Respiratory syncytial virus (RSV) Health Article

Definition

Respiratory syncytial virus (RSV) is a very common virus. This virus causes mild, cold-like symptoms in adults and older healthy children. It can cause serious respiratory infections in young babies, especially those in certain high-risk groups.

Alternative Names

RSV

Causes, incidence, and risk factors

RSV is the most common respiratory pathogen in infants and young children. It has infected nearly all infants by the age of two years. Seasonal outbreaks of acute respiratory illness occur each year, on a schedule that is somewhat predictable in each region. The season typically begins in the fall and runs into the spring.

RSV is spread easily by physical contact. Touching, kissing, and shaking hands with an infected person can spread RSV. Transmission is usually by contact with contaminated secretions, which may involve tiny droplets, or objects that droplets have touched. RSV can live for half an hour or more on hands. The virus can also live up to five hours on countertops and for several hours on used tissues. RSV often spreads very rapidly in crowded households and day care centers.

In infants and young children, RSV can cause pneumonia, bronchiolitis (inflammation of the small airways of the lungs), and croup. In healthy adults and older children, RSV is usually a mild respiratory illness. Although studies have shown that people produce antibodies against the virus, infections continue to occur in people of all ages.

Each year up to 125,000 infants are hospitalized due to severe RSV disease, and about 1-2% of these infants die. Infants born prematurely, those with chronic lung disease, those who are immunocompromised, and those with certain forms of heart disease are at increased risk for severe RSV disease. Those who are exposed to tobacco smoke, who attend daycare, who live in crowded conditions, or who have school-age siblings are also at higher risk.

Symptoms

• Breathing difficulty or labored breathing
• Cough
• Croupy cough (often described as a "seal bark" cough)
• Cyanosis (bluish discoloration of skin caused by lack of oxygen)
• Fever
• Nasal flaring
• Rapid breathing (tachypnea)
• Shortness of breath
• Stuffy nose
• Wheezing

Note: Symptoms vary and differ with age. Infants under age 1 are most severely affected and often have the most trouble breathing. Older children usually have only mild, cold-like symptoms. Symptoms usually appear 4-6 days after exposure.

Signs and tests

Rapid tests for this virus can be performed at many hospitals on fluid obtained from the nose.

Treatment

Antibiotics do not help in the treatment of RSV. Mild infections go away without treatment. Infants and children with a severe RSV infection may be admitted to the hospital so they can receive oxygen, humidified air, and fluids by IV.

A breathing machine (ventilator) may be needed.

Expectations (prognosis)

RSV infection may rarely cause death in infants, but this is unlikely if the child is seen early in the course of the illness.

In older children and adults, the disease will usually be quite mild.

Some evidence suggests that children who have had RSV bronchiolitis have an increased risk for asthma.

Complications

• Ear infections
• Lung failure
• Pneumonia

Calling your health care provider

Call your health care provider if breathing difficulties or other symptoms of this disorder appear. Any breathing difficulties in an infant should be regarded as an emergency and the appropriate help sought.