Respiratory syncytial virus infection,
usually called RSV, is a lot like a bad cold. It causes the same symptoms. And
like a cold, it is very common and very contagious. Most children have had it
at least once by age 2.
RSV is usually not something to worry
about. But it can lead to
pneumonia or other problems in some people, especially
babies. So it's important to watch the symptoms and call your doctor if they
A virus causes RSV
infection. Like a cold virus, RSV attacks your nose, eyes, throat, and lungs.
It spreads like a cold too, when you cough, sneeze, or share food or
There are many kinds of RSV, so your body never becomes
immune to it. You can get it again and again
throughout your life, sometimes during the same season.
RSV usually causes the same
symptoms as a bad cold, such as:
Babies with RSV may also:
Some children have more serious symptoms, like wheezing.
Call your doctor if your child is wheezing or having trouble breathing.
Doctors usually diagnose RSV
by asking about your or your child's symptoms and by knowing whether there is
an outbreak of the infection in your area.
There are tests for
RSV, but they aren't usually needed. Your doctor may want to do testing if you
or your child may be likely to have other problems. The most common test uses a
sample of the drainage from your nose.
RSV usually goes away on its
own. For most people, home treatment is all that is needed. If your child has
When a person with RSV is otherwise healthy, symptoms
usually get better in a week or two.
RSV can be serious when the
symptoms are very bad or when it leads to other problems, like pneumonia.
Certain people are more likely to have problems with RSV:
These people sometimes need treatment in a hospital. So
it's important to watch the symptoms and call your doctor if they get
It's very hard to
keep from catching RSV, just like it's hard to keep from catching a cold. But
you can lower the chances by practicing good health habits. Wash your hands
often, and teach your child to do the same. See that your child gets all the
vaccines your doctor recommends.
Medicines to prevent RSV may be given to babies and children who are more
likely to have problems with the infection. Sometimes these medicines don't
prevent RSV, but they may keep symptoms from getting serious.
Learning about RSV infection:
Respiratory syncytial virus (RSV) is
highly contagious, meaning it spreads easily from person to person. There are
two main types of RSV and many subtypes (strains). For this reason, you cannot
immunity to the virus. And you may have many RSV
infections throughout life.
People with RSV infection may spread
the virus through their secretions (saliva or mucus) when they cough, sneeze,
or talk. You can catch the virus by:
The virus spreads easily in crowded settings, such as child
care facilities, preschools, and nursing homes. Children attending
school often spread the virus to their parents and siblings. The incubation
period—the time from exposure to RSV until you have symptoms—ranges from 2 to 8
days but usually is 4 to 6 days.1
are most likely to spread the virus within the first several days after
symptoms of RSV infection begin. You remain contagious for up to 8 days. Babies and young children may spread the virus for at least 3 to 4
Many different viruses can cause lower
respiratory tract infections in children. These viruses can cause symptoms that are similar to an RSV
respiratory syncytial virus (RSV) infection affects
the nose and throat (upper
respiratory system), symptoms are usually mild and
resemble those of the common cold. They include:
Babies may have additional symptoms, including:
It is hard to distinguish between a common cold and
RSV infection. But unless you or your child has an increased risk of
complications from RSV, it usually is not important to know which virus causes
RSV infection sometimes leads to
pneumonia or both.
Symptoms of these
In healthy children,
respiratory syncytial virus (RSV) infections tend to
be mild and resemble a cold. Children who have only upper
respiratory system symptoms, such as a sore throat or
a runny nose, usually recover in about 10 to 14 days.
different types and many different subtypes (strains) of RSV exist. For this
reason, you cannot have full immunity to the virus and may have many RSV
infections throughout your life. A child's first RSV infection, which almost
always occurs by age 2, usually is the most severe. Certain babies and children have an increased risk of
complications from an RSV infection because of a health condition or another problem. Also, babies have narrow breathing tubes that can clog easily, making
breathing hard. The most common complications for young children are
pneumonia, which are lower respiratory tract
Adults older than 65 have an increased risk of
complications following infection with RSV. Pneumonia is a particular risk,
especially if other health problems exist, such as
chronic obstructive pulmonary disease (COPD) or
It may take older adults
longer to recover from RSV infection and its complications than people in other age
Respiratory syncytial virus (RSV) infects almost all children by the age of 2, and reinfection
throughout life is common. The virus spreads easily and is extremely difficult to
completely avoid. Babies and young children who are in day care centers or
frequently in public places are most likely to become infected, especially
during the peak season.
Older brothers and sisters in school often become
infected with the virus and spread it to other household members, including
babies and preschoolers. Sharing food, touching objects that are contaminated
with the virus, and not washing hands can lead to RSV infection. Older adults
living in nursing homes or other group environments also have a higher risk of
becoming infected with RSV.
Babies ages 2 to 7 months
of age have the highest incidence of RSV infection affecting the lower
respiratory tract. Reinfection with another type or
strain of RSV can occur within weeks. But later infections are usually less
With RSV infections, there is
an increased risk of having
complications, especially in certain
babies and young children and
adults older than 65.
or other emergency services right away if:
See your doctor right away if your
baby or child has moderate trouble breathing.
Call a doctor if your child:
For more information on what to do if your child has trouble breathing, see
Respiratory Problems, Age 11 and Younger.
For an otherwise healthy child who has symptoms
of an upper respiratory infection, such as a cough or runny nose, home
treatment usually is all that is needed. But it is important to watch for signs
and symptoms of
complications, such as
Watchful waiting may not be appropriate when your
child with an upper respiratory infection has
an increased risk for complications. Watch your child closely if he or she
has symptoms of an upper respiratory infection. If symptoms get worse or new
symptoms develop, see a doctor right away.
Respiratory syncytial virus (RSV) infection can be
diagnosed and treated by a health professional such as a:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
In otherwise healthy people, it is
not usually necessary to distinguish
respiratory syncytial virus (RSV) infection from a
common cold. A doctor may suspect RSV infection as the cause of symptoms when
there is evidence of a recent community outbreak. It is generally not necessary
to confirm RSV infection with lab tests. But a
medical history and
physical exam may be done to evaluate symptoms.
viral detection test may be done to confirm a
diagnosis of RSV in symptomatic
adults older than 65 who are at an increased risk for
a severe infection or for complications. The test involves lab analysis of
nasal drainage, obtained with a cotton swab or nasal
wash. Testing may also be recommended for people who are hospitalized if the
cause of symptoms has not already been determined and they have a high risk of
The results of viral
detection tests help determine whether precautions are needed to prevent the
spread of infection. For children who are at risk for getting severe infections
or complications of RSV infections, the results of these tests may help guide
treatment, such as the need for medicines.
Certain tests may be
needed if RSV symptoms do not improve or become worse or if complications such
pneumonia are suspected. These tests may
Respiratory syncytial virus (RSV) infections are usually mild and seem like a common cold. In
most cases, RSV infections go away on their own in about 10 to 14 days. Home
treatment to ease symptoms and prevent
complications is usually all that is needed.
Children who develop lower respiratory infections, especially
bronchiolitis, may need medicines such as
bronchodilators in addition to home treatment.
Antibiotics may be used to treat a bacterial infection (such as pneumonia) that develops as a complication. But antibiotics don't treat RSV or any other viral infection.
When complications develop in otherwise healthy children,
corticosteroid medicines sometimes are used. But more
study is needed before corticosteroids are routinely recommended for this
A child who is having
difficulty breathing or is
dehydrated may need to be cared for in a hospital. The
child may need
respiratory and other medical treatments. In very rare
cases, some children receive the antiviral medicine
ribavirin while they are in the hospital.
Respiratory syncytial virus (RSV) infection is easy to catch (highly contagious). It is common
for children to get viral infections such as RSV if they are often exposed
to infected people and have not built up immunity. There is no sure way to
prevent respiratory illnesses in babies and children.
medicines are used to help
prevent RSV infection in
babies and children who are at risk for complications
from RSV. Even if RSV infection develops, use of these medicines may result in
a less severe infection.
Monoclonal antibodies, such as palivizumab (Synagis), may be used to help prevent
or reduce the severity of RSV infection.
The following may help
reduce your child's risk of respiratory problems:
of RSV often occur between late fall and early
spring. To keep from catching the virus during this time,
limit your exposure to RSV. This is most critical for babies and children who
are at risk for serious RSV infections. Try to
Most mild to moderate
respiratory syncytial virus (RSV) infections in
otherwise healthy people are like the common cold and can be treated at home.
If your child is older than 12 months of age and is not at risk for
complications from RSV infection, try home treatment.
But RSV infections in people with an increased risk of complications need close
People who have
impaired immune systems need to see a doctor for
cold symptoms because of the increased risk for complications.
babies and children—and older adults—who have health problems and other
risk factors should see a doctor at the first sign of RSV.
respiratory syncytial viral (RSV) infections do not
require prescription medicines. But medicines may be recommended for certain
people to help:
A medicine may be given to
infants and children at high risk for complications
of RSV to prevent the infection or reduce its severity.
Monoclonal antibodies, such as palivizumab (Synagis),
are usually given in monthly doses for up to 5 months. This medicine can
stop RSV from multiplying.
Medicines to help treat complications of RSV infection include:
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sign up to get weekly emails about your area of interest.
The National Institute of Allergy and Infectious
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American Academy of Pediatrics (2009). Respiratory syncytial virus. In LK Pickering et al., eds., Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed., pp. 560–569. Elk Grove Village, IL: American Academy of Pediatrics.
Hall CB, Walsh EE (2009). Respiratory syncytial virus. In RD Feigin et al., eds., Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed., vol. 2, pp. 2462–2487. Philadelphia: Saunders Elsevier.
Horga MA, Moscona A (2006). Respiratory syncytial virus. In FD Burg et al., eds., Current Pediatric Therapy, 18th ed., pp. 793–797. Philadelphia: Saunders Elsevier.
Other Works Consulted
Committee on Infectious Diseases, American Academy of Pediatrics (2009). Modified recommendations for use of palivizumab for prevention of respiratory syncytial virus infections. Pediatrics, 124(6): 1694–1701.
Hall CB (2010). Respiratory syncytial virus. In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed., vol. 2, pp. 2207–2221. Philadelphia: Churchill Livingstone Elsevier.
Hayden FG and Ison MG (2006). Respiratory viral infections. In DC Dale, DD Federman, eds., ACP Medicine, section 7, chap. 25. New York: WebMD.
Honegger JR, Brady MT (2011). Viral respiratory infections including influenza. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 961–970. New York: McGraw-Hill.
Levin MJ, Weinberg A (2011). Infections: Viral and rickettsial. In WW Hay et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 1107–1147. New York: McGraw-Hill.
Walsh EE (2012). Respiratory syncytial virus. In L Goldman, A Shafer, eds., Goldman's Cecil Medicine, 24th ed., pp. 2091–2092. Philadelphia: Saunders.
June 25, 2012
Susan C. Kim, MD - Pediatrics
& John Pope, MD - Pediatrics
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