Health Library

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. 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, 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:

• 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

Contagiousness of RSV

RSV is spread 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.

Signs and 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 15-20 seconds)
• Nasal discharge that is usually cloudy
• Fever
• Wheezing (a high-pitched sound usually heard when breathing out)
• Rapid breathing
• Cough
• Pulling in of the chest wall (retractions)
• 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 talk to your child's doctor for a diagnosis.

Diagnosis of RSV

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 bandage) is taped onto a finger or toe.

Treatment of RSV

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.
• Supplemental oxygen
• Bulb suctioning baby's nose before being laid down to sleep and before feedings, which helps the baby be more comfortable
• Bronchodilator medications may be tried when underlying reactive airway disease is suspected.

Preventive Measures

Proper hand washing 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 masks, gowns and gloves when they enter your child's room.

Palivizumab (Synagis), an antibody against RSV, provides passive protection against the virus. Palivizumab is recommended for babies and children at high risk for RSV, including children with a history of prematurity and congenital heart disease to reduce the rate of hospital admissions. Palivizumab is usually given monthly during the RSV season, from late fall through spring. If you have questions about Palivizumab, talk to your child's doctor.

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