Respiratory syncytial virus (RSV)

Description

Respiratory syncytial virus (RSV) causes infections of the lungs and respiratory tract. It is so common that most children have been infected with the virus than 2 years of age. Respiratory syncytial (sin-SISH-ul) virus can also infect adults.

In adults and older, healthy children, respiratory syncytial virus (RSV), the symptoms are mild and typically mimic the common cold. Self-care measures are usually all that's needed to relieve any discomfort.

This virus can cause severe infection in some people, including infants 12 months and younger (children), especially premature babies, older adults, people with heart and lung disease, or anyone with a weak immune system (immunocompromised).

Symptoms

The signs and symptoms of respiratory syncytial virus infection usually occur about four to six days after exposure to the virus. In adults and older children, RSV usually causes mild cold-like signs and symptoms. These may include:

  • Stuffy or runny nose
  • Dry cough
  • Low-grade fever
  • Sore throat
  • Sneezing
  • Headache

In severe cases

RSV infection can spread to the lower respiratory tract, causing pneumonia or bronchiolitis — inflammation of the small airways entering the lungs. Signs and symptoms may include:

  • Fever
  • Severe cough
  • Wheezing — a high-pitched noise that is usually heard on breathing out (exhaling)
  • Rapid breathing or difficulty breathing — the person may prefer to sit instead of lying down
  • Bluish Color of the skin due to lack of oxygen (cyanosis)

Babies are the most severely affected by RSV . The signs and symptoms of severe RSV infection in infants include:

  • Short, shallow and rapid breathing
  • Struggling to breathe — muscles of the chest and the skin is pulled in with every breath
  • Cough
  • A bad power supply
  • Unusual tiredness (lethargy)
  • Irritability

Most children and adults recover within a week or two, although some may be repeated wheezing. Serious or life-threatening infection that requires a hospital stay can occur in premature babies or in any person who has chronic heart or lung problems.

The RSV and COVID-19

Due to RSV and coronavirus disease 2019 (COVID-19) are the two types of respiratory viruses, some of the symptoms of RSV and coronavirus disease 2019 (COVID-19) may be similar. In children, COVID-19 often results in mild symptoms such as fever, runny nose, and cough. For adults with COVID-19 , the symptoms may be more severe and can include difficulty breathing.

Have the RSV can reduce immunity and increase the risk of contracting COVID-19 — for children and adults. And these infections can occur together, which can worsen the severity of COVID-19, the disease.

If you have symptoms of a respiratory illness, your doctor may recommend testing for COVID-19 .

When to see a doctor

Seek medical attention right away if your child or anyone at risk of RSV infection — difficulty breathing, high fever, or a blue coloration of the skin, especially the lips and the nails.

Causes

Respiratory syncytial virus enters the body through the eyes, nose, or mouth. It is easily spread through the air in infected respiratory droplets. You or your child can become infected if someone with RSV coughs or sneezes near you. The virus is also passed on to others through direct contact, such as shaking hands.

The virus can live for hours on hard objects such as countertops, railings, and toys. Touch your mouth, nose or eyes after touching a contaminated object and it is very likely that pick up the virus.

An infected person is most contagious during the first week or so after the infection. But in infants and those with weakened immunity, the virus can continue to spread even after the symptoms disappear, for up to four weeks.

Risk factors

By the age of 2 years, most children have been infected with the respiratory syncytial virus, but can be infected by RSV more than once. Children who attend child care centers or who have a sibling attending the school are at a higher risk of exposure and re-infection. RSV season — when the outbreaks tend to occur — is the crash at the end of the spring.

People at increased risk of serious or sometimes life-threatening RSV infection include:

  • Babies, especially premature infants or infants of 6 months or less
  • Children who have heart disease that is present from birth (congenital heart disease) or chronic lung disease
  • Children or adults with weakened immune systems from diseases such as cancer or cancer treatments such as chemotherapy
  • Children who have neuromuscular disorders such as muscular dystrophy
  • Adults with heart disease or lung disease
  • Older adults, especially those 65 years of age and older

Complications

Complications of respiratory syncytial virus include:

  • Hospitalization. A severe RSV infection may require a hospital stay so that doctors can monitor and treat breathing problems, and to give intravenous (IV) fluids.
  • Pneumonia. RSV is the most common cause of inflammation of the lungs (pneumonia), or of the airways (bronchiolitis) in babies. These complications can occur when the virus spreads to the lower respiratory tract. Inflammation of the lungs can be very serious in infants, young children, older adults, people with weakened immune systems, or people with chronic heart or lung disease.
  • Infection of the middle ear. If germs enter the space behind the eardrum, you can get an infection of the middle ear (otitis media). This occurs more often in babies and young children.
  • Asthma. There may be a link between severe RSV in children, and the chance of developing asthma later in life.
  • The repeated infections. Once you have had the RSV , you could get infected again. It is even possible to occur during the same RSV season. However, the symptoms are usually not as severe, it is usually in the form of a common cold. But can be serious in older adults or in people with chronic heart or lung disease.

Prevention

Respiratory syncytial virus can infect anyone. But premature babies and babies as well as older adults with heart or lung disease or a weakened immune system are at higher risk of serious infection.

Protection for infants and high-risk young children

The two main options that exist to help prevent babies from getting severe RSV . One is an antibody product given to the baby. The other is a RSV vaccine for pregnant people to help protect your baby from birth until 6 months of age. Both are approved by the Food and Drug Administration (FDA). You and your health care professional may discuss what is the best option to protect your child.

  • Antibody product called nirsevimab (Beyfortus).This antibody is a product of a single dose of vaccine is administered in the month before or duringRSVseason. It is for infants under 8 months of age during or enter your firstRSVseason. Nirsevimab can also be given to children of 8 months through 19 months of age who are at increased risk of severeRSVdisease through their secondRSVseason. In the united states, theRSVseason is usually from November to March, but varies in Florida, Alaska, Hawaii, Puerto Rico, Guam and other territories of the Pacific islands of the united states. On rare occasions, when nirsevimab is not available or that a child is not eligible for it, another antibody product called palivizumab may be given. But palivizumab requires monthly injections given during theRSVseason, while nirsevimab is only one shot. Palivizumab is not recommended for healthy children or adults.
  • The vaccine for pregnant people. The FDA approved a vaccine for RSV called Abrysvo for pregnant people to prevent RSV in infants from birth to 6 months of age. A single dose of vaccine Abrysvo can be given at any time of the week 32 to 36 weeks of pregnancy during the months of September to January in the united states

Antibody product called nirsevimab (Beyfortus). This antibody is a product of a single dose of vaccine is administered in the month before or during the RSV season. It is for infants under 8 months of age during or entering their first RSV season. Nirsevimab can also be given to children of 8 months through 19 months of age who are at increased risk of severe rsv disease through their second RSV season. In the united states, the RSV season is usually from November to March, but varies in Florida, Alaska, Hawaii, Puerto Rico, Guam and other territories of the Pacific islands of the united states.

On rare occasions, when nirsevimab is not available or that a child is not eligible for it, another antibody product called palivizumab may be given. But palivizumab requires monthly injections given during the RSV season, while nirsevimab is only one shot. Palivizumab is not recommended for healthy children or adults.

The vaccine for older adults

Older adults have weaker immune systems, especially those with existing conditions, such as heart or lung disease. To help prevent RSV infection, the FDA approved RSV vaccine for adults 60 years and more.

The CDC recommends that adults aged 60 years and over talk with your health care professional about the availability of a vaccine for RSV, especially if they are at increased risk of developing severe RSV . Two vaccines are available for this age group: Abrysvo and Arexvy. The CDC does not recommend one over the other. Each is one of a single dose of vaccine.

Talk with your health care team about the benefits and risks of vaccines against RSV for your situation.

Lifestyle habits

These lifestyle habits can help prevent the spread of this infection:

  • Wash your hands often. Teach your children the importance of washing hands.
  • Avoid exposure. Cover your mouth and nose when coughing or sneezing. Limit your baby's contact with people who have fever or a cold.
  • To keep things clean. Make sure countertops for kitchens and bathrooms, doorknobs and handles are clean. Put used tissues in the trash immediately.
  • Do not share drinking cups with others. Use your own glass or disposable cups when you or someone else is sick. The label of each person of the cup.
  • Do not smoke. Babies who are exposed to tobacco smoke have a greater risk of contracting RSV and potentially more severe symptoms. If you smoke, never makes it inside the house or the car.
  • Wash the toys regularly. To do this, especially when your child or a friend is ill.

Respiratory syncytial virus (RSV)

Diagnosis

Your doctor may suspect respiratory syncytial virus based on the findings of the physical examination and the time of year the symptoms occur. During the examination, the doctor will listen to your lungs with a stethoscope to check for wheezing or other abnormal sounds.

Lab and imaging tests are not usually necessary. However, they can help diagnose respiratory syncytial virus (RSV) complications or rule out other conditions that can cause similar symptoms. Tests may include:

  • Blood tests to check white cell counts or to look for viruses, bacteria, and other germs
  • The chest x-ray to check for lung inflammation
  • Sample of secretions from the inside of the mouth or nose to check if there are any signs of the virus
  • Pulse oximetry, a pain on the skin to monitor, detect lower than normal levels of oxygen in the blood

Treatment

Treatment for respiratory syncytial virus in general, consists in measures of self-care to make your child more comfortable (palliative care). But hospitalization may be necessary if severe symptoms are present.

Supportive care

Your doctor may recommend an over-the-counter medications such as acetaminophen (Tylenol, others) to reduce fever. (Never give aspirin to a child.) The use of nasal saline drops and suction can help clear the stuffy nose. Your doctor may prescribe antibiotics if there is a complication of bacterial, such as bacterial pneumonia.

Keep your child as comfortable as possible. Offer plenty of fluids and watch for signs of loss of body fluids (dehydration), such as dry mouth, little or no urine output, sunken eyes, and the extreme fussiness or sleepiness.

The in-Hospital care

If RSV infection is severe, hospitalization may be necessary. In-hospital treatments may include:

  • Intravenous (IV) fluids
  • Humidified oxygen
  • A breathing machine (mechanical ventilation), in rare cases

An inhaler (bronchodilator) or steroids have not been shown to be useful in the treatment of RSV infection.

Self-care

You may not be able to shorten the length of a respiratory syncytial virus infection, but you can try to relieve some of the signs and symptoms.

If your child has RSV , do your best comfort or distract him or her to cuddle, read a book or playing a quiet game. Other tips for the relief of the symptoms are:

  • Create the moisture in the air to breathe. To keep the room warm but not too hot. If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing. Be sure to keep the humidifier clean to prevent the growth of bacteria and molds.
  • Drink fluids. Continue breastfeeding or bottle feeding to your baby as you normally would. For older children and adults, to maintain a constant supply of fresh water to the side of the bed. Offer warm liquids, such as soups, which can help loosen thickened secretions. Ice cream can be soothing as well.
  • Try saline nose drops. Over-the-counter (OTC) drops of a safe, effective way to relieve congestion, even for small children. Follow your doctor's recommendations and instructions on the product.
  • The use of over-the-counter pain medications. over-the-counter (OTC) pain relievers such as acetaminophen (Tylenol, others) may help to reduce fever and relieve sore throat. Ask your doctor for the correct dose for the age of your child.
  • Stay away from cigarette smoke. The second-hand smoke can aggravate the symptoms.

Preparing for your appointment

Unless severe symptoms result in an emergency room (ER) visit, you will likely start by seeing your family doctor or your child's doctor. Here's some information to help you prepare for your appointment and know what to expect from your doctor.

What you can do

Before your appointment, you can make a list of:

  • Any symptom noticed, and when they began to work, even if it seems not to be related to an upper respiratory infection.
  • Key medical information, such as, for example, if your child was born before time, or if he or she has a heart or lung problem.
  • Details about the care of children, taking into account other places where your family may have been exposed to respiratory infections.
  • Questions to ask your doctor. A list of questions from most important to least important in case time runs out.

Questions for your doctor may include:

  • What is likely the cause of these symptoms? There are other possible causes?
  • What tests may be needed?
  • How long do the symptoms last?
  • What is the best treatment?
  • Is the medicine you need? If you are prescribing a brand-name drug, is there a generic alternative?
  • What can I do to make my child feel better?
  • Are there brochures or other printed material that I can take home? What sites do you recommend?
  • Up to what point should I isolate my son while infected?

Do not hesitate to ask any additional questions that you can think of during your appointment.

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • When did you first notice the symptoms?
  • The symptoms come and go or are they continuous?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Is anyone else in your family sick? What are the symptoms?

Your doctor will ask additional questions based on your responses, symptoms, and needs. Prepare and anticipate questions will help you make the most of your time with the doctor.

Symptoms and treatment of Respiratory syncytial virus (RSV)