Infectious Diseases Conditions and Diagnoses

Respiratory Syncytial Virus (RSV)

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What is respiratory syncytial virus (RSV)?

Respiratory syncytial virus (RSV) is a viral organism that can cause upper and lower respiratory tract infections. It commonly causes bronchiolitis (inflammation of the lower airways) and pneumonia in children and infants under the age of 1. In the United States, RSV is more common during the winter and spring months.

For most children and infants, RSV infections can be managed on an outpatient basis. However, about 0.5 to 2% of children and infants who develop RSV may require hospitalization.

The disease usually runs its course in one to two weeks. Children who are at risk for developing more severe cases of RSV include the following:

Children / infants younger than 1 year, particularly those between 6 weeks and 6 months

Premature infants

Children / infants with breathing or heart problems

Children / infants with weakened immune systems

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How is RSV transmitted?

RSV transmission occurs by coming in contact with infectious material either from another individual or inanimate object. The secretions from the eye, mouth, or nose (and possibly from a sneeze) contain the virus. The virus can also survive for many hours on inanimate objects such as doorknobs, hard surfaces, and toys. It can also live on human hands for up to 30 minutes.

After being exposed to the virus, symptoms may not appear for four to six days. An individual with RSV is usually contagious for three to eight days, although this may be longer in younger children.

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What are the symptoms of RSV?

The following are the most common symptoms of RSV infections. However, each child may experience symptoms differently. Symptoms may include:

Lethargy and inactivity
Irritability
Poor feeding
Episodes of apnea (more common in infants; an event where an infant may not take a breath for longer than 10 seconds)
Nasal discharge that is usually clear
Fever
Wheezing (a high-pitched sound usually heard on expiration, breathing out)
Rapid breathing
Cough
Retractions (pulling in) of the chest wall
Nasal flaring
Rattling in the chest that may be felt over an infant's back or chest

The symptoms of RSV may resemble other problems or medical conditions. Always consult your child's physician for a diagnosis.

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How is RSV diagnosed?

In addition to a complete medical history and physical examination, other diagnostic tests for RSV may include:

Testing of your child's nasal drainage
Chest X-ray
Pulse oximetry - an oximeter is a small machine that measures the amount of oxygen in the blood. To obtain this measurement, a small sensor (like a band-aid) is taped onto a finger or toe.

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How is RSV treated?

There is no cure for RSV, so once the child is infected treatment is supportive (aimed at treating the symptoms present). Care of the child or infant involves treating the effects of the virus on the respiratory system.

Because a virus causes the infection, antibiotics are not useful. Specific treatment for RSV will be determined by your physician based on:

Your child's age, overall health, and medical history
Extent of the condition
Your child's tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference

Treatment for RSV may include:

Keeping your child well hydrated by encouraging fluids by mouth. If necessary, an intravenous (IV) line may be started to give your child fluids and essential electrolytes.
Bronchodilator medications administered in an aerosol mist by a mask or through an inhaler (to open your child's airways)
Supplemental oxygen
Bulb suctioning baby's nose before being laid down to sleep and before feedings, which helps the baby be more comfortable

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How is RSV prevented?

Proper handwashing is important to prevent the spread of RSV to other infants, children and adults. If your child is in the hospital, healthcare workers will wear special isolation apparel such as gowns and gloves when they enter your child's room.

Palivizumab (Synagis"), an antibody against RSV, is recommended for babies and children at high risk for RSV to protect them against the serious complications of the illness. This includes children with weakened immune systems, organ recipients and premature infants. Palivizumab is usually given monthly during the RSV "season," from late Fall through Spring. It is not a vaccine and does not prevent the virus. However, it does lessen the severity of the illness and may help shorten the hospital stay. If you have questions about Palivizumab, please consult your child's physician.

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Additional information

Bronchiolitis - Information for parents including signs and symptoms, prevention, treatment and when to go to the Emergency Room.
Information about RSV and the Synagis" therapy program available from Home Care

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