RSV, short for Respiratory Syncytial Virus. Sometimes referred to as hRSV (where the “h” stands for "human").

RSV is not unique to children—adults can get it as well, albeit usually with milder symptoms. It matters for children, especially babies because it’s the most common cause of respiratory-related hospitalization for infants. Most children experience at least one bout of RSV before the age of 2 years.

Symptoms can vary from fever and cough to development of wheezing and difficulty breathing, to the point of needing hospitalization. Approximately 20% of infants develop RSV-associated wheezing during the first year of life; 2% to 3% require hospitalization.

Symptoms often mimic that of a common cold, but wheezing can still occur in up to 35% of adults and older children that are affected.

RSV is caused by infection from viral particles via contact or inhalation. Close contact with someone who is infected is the most likely source of transmission. It may also be picked up from contaminated surfaces. The virus attaches to and infects cells within the upper and lower airways.

Humans of all ages may develop RSV infections, but the more severe cases most often present in children under 2 years of age. There are currently no vaccines to prevent RSV infection, and reinfection is common over the course of a lifetime.

Those infected with RSV should be considered contagious for 2-7 days on average, but younger children and the immunocompromised can be contagious for up to a month. Adults can infect children and vice versa.

Although the symptoms of RSV resemble those of many other common respiratory infections, it can often be diagnosed clinically based on the symptoms your child is experiencing. When necessary, RSV can be identified via several testing methods, most commonly collected via a nasopharyngeal or nasal swab. Sometimes, a saliva sample or a nasal wash which is a rarely used method, is also able to test for RSV. A pulse oximeter test (a painless device that gently attaches to the finger or toe of the child) is also typically performed, to check oxygen levels.

It’s not immediately necessary to distinguish between RSV and other viruses. If symptoms remain mild and the child continues eating, drinking, and passing urine and stool as normal, there is no need for immediate alarm. 

However, especially in children under 2 years of age, symptoms may worsen. Concerns over the oxygen levels or pneumonia development due to infection of the lower respiratory tract is something your pediatrician will monitor which may eventually warrant a test for RSV.

Because RSV is a viral infection, antibiotics are not effective in treatment and are not recommended. If RSV is suspected, a clinical evaluation is recommended in order to provide proper diagnosis and treatment. This will result in avoiding overuse of antibiotics, which can result in long-term antibiotic resistance.

Most cases of RSV can be cared for at home following a diagnosis with “supportive care.” This could include:

• Managing fevers with over-the-counter (OTC) fever reducers like acetaminophen (Tylenol), or ibuprofen (Advil or Motrin). Note - never give aspirin to children and ibuprofen is only to be used in children 6 months of age and older.
• Plenty of fluids and rest
• Use of a cool-mist humidifier at bedtime, naptime, or throughout the day
• Monitoring changes in breathing
• Nasal saline drops and/or suctioning to clear nasal passages
• Possible prescribed nebulizer breathing treatments, if indicated

It’s important to reach out to your healthcare professional once severe symptoms appear or you notice significant changes in your child’s wellness so that a proper evaluation can be conducted. Most cases are not severe, but distinguishing between RSV and other viruses can help form a better treatment plan.

Most RSV infections resolve with at-home supportive care within 1-2 weeks. Many children may continue to cough even after recovering. This is commonly referred to as a “post-viral cough.” After they have fully recovered, the cough should not be treated as a sign of ongoing infection. 

RSV infection in infancy has been associated with recurrent wheezing and the development of asthma in some patients. Therefore, if your child continues to experience wheezing or chronic cough, follow-up with your primary care provider is very important.