The virus can be as mild as a common cold but in some severe cases it can lead to a patient requiring hospitalization. Cases are most likely to become serious in very young children and those with compromised immune systems or certain chronic diseases.
Here are some key points about respiratory syncytial virus. More detail and supporting information is in the main article.
- Most children will be infected with respiratory syncytial virus by the time they reach the age 2.
- Respiratory syncytial virus can spread through both direct and indirect contact with secretions from infected people.
- The virus can survive on hard surfaces such as tabletops and toys for several hours.
- Full recovery from infection usually occurs after 1-2 weeks.
- Treatment for the virus typically involves alleviating its signs and symptoms.
- Respiratory syncytial virus is most common in the US during the spring, fall and winter months.
- The spread of respiratory syncytial virus can be prevented by handwashing.
- Hospitalization for respiratory syncytial virus infections is required in 0.5-2% of infants and children with their first infection, with most under 6 months old.
What is it?
RSV is spread when people come into contact with droplets containing the virus that are produced when infected people sneeze or cough.
Respiratory syncytial virus (RSV) is a highly contagious infection that will affect most children by the time they reach 2 years old. Among adults, the virus is most likely to affect health care workers and those who look after young children.1
The virus is also known as a common cause of other respiratory complaints. In children aged 1 year old and younger in the US, RSV is reported to be the most common cause of pneumonia and bronchiolitis - inflammation of small airways in the lung.
According to the Centers for Disease Control and Prevention (CDC), around 25-40 of every 100 children exposed to RSV for the first time will develop signs of bronchiolitis or pneumonia.
Highly contagious, RSV is spread through droplet transmission. When infected individuals cough or sneeze, secretions from their respiratory tract containing the virus are passed out into the air.
RSV can survive for hours on surfaces such as tabletops, hands and clothing, making it easy for the virus to be transmitted from person to person.
Certain populations of people are at higher risk of RSV complications, including older adults and infants.1 Those at highest risk for severe disease include premature infants, and children younger than 2 and adults who are immunocompromised or have congenital heart or chronic lung diseases.1,2
Other risk factors include:2
- Children or siblings attending day care or school
- Immunocompromised children and adults
- Older adults and adults affected by medical conditions such as asthma, congestive heart failure and chronic obstructive pulmonary disease (COPD).
RSV can be dangerous in infants, especially in:
- those born pre-term
- infants under the age of 6 months
- those under 2 years with lung, heart, or neuromuscular problems
- children with a weakened immune system
However, most children experience an RSV before the age of 2 years without haveing any serious problems.
Symptoms of RSV in infants and children will typically be seen 2-8 days following infection.1 Children and infants will usually recover within 1-2 weeks. However, RSV continues to spread for 1-3 weeks in certain populations including very young infants and immunocompromised children.1
Symptoms of RSV include:1-3
- Runny nose
- Sore throat
- Mild headache
- Decreased appetite
- Wheezing, rapid breathing and other breathing difficulties
- Irritability and decreased activity in infants
- Short, shallow and rapid breathing in infants
- Blue color to skin (cyanosis).
Complications of RSV include pneumonia, bronchiolitis, middle ear infection, asthma and recurrent RSV infections. Occasional recurrences of RSV after an initial infection are common.2
Hospitalization can be required in severe cases so that doctors can monitor closely any breathing problems that a patient may have. They will also be able to offer advanced forms of treatment and provide intravenous fluid.
Bronchiolitis is a lower respiratory tract infection that can result from RSV. It commonly affects those under 2 years old. The airways become inflamed and infected and the following symptoms may occur:
- dry, persistent cough
- feeding problems
Most cases are not serious, but if your child has difficulty breathing or feeding, if they have a high temperature, or if they seem tired or irritable, you should call a doctor.
During evaluation for RSV, health care providers will perform a physical exam with lung evaluation, obtain a medical history and possibly evaluate oxygenation status with pulse oximetry.2,3
In most cases, doctors do not need to distinguish between RSV and other respiratory infections such as the common cold. However, if a child has other health conditions, the doctor may decide to make a specific diagnosis and arrange for additional testing.3
Additional testing which may be ordered to rule out other infections includes laboratory blood tests, chest X-rays, and possibly laboratory evaluation of nasal secretions.2,3
Cool mist humidifiers can be used to moisten the air and relieve the symptoms of RSV.
In cases of mild RSV, comfort measures to lessen the impact of symptoms are often the only required treatment.
Measures that can be taken include use of cool mist humidifiers, bulb suction, increased fluid intake, maintaining an upright position, nasal saline and possibly the use of acetaminophen for fevers.2,3
Severe cases of RSV that are being treated in a hospital may require oxygen supplementation, the removal of mucus from the respiratory tract and intubation in infants.1,2
In such cases, inhaled medications such as nebulized bronchodilators can also be necessary. These medications include albuterol (ProAir HFA, Proventil-HFA, Ventolin HFA) and at times ribavirin (Virazole) - an antiviral.2 Epinephrine - inhaled or injected - may also be recommended for symptom relief.2
RSV infections tend to resolve within 1-2 weeks, even in cases where the patient has to be hospitalized for further treatment.
The best way to prevent the spread of RSV is handwashing. Always wash your hands after coming into contact with anyone with cold-like symptoms and before coming into contact with your child. Doing so can also help demonstrate to children the importance of handwashing.
In addition, it may be recommended that infants who are at a higher risk of contracting RSV undergo monthly RSV antibody injections (palivizumab).1-3
RSV can also be prevented by cleaning surfaces such as toys, tables and knobs, encouraging covering the mouth when coughing or sneezing, not sharing cups and other utensils, limiting all contact with those who have cold-like symptoms, avoiding smoking and avoiding exposure to the smoking of others.1-3
If you think you or your child have symptoms of RSV or have been exposed to the virus, contact your health care provider for evaluation.
Data-crunching scientists have run New York City medical databases through an algorithm to find that 55 diseases show a correlation with the season of birth, concluding that the worst time for offspring lifetime risks is a pregnancy that produces childbirth in October.
Viral infections are much more common than bacterial ones in children diagnosed with pneumonia, and respiratory syncytial virus is the most common cause, suggests a study of patients across Utah and Tennessee.