As much as we love them, our little ones tend to be germ magnets. Once they start going to daycare and school with other germ magnets, illnesses tend to spread quickly and easily.
Most children will have six to eight colds per year. While most common colds may be mild and a bit of a snotty nuisance, there is another virus to be aware of – especially if you have small children: respiratory syncytial virus, or RSV.
RSV causes cold-like symptoms, such as a cough, runny nose and sometimes a fever. But in some children, it can be much more serious.
“In older children and adults who are otherwise healthy, RSV often acts like a cold, but RSV can cause serious, even life-threatening, problems in small children,” said Helene Felman, MD, a pediatrician with Banner Children's.
While most signs of the sniffles may be no cause for concern, read on to better understand RSV, its symptoms and steps you can take to protect your child.
What is RSV?
RSV is the most common respiratory illness that causes infections in the respiratory tract (lungs, nose and throat). According to the Centers for Disease Control and Prevention (CDC) almost all children will have an infection before the age of 2. Most cases cause mild, cold-like symptoms, but in some cases, it can be severe and possibly require hospitalization.
“RSV poses a higher risk for severe infection and complication in infants, especially premature infants, young children with congenital heart disease or chronic lung disease and children with weakened immune systems,” Dr. Felman said. “It can cause serious problems, such as pneumonia, and trigger symptoms in children with asthma.”
The virus spreads through the air – either by coughing or sneezing – direct contact or on surfaces like counters, handles, children’s toys and even clothes. “The virus can survive several hours on hard surfaces,” Dr. Felman said. “If your child touches their eyes, nose or mouth after touching an object that has the virus particles on it, they may become infected.”
Most often, RSV season occurs in the fall and winter months, but it can be seen year-round.
What are the symptoms of RSV?
RSV is very contagious. It is normally infectious for about three to eight days after symptoms develop. “Many symptoms may resemble the common cold, such as a cough, congestion, fever, sore throat, headache and fatigue,” Dr. Felman said.
However, severe RSV in children can lead to more dangerous conditions. Contact your child’s health care provider if your child has the following symptoms:
- Whistling or wheezing noise when they breathe
- Short, shallow or fast breaths
- Trouble eating, drinking or swallowing (for breastfed children: refusing to breastfeed or bottle feed)
- High fever
- Worsening cough
- Signs of dehydration, including a lack of tears when crying, little or no urine in the diaper for six hours, and cool, dry skin
If your child is very tired or unalert, has difficulty breathing and/or is turning blue around the lips and fingertips, call 911.
Treatment for RSV
While there is no one specific treatment yet and medications like steroids and antibiotics are ineffective, most children recover on their own within a week or two.
“RSV is a virus, so antibiotics will not help cure the infection,” Dr. Felman said. “In fact, the antibiotics, if used incorrectly, may only breed worse infections in the future for that child.”
Most treatments instead focus on reducing congestion and opening the airways. This may include:
- Keeping them home if they aren’t feeling well so they can rest and protect other children.
- Drinking lots of fluids to prevent dehydration.
- Taking over-the-counter medications for pain relief and to reduce fevers as needed. Follow your child’s provider’s guidance on medicines and never give your child aspirin, as it can lead to a disease called Reye's syndrome.
- Using saline nasal sprays or drops to loosen a stuffy noise.
- Using a cool mist vaporizer or humidifier to make breathing easier and reduce coughing.
Serious cases may require hospital care, which will involve IV fluids, extra oxygen and/or bronchodilator medications to open your child’s airways. If your child is under six months of age or at high risk for severe illness, contact your child’s doctor at the first signs of symptoms.
How to prevent getting (or spreading) RSV
There are steps you can take to help prevent the spread of RSV and other respiratory viruses. Here are some tips that can help:
- Wash your child’s hands often with soap and warm water, especially before eating and after using the bathroom or diaper change.
- Avoid sharing food, cups and eating utensils, towels, toothbrushes or pacifiers.
- Wash and disinfect toys, clothes, counters and other shared surfaces.
- Ask people to wash their hands before they touch or hold your baby.
- Keep your child away from anyone with cold symptoms.
- Don’t smoke or allow others to smoke around your child, which can increase the risk of infection and severity of symptoms.
- Keep your child home from school or daycare when they are sick.
- Get tested for COVID-19 and other illnesses.
- Keep your child up-to-date on their immunizations and get annual flu (influenza) and COVID-19 vaccines.
“Vaccines prevent serious illness, including hospitalizations, and occasionally children get more than one virus at a time,” Dr. Felman said. “I strongly recommend both the COVID-19 and influenza or flu vaccinations for all my eligible patients. For very premature infants, and kids with chronic heart or lung disease, there is a medication administered by monthly injections to prevent RSV.”
The Centers for Disease Control and Prevention (CDC) recommends that all infants under 8 months of age who are born during, or entering, their first RSV season receive an injection of nirsevimab (a monoclonal antibody product) to help protect against severe RSV infections. A dose is also recommended for children age 8 to 19 months entering their second RSV season if they are at higher risk for severe RSV. These monoclonal antibodies are not a RSV vaccine but help to fight RSV infections. The vaccine Arexvy has been approved for older aduts for the prevention of lower respiratory tract diesase caused by RSV.
Respiratory syncytial virus, or RSV, is a common and contagious respiratory illness that is common in children. Most often symptoms are mild and resemble the common cold, but the illness can be especially dangerous for children younger than six months of age and those with weakened immunity.
Contact your child’s health care provider if they are showing signs and symptoms of RSV. Most often treatment is focused on symptom management. For severe RSV infection, your provider may recommend further medical treatment.
If your child is very tired or unalert, has trouble breathing and/or is turning blue around the lips and fingertips, call 911.
To find a Banner Health specialist near you, visit bannerhealth.com.
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Updates were made to this article on August 4, 2023.