Respiratory Syncytial Virus, commonly known as RSV, is a prevalent virus that infects the respiratory tract, including the nose, throat, and lungs. This highly contagious virus spreads easily through respiratory droplets produced when an infected person coughs, sneezes, or talks. Transmission can also occur by touching contaminated surfaces and then touching your face, particularly the eyes, nose, or mouth.
RSV is remarkably resilient and can survive for extended periods on hard surfaces such as tables and cribs. While it persists for a shorter duration on softer materials like tissues and hands, its ease of transmission makes it a common childhood illness. Children are frequently exposed to RSV in environments outside the home, such as schools and daycare centers, and can unknowingly bring it home, spreading it to family members. In fact, RSV is so widespread that it is estimated nearly every child will contract an RSV infection before their second birthday.
While RSV infections typically cause mild, cold-like symptoms in healthy adults and older children, they can pose significant health risks to young children, especially infants, and older adults. It’s important to note that approximately 80% of children under the age of two hospitalized due to RSV do not have any pre-existing risk factors, highlighting the virus’s potential impact on even healthy infants.
Understanding the Burden of RSV Infections
RSV is not just a common virus; it represents a substantial public health burden, particularly in vulnerable populations. In the United States, RSV stands as the leading cause of hospitalization for infants under one year of age.
- Annually, RSV is responsible for an estimated 2.1 million outpatient visits and between 58,000 and 80,000 hospitalizations among children younger than 5 years in the US.
Furthermore, there is increasing recognition of RSV as a significant cause of respiratory illness in adults, especially older adults.
- Estimates suggest that RSV causes between 100,000 and 160,000 hospitalizations each year among adults aged 60 years and older in the US.
These figures likely underestimate the true burden of RSV infections across all age groups due to underreporting and variations in diagnostic testing.
Individuals at the highest risk of developing severe illness from RSV infection include:
- Premature infants and infants younger than 6 months old due to their underdeveloped immune systems and smaller airways.
- Adults of any age with pre-existing chronic conditions such as heart or lung disease, or other underlying medical conditions like diabetes or obesity, as these conditions can compromise the body’s ability to fight off infection.
- Adults with weakened immune systems, including those undergoing immunosuppressive therapies or living with conditions that suppress immunity.
- Older adults, particularly those who are frail or residing in long-term care facilities like nursing homes, are more susceptible to severe RSV outcomes due to age-related decline in immune function.
For more in-depth information, resources like the NFID Progress Report: Reducing the Burden of RSV across the Lifespan and the article “Reducing the Burden of Respiratory Syncytial Virus Across the Lifespan” by NFID Spokesperson Dr. William Schaffner offer comprehensive insights.
Recognizing the Symptoms of RSV
RSV symptoms can often be mistaken for other common respiratory viruses such as the flu (influenza) or COVID-19, as they present with similar manifestations. Common RSV symptoms include:
- Runny nose
- Coughing
- Sneezing
- Fever
- Decreased appetite
- Wheezing
In very young babies, the presentation of RSV can be subtle and may not include typical cold-like symptoms. Instead, infants may exhibit:
- Increased fussiness and irritability
- Reduced activity levels
- Difficulty breathing or rapid breathing
Symptoms typically emerge about 4 to 6 days after initial infection. While healthy adults may experience only mild symptoms or even be asymptomatic, they can still transmit the virus to others, making them vectors of spread.
Individuals infected with RSV are usually contagious for a period of 3 to 8 days. Most people recover from RSV infections within 1 to 2 weeks. However, it’s crucial to note that infants and individuals with compromised immune systems can remain contagious for as long as 4 weeks, even after their symptoms have improved or resolved, posing a continued risk of transmission.
In temperate climates like the US, RSV circulation typically increases during the fall and winter months, mirroring the seasonality of other respiratory viruses like influenza. Due to the overlapping symptoms with flu and COVID-19, laboratory testing is often necessary to definitively diagnose RSV infection, especially when clinical management decisions depend on accurate diagnosis.
Prevention Strategies for RSV Infection
Preventing the spread of RSV relies on practicing good hygiene and, for high-risk groups, utilizing available immunizations. Effective prevention measures include:
- Covering coughs and sneezes: Using a tissue or your elbow to minimize droplet spread.
- Frequent handwashing: Washing hands thoroughly with soap and water for at least 20 seconds, especially after being in public places or around sick individuals.
- Avoiding close contact: Limiting contact with people who are showing symptoms of respiratory illness.
- Avoiding touching the face: Reducing touching of the eyes, nose, and mouth to prevent self-inoculation with the virus.
- Cleaning and disinfecting frequently touched surfaces: Regularly cleaning surfaces like doorknobs, toys, and shared objects, particularly in homes with young children or vulnerable individuals.
- Seeking medical advice: Consulting a healthcare professional if you or your child develops cold-like symptoms that persist or worsen, to get appropriate guidance and care.
- Immunization: Getting vaccinated or receiving preventive monoclonal antibodies as recommended to protect against severe RSV.
Vaccines and preventive monoclonal antibodies are available to help protect against severe RSV disease:
For Adults: RSV vaccination is recommended for adults in specific age groups and risk categories. A single dose of RSV vaccine is recommended for all adults aged 75 years and older. For adults aged 60 to 74 years, especially those with underlying health conditions, RSV vaccination is also recommended based on shared clinical decision-making with their healthcare provider.
For Infants and Babies: Two primary immunization strategies are available to protect infants from severe RSV: either maternal RSV vaccination during pregnancy or administration of an RSV monoclonal antibody to the infant shortly after birth. Maternal RSV vaccine given during pregnancy provides protection to the baby for the first few months of life. Alternatively, an RSV antibody, nirsevimab, can be given directly to the infant to provide immediate protection.
The Centers for Disease Control and Prevention (CDC) provides updated recommendations for RSV vaccines in adults.. For the 2024-2025 respiratory season, the CDC recommends RSV vaccination for:
- All adults aged 75 years and older.
- Adults aged 60–74 years who are at increased risk for severe RSV, including:
- Individuals with chronic health conditions, such as chronic lung disease or heart disease.
- Residents of nursing homes and other long-term care facilities.
It is important to note that RSV vaccination is typically a single dose, and individuals who received a dose in the previous season are not recommended to receive another dose in the 2024-2025 respiratory season.
The CDC emphasizes the importance of protecting all infants from severe RSV through either maternal vaccination or infant immunization with monoclonal antibodies.
Ongoing research is focused on developing additional preventive tools for RSV, particularly for immunocompromised populations and other high-risk groups, highlighting the continuous effort to combat this widespread virus.
Treatment Options for RSV Infections
Currently, there are no specific antiviral medications specifically approved to treat RSV infections. The cornerstone of RSV treatment is supportive care, aimed at managing symptoms and supporting the body’s natural defenses. Supportive treatment may include:
- Oxygen therapy to address low blood oxygen levels in severe cases.
- Respiratory support treatments such as suctioning and, in severe cases, mechanical ventilation to assist with breathing.
- Intravenous fluids to prevent dehydration, especially in infants and young children who may have difficulty feeding due to respiratory distress.
Read about Other Vaccines You May Need
Updated September 2024
Sources: American Academy of Pediatricians and Centers for Disease Control and Prevention
