Respiratory Syncytial Virus (RSV)

Respiratory syncytial virus, more commonly known as RSV, isn’t new. It’s a very common virus that affects the lungs and breathing passages. In fact, most kids will have had a case of RSV by the time they are 2 years old, per the Centers for Disease and Prevention (CDC). It usually causes mild, cold-like symptoms. Like the flu, it usually occurs in the late fall to early spring. And, like the flu and COVID-19, it is a contagious respiratory virus. This means they are spread from person to person through respiratory droplets – think sneezing or coughing – or hand-to-hand contact. That’s why it’s important to be aware of the symptoms and understand what to do to prevent yourself or your family from becoming seriously ill.

RSV is usually mild for most people. But some people get complications of RSV like bronchitis and pneumonia. According to the CDC, each year in the United States, RSV leads to approximately:

• 58,000 to 80,000 children 5 years old and younger being hospitalized with 100 to 300 deaths
• 60,000 to 120,000 adults aged 65 and older being hospitalized with 6,000 to 10,000 deaths

Most RSV infections go away on their own in a week or two, but it can be a scary time for parents and other caregivers.

Sometimes more serious symptoms can happen, which can cause shortness of breath and low oxygen levels.  RSV can also lead to worsening of other medical conditions such as asthma, chronic obstructive pulmonary disease (a chronic disease of the lungs that makes it hard to breathe), or congestive heart failure (when the heart can’t pump enough blood and oxygen through the body).

While all three respiratory viruses have similar symptoms, the only way to confirm a diagnosis is by medical testing. This helps identify the virus to determine the best way to treat it.

While most people, including infants, usually develop only mild symptoms like a common cold, RSV can be severe and even life-threatening, especially for young infants and older adults.

RSV is the leading cause of hospitalizations for infants and older babies at higher risk, per this article in the National Institutes of Health.

Early symptoms of RSV may include:

• Runny nose and congestion
• Decrease in appetite
• Cough, which may progress to wheezing
• Fever may or may not be present

Premature infants or infants less than 6 months old may have these symptoms:

• Irritability
• Decreased activity
• Decreased appetite
• Apnea (pauses while breathing)

Complications from RSV can happen fast. That’s why it’s important to know the signs of a serious case and call your doctor right away if your child’s health condition changes. This includes:

• Having difficulty breathing
• Not drinking enough fluids
• Other symptoms getting worse

If your infant develops severe RSV, they will have short, shallow, and rapid breathing. This can be seen by caving-in of the chest in between the ribs and under the ribs, spreading-out of the nostrils with every breath, and abnormally fast breathing. Also, your infant’s mouth, lips, and fingernails may turn a bluish color. This is due to lack of oxygen. Call 911 immediately if your baby is having difficulty breathing or turning blue from lack of oxygen. Don’t wait.

RSV is most serious for infants less than a year old and for those born prematurely. Older children who may not get seriously ill with RSV can transmit the virus to their at-risk younger siblings. Talk to your child’s doctor about precautions you should take to protect your baby.

Older adults are more at risk because our immune system weakens as we age. Those at highest risk include:

• Those 65 years and older
• Adults with chronic heart or lung disease
• Adults with weakened immune systems

When an older adult gets RSV, they typically have mild cold-like symptoms. However, some may develop a lung infection or pneumonia. Call your doctor if you’re concerned about your symptoms or your symptoms don’t improve or get worse. Don’t wait.

The Food and Drug Administration recently approved two immunization options. One is for individuals at least 60 years of age. The other is for babies and toddlers. These treatments are shown to be effective in preventing the lower-respiratory tract disease caused by RSV.

The CDC recommends all infants under 8 months old receive an injection of nirsevimab, the newly approved monoclonal antibody, as they enter their first RSV season (usually fall through spring).Some children at higher risk for serious RSV disease may need a shot in their second year. This single shot of antibodies was shown in clinical trials to significantly reduce the risk of RSV health care visits and hospitalizations in infants up to 80%, per the CDC. lower the need for medical care from RSV for babies by 70 to 75%. Talk to your child’s doctor for more information.

The good news is we’ve all learned a lot of safety measures during the COVID-19 pandemic that can help keep us safe from getting RSV and other respiratory infections:

• Wash your hands often with soap and water for at least 20 seconds
• Use an alcohol-based hand sanitizer if soap and water are not available

• Avoid touching your eyes, nose, and mouth with unwashed hands
• Stay away from people who are sick
• Clean and disinfect surfaces
• Cover your coughs and sneezes
• Stay home when not feeling well to prevent others from getting sick

Resources:

• https://www.cdc.gov/rsv/high-risk/infants-young-children.html
• https://www.lung.org/lung-health-diseases/lung-disease-lookup/rsv
• Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023 | MMWR (cdc.gov)
• RSV Vaccine Information Statement | CDC

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