Respiratory syncytial virus (RSV)

Overview

Respiratory Syncytial Virus (RSV) is a common cause of lung and respiratory tract infections, affecting both children and adults. By the age of 2, the majority of children have been exposed to this virus. While RSV symptoms in healthy adults and older children are usually mild and similar to those of a common cold, self-care measures are typically enough to manage any discomfort.

However, RSV can pose serious risks for certain groups, including babies under 12 months old, especially premature infants, older adults, individuals with heart and lung conditions, or those with weakened immune systems. In these vulnerable populations, RSV infections can lead to severe illness and complications.

Symptoms

The typical onset of signs and symptoms of respiratory syncytial virus infection occurs approximately four to six days following exposure to the virus. In adults and older children, RSV typically manifests as mild cold-like symptoms. These may include:

• Fever
• Dry cough
• Sneezing
• Headache
• Congested or runny nose
• Sore throat

Severe symptoms

RSV infection has the potential to spread to the lower respiratory tract, leading to pneumonia or bronchiolitis, characterized by inflammation of the small airway passages entering the lungs. Signs and symptoms may encompass:

• Fever
• Severe cough
• Rapid breathing or difficulty breathing: The individual may find it easier to sit up rather than lie down.
• Wheezing: Characterized by a high-pitched noise typically heard during exhalation.
• Bluish discoloration of the skin due to oxygen deficiency (cyanosis).

RSV has the most severe impact on infants. Signs and symptoms of severe RSV infection in infants include:

• Cough
• Short, shallow and fast breathing
• Difficulty breathing — chest muscles and skin retract inward with each breath
• Lethargy
• Poor feeding
• Irritability

Most children and adults generally recover from RSV within one to two weeks, although some may develop recurrent wheezing. However, severe or life-threatening infections requiring hospitalization can occur, particularly in premature infants or individuals with chronic heart or lung conditions.

If your child or anyone at risk of severe RSV infection experiences difficulty breathing, a high fever, or a bluish discoloration of the skin, especially on the lips and nail beds, it’s crucial to seek immediate medical attention.

Causes

RSV enters the body through the eyes, nose, or mouth and spreads easily through the air via infected respiratory droplets. Exposure to coughs or sneezes from someone with RSV can lead to infection. Additionally, direct contact, such as handshakes, can transmit the virus. The virus can survive on hard surfaces like countertops, crib rails, and toys for several hours. Touching a contaminated object and then touching your mouth, nose, or eyes increases the risk of viral transmission.

An infected individual is most contagious during the first week or so after contracting the virus. However, in infants and individuals with weakened immune systems, the virus may continue spreading even after symptoms have resolved, for up to four weeks.

Risk factors

By the age of 2, most children will likely have encountered RSV, with the possibility of multiple infections. Those attending childcare centers or having siblings in school face a heightened risk of exposure and subsequent reinfection. RSV outbreaks typically transpire from fall to late spring, marking the RSV season.
Individuals at elevated risk of severe or potentially life-threatening RSV infections comprise:

• Babies, particularly those born prematurely or those six months of age or under
• Children with chronic lung disease or congenital heart disease
• Children suffering from neuromuscular disorders like muscular dystrophy
• Children or adults weakened by diseases like cancer or treatments like chemotherapy
• Adults with lung or heart diseases
• Elderly adults, especially those 65 years of age and above