
- Avoid crowds and people who are ill.
- Clean and disinfect surfaces and objects, such as doorknobs and toys, that are touched often.
- Keep your child away from tobacco smoke and other irritating fumes.
- Don't share or let anyone else share eating or drinking utensils with your child.
- Breastfeeding provides infection-fighting antibodies.
- Beginning at age 6 months, make sure you baby gets a flu shot every year in the fall or early winter. If your child gets the flu and RSV, he may have a more serious infection.
- Make sure the adults around your child receive the DTaP vaccine, to protect against whooping cough. If your child gets whooping cough and RSV, she may have a more serious infection.
- If your child is at high risk (see “Is my child at a higher risk of developing a more serious infection?”), consider arranging for in-house care during RSV season (usually October or November to April or May, with a peak in January and February).
- Also for high-risk children, the doctor may prescribe palivizumab, a monthly injection given in the fall, winter, and spring months to help prevent RSV.
Is RSV a serious concern for older kids and adults?
RSV isn't as much of a health concern for school-age children and adults as it is for babies and younger children. Their immune systems are stronger, and their airways are bigger and less likely to become dangerously obstructed by inflammation. Most older children and adults with RSV simply have an upper respiratory infection characterized by a cough.