RSV: Everything You Need To Know - Baby Chick
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RSV: Everything You Need To Know

Learn who's at risk for severe RSV infection, what the symptoms are, treatment options, and how to prevent RSV and protect your family.

Updated October 21, 2024

by Cameual Wright

OBGYN and Indiana Market Chief Medical Officer for CareSource

Additional contribution by Melissa Hardy

Pediatrician, Breastfeeding Medicine Specialist, IBCLC
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Children have had an unprecedented amount of severe respiratory syncytial virus (RSV) cases in the last couple of years. The Centers for Disease Control and Prevention (CDC) report an increase in emergency room visits and hospitalizations across the United States.13 Most people recover in less than two weeks, but it can be severe, especially in those with weaker immune systems. And RSV doesn’t just infect children; it can also infect older individuals. According to the CDC, RSV infection leads to between 6,000 and 10,000 deaths per year among adults 65 and older and hospitalizes tens of thousands of children younger than 5.1,6 Below is everything you need to know about the virus, including how to prevent infection and what to do if you or someone you love contracts RSV.

What Is RSV?

RSV is a common respiratory virus that usually causes mild, cold-like symptoms. While most individuals recover in a week or two, RSV can be severe, especially for infants and older adults. It’s highly contagious and spreads from person to person through touching infected people or surfaces. The CDC says that RSV is the most common cause of bronchiolitis and pneumonia in children younger than 1 in the U.S.1,4

Who’s at Risk for Severe Infection?

The younger a child is, the higher their risk of getting very sick. Children with the highest risk are premature infants, children with chronic lung issues, and children with heart or immune system issues. Adults in the 65+ age group are also at high risk for severe RSV infections.2

There isn’t a definitive reason why RSV has been so severe in these last couple of years. During the COVID-19 pandemic, it’s possible that mask-wearing and social distancing kept our immune systems from normal exposure to seasonal viruses.7,8 Now that we’ve been back to our normal routines, we’re exposed to more people and infections.

What Are the Symptoms, and When Should I Call the Doctor?

RSV symptoms include sneezing, runny nose, fever, cough, sore throat, difficulty breathing, and generally not feeling well. Children might not want to eat, drink, or play as much. Some individuals experiencing more severe symptoms may need to be admitted to the hospital. Call the doctor if your child is wheezing, can’t eat or drink, is becoming dehydrated and not producing wet diapers, or has worsening general symptoms. Seek immediate help if your child has difficulty breathing, has a bluish color to the face, or is very sleepy.9

How Do You Diagnose RSV?

Diagnosis can be based on suspicion, mainly because we know it’s common throughout communities, especially in the winter. The flu, RSV, and COVID-19 can all present similar symptoms, so the doctor would send a viral panel using a nasal swab to tell the difference. This can help guide treatment, as there are specific medications for flu and COVID-19.10

What’s the Treatment?

The best treatment for RSV is supportive. In other words, begin treatment as soon as possible when you get the diagnosis, and take actions to reduce symptoms and help the body get rid of the virus. For example, providing at-home care to a child with RSV should include ensuring they hydrate regularly, are resting enough, and have their nose regularly suctioned if nasal congestion is present and if it’s making it difficult to breathe, eat, or sleep. RSV tends to worsen over the first few days while it peaks around day four or five. So, some patients (especially infants and immunocompromised people) may need a higher level of care a couple of days into their illness.11

If symptoms worsen or the child struggles with eating, hydration, or breathing, you should have a medical professional see them. Usually, adults get mild to moderate cold symptoms with a runny nose and sneezing. The younger the child, the more serious symptoms they tend to experience, such as respiratory distress.11

What’s the Best Way To Prevent RSV?

Hand-washing is the number-one way to prevent getting this virus, especially if you’ve been around someone sick. Also, avoid people with these symptoms in large settings, such as the grocery store or mall. This is especially important if you have very young children at home or children at high risk of becoming very sick. If you have older kids in school who become ill, try to keep them away from younger children in the house.3 SYNAGIS (palivizumab) is a medication that can prevent the severity of RSV illness if given monthly for five shots during RSV season. However, it’s an antibody, not a vaccine, and is only approved for selected high-risk groups.12

There are now more RSV antibodies and immunizations available for infants, pregnant people, and adults 60 years and older. Nirsevimab is an injectable antibody that can prevent severe disease in infants and young children. It’s more widely available than SYNAGIS, and it’s approved for infants up to 19 months old. Ask your pediatric clinic if they have the RSV antibody available.5

For pregnant people, there’s a vaccine called ABRYSVO that can be given when they’re 32-36 weeks pregnant. This vaccine has been shown to decrease the severity of RSV in babies up to 6 months old.5 There are also three vaccines available to adults ages 60 and older, and you can ask your doctor which one is available in your community:5

  1. ABRYSVO
  2. AREXVY
  3. mRESVIA

What About Masks?

RSV spreads through contact with the virus on people or things and through droplets (such as a sneeze or a cough). If patients are symptomatic with RSV, masks will help reduce the spread of the virus because they can contain coughing and sneezing well. Individuals with no symptoms who wear masks will also have a barrier and be less likely to touch something such as their face, which reduces their risk of infection.7

If you suspect your child has RSV, it’s essential to begin treatment as soon as possible. You want to reduce symptoms because RSV tends to worsen over the first few days. And remember, if symptoms worsen, get your child to their medical professional quickly for evaluation.

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