Jyoti Kinghorn 
Respiratory syncytial virus, or RSV, is a common respiratory virus that affects the nose, throat, lungs, and breathing passages. RSV is a seasonal respiratory virus that generally starts circulating in the US during the fall and peaks during the winter months.
The virus is very common, and most school-aged children get it at least once or twice a year. While acting like a mild cold for most adults and older children, RSV can sometimes lead to serious health complications and hospitalization.
The worst effects of RSV are often seen in children under the age of 5, older individuals over the age of 65, and people with diseases that compromise their immunity or the health of their heart or lungs.
RSV spreads fast
RSV is very highly contagious. After symptoms begin, someone with RSV is typically contagious for no more than 10 days, though some people can stay contagious for longer.
RSV spreads by coming in contact with respiratory droplets from an infected person. Respiratory droplets can spread from a sick person by coughing, sneezing, kissing, or touching surfaces with dirty hands. When someone comes in contact with the respiratory droplet in the air or touches contaminated surfaces and then touches their nose and mouth, they can also get sick. Healthy adults may not be symptomatic, but may still spread the virus through nasal secretions. A typical channel of RSV spreading is children encountering RSV in school and daycare, and transmitting it to other family members.
Common RSV symptoms
Once exposed, symptoms start developing in 4-6 days. Symptoms from RSV infection include a runny nose, sneezing, coughing which can turn into wheezing, a decrease in appetite, and sometimes fever. People may show one or more of these symptoms. In infants younger than six months old, symptoms include irritability, breathing difficulties, reduced consumption of breastmilk or formula, and decreased activity such as reduced kicking or rolling. A baby with RSV infection may only show a few of these symptoms.
Since many RSV symptoms mimic those from other respiratory viruses such as COVID-19 and the common cold, RSV infection can only be confirmed by at-home or laboratory testing.
Impact of RSV on Different Age Groups
Different age groups respond differently to RSV infection. A majority of RSV cases and complications are seen in children, particularly infants under the age of 2. According to the National Foundation for Infectious Diseases (NFID), RSV is the most common cause of both bronchiolitis and pneumonia in small children under the age of 1. RSV-related complications in children under the age of 5 cause 58,000-80,000 hospitalizations, and 100-300 deaths annually.
It is increasingly being understood that RSV can also have severe consequences for the elderly, as well as those who are immunocompromised or have comorbidities such as heart or lung diseases. As per NFID, RSV-related complications in older adults (over 65 years of age) cause 60,000-160,000 hospitalizations and 6,000-10,000 deaths annually.
At-home care or hospitalization
Recovery from RSV-caused sickness generally takes one to two weeks, although a persistent cough could last up to six weeks before clearing out. Self-care includes staying hydrated, and use of saline nasal drops or sprays. Never give over-the-counter drugs to your baby or toddler without checking with a pediatrician. If symptoms begin to worsen, seek medical advice from a pediatrician or a physician (for adults).
Rush the patient to the emergency room if any of the following symptoms develop- a wheezing cough, difficulty in breathing, shortness of breath, sharp or stabbing chest pain felt during breathing, the child’s mouth, lips, or nails turning blue, ribs sticking out, or apnea in infants (particularly those under 2 months of age). Hospitalization could be needed to ensure that the patient gets enough oxygen, resumes breathing, and starts recovering. IV fluids may be given to a dehydrated patient. In the most extreme cases, suction of mucus, tube feeding, or mechanical ventilation may be necessary.
Methods to prevent RSV
Careful vigilance and care can prevent the spread of RSV infections.
1. Wash hands with soap and water often, and every time after touching surfaces that may be contaminated.
2. When outside the house, avoid touching your (or your baby’s) face, eyes, nose, and mouth with your hands.
3. Regularly clean often-touched surfaces such as keys, cell phones, and doorknobs.
4. Stay at home when sick and suspecting RSV infection.
5. Cover coughs and sneezes.
6. Avoid contact of babies and elders with sick persons in the family.
7. Do not share anything that goes into the baby’s mouth, such as pacifiers, bottles, spoons, etc. Wash the baby’s clothes and toys often.
8. Get RSV vaccinations currently available for infants, and older adults. RSV vaccines are also given to pregnant individuals to protect newborns from RSV.
