Respiratory syncytial virus (RSV): When the problem is more than just a cold

By Mary Caserta, MD, FAAP, and Andrea Jones, MD, FAAP

Nearly all children are infected with respiratory syncytial virus (RSV) at least once before the age of 2 years. For most healthy children, RSV is like a cold. But some children become very sick from respiratory syncytial virus.

If you are a parent of an infant or young child, you may have questions about RSV and how to prevent it. Read on to learn more.

What is respiratory syncytial virus or RSV?

Respiratory syncytial virus, or RSV, is one of many viruses that cause respiratory illness. It spreads from person to person like a cold virus. It enters the body through the nose or eyes, usually through contact with infected saliva, mucus, or nasal secretions.

This virus usually occurs in late fall to early spring. Deadlines may vary in some areas of the United States.

RSV is the most common cause of hospitalization in children younger than 1 year old. Two to three out of every 100 babies infected with RSV may require hospitalization. These babies may need oxygen to help breathing or intravenous fluids while not eating or drinking. Most of these children will get better and be able to go home within a few days.

New way to protect babies from RSV infection

There are two new ways to protect babies from serious illness in the United States during RSV season. You can choose to get the RSV vaccine during pregnancy (CDC recommendation), or your baby can be vaccinated after birth. Most infants may only need protection from maternal RSV vaccine or childhood vaccination, but not both.

RSV vaccination during pregnancy

Pregnant women can receive the RSVpreF vaccine between 32 and 36 weeks of pregnancy if the baby is born during RSV season. The vaccine reduces a baby’s risk of hospitalization from RSV by 57% in the first 6 months of life.

Infant RSV Vaccine

For infants and some young children, an RSV vaccine called nirsevimab is available and may be included in your baby’s regular vaccines. Nirsevimab has been shown to reduce the risk of RSV-related hospitalizations and doctor visits in infants by approximately 80%.

This vaccine works slightly differently than other vaccines. Provides antibodies that start working immediately to protect the baby. Protection lasts throughout a typical RSV season.

What will happen with palivizumab?

For some children, there is another product called palivizumab that is given as a monthly injection during respiratory syncytial virus season. It is used in children younger than 24 months who have certain conditions that put them at high risk for severe RSV.

Children receiving nirsevimab should not receive palivizumab. However, if your child has not received all doses of palivizumab, he or she may be eligible to receive nivolumab. Children who received palivizumab during the first season could receive nivolumab during the second season if eligible.

Symptoms of RSV in babies

Typically, RSV causes

cold This can be followed by

Bronchiolitis anyone pneumonia. RSV symptoms are usually most severe between days 3 and 5 of illness. Symptoms usually last an average of 7 to 14 days.

Call your pediatrician right away if your child:

• Symptoms of Bronchiolitis (mentioned above)

• symptom
  dehydration (less than 1 wet diaper every 8 hours)

• Apnea or difficulty breathing

• Tongue, lips, or skin appear gray or purple

• Activity and alert levels dropped significantly

Some children with RSV may be at higher risk of bacterial infections, such as ear infection. Call the doctor if your child:

• Symptoms worsen or do not begin to improve after 7 days

• 
  fever Less than 3 months (12 weeks) old and with a rectal temperature of 100.4°F (38°C) or higher

• 
  
  fever A child of any age whose body temperature repeatedly rises above 40°C (104°F)

• Poor or restless sleep, chest pain, ear pulling or ear discharge

How do doctors diagnose RSV?

Pediatricians diagnose whether a child has a cold or bronchiolitis by asking about symptoms and performing a physical exam. Your pediatrician may direct you to get a nasal swab test to determine if your child has RSV or another virus. A chest X-ray or oxygen saturation test may also be done to check for congestion in the lungs. Because most children recover without difficulty and there is no treatment for RSV, these tests are usually not necessary.

What you can do to help your child with mild RSV feel better

There is no specific treatment for RSV. and medications, such as steroids and antibiotics,
they don’t help with VRS.

To help your child feel more comfortable, start by doing the same things you would do if:
any severe cold:

• 
  Nasal saline and gentle suction Breathe better and eat better

• 
  cool mist humidifier (steam) helps soften mucus and allows you to breathe better

• 
  Liquids and regular meals. Make sure your child stays hydrated. Babies with the common cold may eat more slowly or not want to eat because they have trouble breathing. Before trying to breastfeed or bottle feed, try sucking your baby’s nose. There is no need to provide supplemental water or formula to breastfed infants. If your baby is having trouble breastfeeding, you may choose to express milk from your breasts and feed it to him from a bottle.

• 
  
  Acetaminophen or ibuprofen (If over 6 months old) Helps reduce low-grade fever.
  always avoid Aspirin and cough and cold medicine.

Keep in mind that children and adults can be infected with RSV multiple times, even during a season. However, repeat infections are usually less severe than the first infection.

Other steps to help prevent RSV

• 
  Stay up to date on vaccination schedules. Keep your children up to date on their vaccinations, and get the whole family annual flu and COVID vaccines. Adults over the age of 60 can get the RSV vaccine. Getting the Tdap vaccine to prevent whooping cough is especially important for adults around babies.

• 
  Limit your baby’s exposure crowds, other children, and people with colds.Do not send your children to school or
  kindergarten When they are sick, teach them to cover their mouths and noses when they cough and sneeze.

• 
  handwashing. Just like always to prevent germs, scrub with soap and water for at least 20 seconds. Remind children to practice good hand hygiene year-round.

• 
  Eliminate germs. Disinfect objects and surfaces in your home regularly and avoid exposing your child to tobacco smoke or other substances.

• 
  Feed your baby breast milk.have
  unique antibodies To avoid and fight infection.

Medicine is always progressing! Scientists continue to explore new options for preventing and treating RSV. In the meantime, rest assured that most people recover well from RSV.

Additional Information: