RSV Symptoms, Risks, and Helpful Prevention Tips for Families

RSV - respiratory syncytial virus - causes acute respiratory tract illness in people of all ages. It produces seasonal outbreaks worldwide. In the United States, RSV season typically begins in October or November and continues through April or May, with cases peaking in January or February.

Most infections cause mild, cold-like symptoms and resolve within one to two weeks. However, in certain groups -particularly infants and older adults and the immunocompromised - RSV can cause more serious illness and even require hospitalization.

Learn about this highly contagious disease and its symptoms to protect your family.

Dr. Catherine R. Murphy, Pediatric Infectious Diseases Attending at Baystate Children’s Hospital shares some helpful tips and gives insight into the virus.

RSV: A Widespread Virus That Affects All Ages

RSV is the most common cause of bronchiolitis and viral pneumonia in children under one year of age. The Centers for Disease Control and Prevention (CDC) reports that each year about 60,000-80,000 children under 5 years of age are hospitalized with the infection. Most infants have been infected by RSV by the time they reach the age of 1, and nearly all children will get RSV by the time they reach the age of 2.

But it’s not just kids that are affected. RSV can also infect teenagers and adults.

How RSV Spreads

RSV is highly contagious and can spread among people of all ages, from babies and toddlers to adults. It spreads directly from person to person when an infected person coughs or sneezes sending virus-containing droplets into the air. These droplets can infect others who inhale them, as well as by hand-to-nose, hand-to-mouth, and hand-to-eye contact.

The virus can also be spread indirectly when someone touches any object infected with the virus, such as toys, countertops, doorknobs, or pens. RSV can live on environmental surfaces for several hours, making transmission possible.

Recognizing RSV Symptoms

It can be hard to tell whether you have COVID, the common cold, the flu, or RSV. You may only know for sure if you’re tested by a doctor.

Children infected with RSV usually show symptoms – which don’t appear all at once - within 4-6 days after being infected.

RSV symptoms include:

• Runny nose
• Decrease in appetite
• Coughing
• Sneezing
• Fever
• Wheezing
• Difficulty breathing

RSV symptoms in infants less than 6 months may include:

• Irritability
• Decreased appetite
• Decreased activity
• Difficulty breathing
• Apnea (a temporary stop in breathing)

Low-grade fevers (typically around 101°F - 102°F) are common in RSV infections and may come and go over several days. However, RSV can also cause very mild or even no noticeable symptoms, allowing some infections to go undetected.

There is no specific treatment for RSV. “It’s all about symptom management...making sure your child is hydrated, their fever is under control, and that they’re not having any trouble breathing,” said Dr. Murphy.

Most People Will Have Minor Symptoms

Not everyone who gets RSV gets a serious case and needs to be hospitalized.

“Most children will have only minor symptoms with only a small percentage of youngsters developing severe disease and requiring hospitalization. Those hospitalized often have severe breathing trouble and need respiratory support and/or are seriously dehydrated and need IV fluids. In most cases, hospitalization only lasts a few days, and complete recovery usually occurs in about 1-2 weeks,” said Dr. Murphy.

The severity of the disease can vary depending on the age of the child, and whether they have any underlying medical problems, such as prematurity or asthma. Children with RSV are also at risk for secondary bacterial infections, including ear infections and pneumonia, among others.

Children under the age of one are most frequently affected by the serious symptoms of RSV.

When to Call Your Healthcare Provider

“If a child is having high fevers without relief for multiple days, or increased difficulty with breathing, such as wheezing, grunting, or ongoing flaring of the nostrils is observed along with a child’s runny nose and cough, then a call to your pediatrician is warranted,” Dr. Murphy said.

Those who have a high risk for severe illness caused by RSV include:

• Premature babies
• Adults 65 years and older, 177,000 of whom are hospitalized and 14,000 of them die each year in the U.S.
• People with chronic lung disease or certain heart problems
• People with weakened immune systems, such as from HIV infection, organ transplants, or specific medical treatments like chemotherapy

RSV Vaccines and New Options for Prevention

There are no RSV vaccines for children yet. However, there are now RSV vaccines available for older adults, higher-risk adults, and pregnant women. Vaccinating against RSV in adult populations may help protect children who are more vulnerable to developing severe disease due to RSV.

Pregnant women who receive the RSV vaccine produce protective antibodies that can be passed to their babies in utero. These maternal antibodies help safeguard newborns from severe RSV disease for several months after birth.

For babies whose mothers did not receive the RSV vaccine during pregnancy, monoclonal antibody treatments are available after birth to help prevent severe illness due to RSV. Antibodies given to babies after birth wane over time, so some infants and higher-risk children may need additional doses.

Parents and families are encouraged to discuss all of these preventative measures with their doctors. 

Simple Steps to Help Prevent RSV

Dr. Murphy and the CDC recommend the following steps to help prevent the spread of RSV:

• Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands.
• Wash your hands often with soap and water for 20 seconds.
• Keep your hands off your face; germs can spread by touching your eyes, nose and mouth.
• Avoid close contact with sick people, as well as kissing, shaking hands, and sharing cups and eating utensils with others.
• Clean and disinfect surfaces.
• Stay home when you are sick.

In a growing trend aimed at providing extra protection for newborns, some parents are placing signs on their baby’s car seat or stroller asking others to not touch their infant. A typical sign might read: “Stop! I know I’m cute as can be but please do not touch little me. Thank you!” or “Wash Hands & No Kissing Please – Your Germs Are Too Big for Me.

“The good news is that most infants and children overcome RSV infections without any short or long-term complications,” said Dr. Murphy. “And we can do more for those people who are at higher risk of developing more severe RSV infections to help prevent them.”