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Respiratory Syncytial Virus (RSV)

Respiratory syncytial virus (RSV) is a virus that infects the lungs and airways (breathing passages). RSV can affect anyone of any age, but it’s most common in infants and young children. In fact, it’s so common that almost all children have been infected with RSV by the age of three.

RSV is usually a mild disease that goes away on its own. In very young children RSV can sometimes lead to serious infections like pneumonia or bronchiolitis (a swelling of the bronchioles — the smallest air passages of the lungs).

When do people usually get Respiratory Syncytial Virus?

RSV usually happens in outbreaks starting in late fall through early spring. Outbreaks usually peak during the winter months.

Children in day-care centres and preschools are at greatest risk for RSV. Infants are at greater risk if they have an older brother or sister in school. RSV is an especially contagious virus because it can live on surfaces for hours, and is easily passed from person to person.

Because RSV occurs in sudden, large outbreaks throughout the year, it is hard to prevent your child from being exposed to the virus.

Still, there are many things you can do to reduce your child’s risk of getting RSV:

  • Wash your child’s hands with soap and water. Good and frequent hand-washing is the best way to prevent RSV infection.
  • Throw used tissues in the garbage.
  • Avoid people who are sick.
  • If your older child comes down with a cold, keep him away from an infant brother or sister until the symptoms pass.
  • Don’t let your child share things that could easily pass germs, like cups, spoons or pillows.

In most children, RSV usually causes symptoms similar to the common cold:

  • stuffy or runny nose
  • cough
  • ear infections (sometimes)
  • low-grade fever
  • sore throat

Warning signs of a serious RSV infection

These signs may mean your child has a more serious case of RSV. Get emergency help right away if your child has:

  • trouble breathing
  • fast, rapid breathing
  • wheezing
  • deeper and more frequent coughing
  • blue lips or fingernails
  • dehydration
  • difficulty breast feeding or bottle-feeding

RSV usually goes away on its own and does not require a hospital visit or specific medical treatment. Symptoms may last for one to two weeks, and a cough may last for two weeks or more. Symptoms in older children and adults are usually milder.

When should I call the healthcare provider?

Get emergency help if your child has warning signs of a serious RSV infection. As in any case of illness, you should call your healthcare provider if you are worried about your child. Your child’s healthcare provider can best decide with you whether the symptoms and behaviours you describe need medical treatment. When in doubt, call for advice.

In most cases, RSV infection will go away on its own, without any special treatment.

Most of the time, RSV infection is not treated with antibiotics because antibiotics do not work against viruses. But if your child gets an ear infection associated with RSV, your healthcare provider may prescribe antibiotics. Younger children, especially infants, who have severe RSV pneumonia or bronchiolitis, may need to be treated in hospital. They may be given oxygen with mist and medicines to open up their airways.

An antiviral medicine called ribavirin may sometimes be given to very sick children who are hospitalized for severe pneumonia caused by RSV, but its use is controversial among healthcare providers.

Caring for a child with Respiratory Syncytial Virus

There are many things you can do at home to help a child with a mild case of RSV feel better:

  • Give plenty of clear fluids to prevent dehydration — diluted juice, water and popsicles, Pedialyte or another electrolyte drink for children — to prevent dehydration.
  • Use a cool-mist vaporizer to humidify the air, soothe irritated breathing passages and relieve coughing.
  • Use saline (salt water) nose drops to loosen mucus in the nose (you buy these at the drugstore over the counter).
  • For children who are too young to blow their nose, use a nasal aspirator to remove sticky nasal fluids.
  • Treat fever using a non-aspirin fever medicine like acetaminophen (for example, Children’s Tylenol or Tempra). Never give a child or teen acetylsalicylic acid (also called ASA or aspirin).

Can my child get RSV again?

Yes. RSV can infect the same person more than once throughout their lifetime. Symptoms are usually less severe after the first RSV infection. Symptoms for older children and adults are more like cold symptoms.

Will RSV weaken my child’s lungs and make them more prone to pneumonia in the future?

Most children recover completely from RSV and won’t have any extra problems the next time they have a respiratory infection (cold, flu or something similar). But for a few children, having RSV will make them more prone to other lung and breathing problems later on. These later problems could be caused by an underlying medical condition or allergy, and not RSV.

Can RSV be serious?

Yes. Infants or young children who have RSV for the first time may get a serious infection in their lower respiratory tract, like bronchiolitis or pneumonia. They will need to be treated in hospital. Most children with RSV who are sick enough to go to the hospital are either very young (infants) or have an underlying health condition, like heart or lung disease. RSV can be more serious in premature and newborn babies.