RSV in Babies and Children

Respiratory syncytial virus (RSV) is a common, highly contagious virus that affects people of all ages but is most severe in young children, older adults and those with compromised immune systems.

“Most children have one RSV infection by the time they’re 2 years of age,” says Andi Shane, MD, MPH, MSc, System Medical Director of Infectious Diseases at Children’s Healthcare of Atlanta. “The virus spreads easily by contact with droplets from sneezing or coughing and droplets on unwashed hands, counter tops, crib rails and toys.”

RSV infections typically occur from late fall through early spring, spreading rapidly through childcare centers, schools and any other place where people have close contact with each other. In otherwise healthy children, RSV typically results in coughing and a runny nose, with a fever that resolves in about one week.

What does RSV mean for babies and children with chronic illnesses?

Babies can frequently get a run-of-the-mill cold. But if your infant’s runny nose and cough turn into more serious breathing trouble, the problem could be RSV, which is potentially life-threatening for little lungs.

In children who were born prematurely and in those with other medical conditions such as lung or heart conditions, an RSV infection can be more severe.

What Are Signs and Symptoms of RSV in Babies and Children?

In otherwise healthy children, RSV symptoms may look like a common cold and include:

• Congested or runny nose
• Cough
• Fever

RSV symptoms may appear two to eight days after infection and usually last about a week but, in some cases, can last longer. 

When Should I Call the Doctor?

Seek medical care if your child has any of the following symptoms of RSV:

• Difficulty breathing or fast breathing with tugging of the chest muscles
• Gray or blue-tinged skin color (this typically shows up on the lips and fingernails)
• Wheezing — a high-pitched noise usually heard when a child exhales
• Apnea (stopping breathing)
• Extreme tiredness
• Refusal to drink liquids or breastfeed
• Decreased number of wet diapers

Your healthcare professional may take a swab of your baby’s nasal fluids to confirm if the problem is RSV.

Some other conditions associated with RSV infections include:

• Ear infection
• Asthma — possible link between severe RSV in children and the chance of developing asthma later in life

“If your child’s RSV symptoms are mild, make your child as comfortable as possible and provide plenty of fluids. Supportive care and fever-controlling medications may be all that is needed,” Dr. Shane says.

Some other tips for at-home care include the following:

• Use a nasal aspirator or bulb syringe to remove sticky nasal fluid, if your child is too young to blow their nose.
• Use a fever-controlling medication that does not contain aspirin, like acetaminophen or ibuprofen.
• Do NOT give your child cough and cold medicines. These do not help to relieve symptoms of RSV in young children and should be avoided. 

“Children who may have difficulty breathing and staying hydrated are usually hospitalized so they can get oxygen treatment, and intravenous fluids,” Dr. Shane added. If your child has difficulty breathing and is unable to stay hydrated, contact a healthcare professional immediately.

Like the common cold, the most effective way to avoid infection is to encourage good hand hygiene in children and adults. Some other ways to prevent your child from getting sick:

• Avoid others with cold-like symptoms or a fever.
• Insist that everyone who comes close to your child practice good hand hygiene. RSV is easily spread from person to person by contact.
• Don’t smoke. Exposure to tobacco smoke increases the risk of severe RSV illness.

We can all do our part to protect babies and young children from RSV infections. And knowing the symptoms of a more severe RSV infection can be lifesaving.

There are two ways to protect babies from severe RSV:

• An RSV vaccine given to a birth parent during pregnancy (September through January).
• Infant RSV antibody given to infants after birth during the RSV season (October through March).

Steps You Can Take at Home to Prevent RSV

Like the common cold, the most effective way to avoid infection is to encourage good hand hygiene in children and adults. Some other ways to prevent your child from getting sick:

• Avoid others with cold-like symptoms or a fever.
• Insist that everyone who comes close to your child practice good hand hygiene. RSV is easily spread from person to person by contact.
• Don’t smoke. Exposure to tobacco smoke increases the risk of severe RSV illness.