Respiratory Syncytial Virus (RSV)

What is RSV?

RSV is a common respiratory virus that affects the lungs and airways.

According to the Centers for Disease Control and Prevention, almost all children will become infected with RSV by the time they’re 2 years old, with a majority only experiencing mild, cold-like symptoms.

RSV prevention

For infants, babies, young children and people age 60 and older, RSV may result in hospitalization. There is currently no RSV vaccine for children, however, in 2023 two RSV vaccines were approved by the Food and Drug Administration for expectant moms and adults 60 and older. The vaccine for expectant moms is given from 32 through 36 weeks of pregnancy to prevent lower respiratory tract disease (LRTD) caused by RSV in infants from birth through 6 months of age.

Also, for children under age 2 who are more vulnerable to RSV illness, a preventive monoclonal antibody treatment called nirsevimab became available in 2023. (This is not an RSV vaccine.) Talk to your child's pediatrician or primary care clinician for guidance on whether your child would benefit from this treatment.

There are steps to help prevent children from getting sick with RSV:

• Frequently wash your hands with soap and water (or hand sanitizer).
• Try not to touch your face.
• Avoid close contact, like kissing and sharing cups and utensils, with people who are sick.
• Cover your coughs and sneezes.
• Clean and disinfect surfaces and objects that are touched often, including toys, doorknobs, countertops and electronics.
• Stay home when you aren’t feeling well.

Mild RSV symptoms in children

Mild symptoms your child may experience include:

• Congested or runny nose
• Decreased appetite
• Dry cough
• Headache
• Low-grade fever
• Mild irritability or decreased activity (specifically in infants)
• Sneezing
• Sore throat

What to do if your child has RSV

Most children will completely recover from RSV within a week or two with plenty of rest and fluids.

At home, you can take the following steps to improve your child’s symptoms:

• For infants, perform nasal suctioning with saline before and after naps and prior to feeding. Watch the following video for step-by-step instructions from a pediatric emergency medicine physician:
• Give appropriate over-the-counter medications recommended by your child’s pediatrician.

However, if your child’s mild symptoms aren’t getting better or are getting worse over time, you should make an appointment with your pediatrician or take them to an ExpressCARE or Children's ExpressCARE location.

When it comes to fevers, call your pediatrician if your child is:

• 3 months old or younger and has a fever of 100.4°F or higher for any length of time
• Between 4 months and 2 years old and has a fever of 100.4°F or higher for more than a day
• 2 years old or older and has a fever of 100.4°F or higher for more than three days

Infants with a severe case of RSV may have trouble feeding or produce fewer wet diapers than usual (which is a sign of dehydration). If your infant is sick and experiencing either of these symptoms, you should contact their pediatrician as soon as possible for guidance.

Serious RSV symptoms that require emergency care

If your child experiences any of the following symptoms, they should be seen at an emergency room (like the Children’s Hospital’s Breidegam Family Children’s ER, which is the region’s only 24/7 emergency room specifically for kids) as soon as possible:

• Severe drowsiness or lack of alertness
• Severe cough
• Skin, lips or fingernails that appear blue
• Trouble breathing
• Struggling for each breath or being short of breath
• Tight breathing that makes it difficult to speak or cry
• Retractions (when the ribs pull in with each breath)
• Noisy breathing (such as wheezing)
• Breathing much faster than normal

How to protect yourself or your baby from RSV or other viral respiratory illnesses

The Centers for Disease Control and Prevention (CDC) recommends some easy-to-follow practices that can help protect you and others from viral respiratory illnesses like respiratory syncytial virus (RSV), COVID-19 or influenza (flu):

• Stay up to date with vaccinations: RSV vaccinations are available for certain people, including pregnant women and adults 60 and older. Speak with your primary care clinician about whether you would benefit from an RSV vaccination. A reminder that vaccinations are available for flu and COVID-19 and can help prevent or reduce severity of these illnesses.
• Practice good hygiene:  That means remembering to cover your mouth if you cough or your nose if you sneeze; washing your hands often or using hand sanitizer frequently; and regularly cleaning surfaces that are frequently touched, like doorknobs, appliance handles, remote controls, phones, etc.
• Breathe cleaner air: Do that by allowing fresh outside air to circulate in your home, purifying indoor air or holding gatherings with your friends and family outdoors, when possible.

Please note that the CDC has separate guidance for health care settings to help prevent spread of infection.

What steps should I follow if I’m sick (or my child is sick) with RSV or another respiratory viral illness?

In March 2024, the CDC updated its guidance for the community, concerning what people should do if they’re sick with RSV or another respiratory viral illness such as COVID-19 or influenza (flu).

1. Stay away from others. If you are sick with a respiratory virus, you should stay home to avoid spreading the infection to others.
2. Wear a face mask: To help protect others, including those you live with, the CDC recommends that adults wear a face mask to reduce the spread of germs into the air. (More info from CDC.)
3. Seek treatment. If you have symptoms of RSV, reach out to your primary care clinician or your child’s pediatrician for guidance concerning treatment of symptoms.

To help protect others from infection as you finish recovering from illness, take these additional steps for the next five days:

• Wear a well-fitting mask.
• Keep a distance from others.
• Get tested for respiratory viruses.

Also, keep up hand hygiene, cough/sneeze protection etiquette and use the fresh air strategies to protect others.

If symptoms return, contact your primary care clinician for advice on next steps.