What is RSV? How to spot this common infection in infants

While this cold and flu season feels scarier thanks to COVID-19, pediatricians worry about another virus impacting their youngest patients — respiratory syncytial virus, commonly known as RSV. The virus spreads most frequently from October to April each year and almost every child under age 2 develops it, though in many cases it's like a cold.

“This is a virus that is pretty common,” Dr. Rosemary Olivero, head of infectious diseases at Helen DeVos Children’s Hospital in Grand Rapids, Michigan, told TODAY. “It is an interesting virus — almost anyone can get infected by RSV, but the population that is most severely impacted are our youngest children.”

What is RSV?

RSV is a respiratory virus that spreads when someone with the virus on their hand touches another person. Frequent hand washing remains essential to preventing its spread and experts recommend that parents of children under 2 ask loved ones to wash their hands before touching their babies.

“RSV is spread easiest with contaminated hands,” Olivero said. “Hand washing is probably more important than mask wearing with RSV.”

Asking people not cuddle young babies might also reduce its spread.

“Trying to avoid kissing or hugging on top of the washing hands is critical,” Dr. Asuncion Mejias, an infectious disease doctor at Nationwide Children’s Hospital in Columbus, Ohio told TODAY. “It’ll really help you to decrease the exposure of RSV in young babies.”

While it’s too soon to tell, social distancing might also slow RSV this season.

“I don't know what's going happen in the U.S. to be honest, but I would think that if we continue at least partially trying to social distance to prevent the spread (of COVID-19) we will be able to also decrease the rates of this,” Mejias said.

Symptoms of RSV

In many ways, RSV looks like any other respiratory infection. Mild symptoms include:

  • Nasal congestion

  • Runny nose

  • Some coughing

  • Sneezing

  • Fever

More serious symptoms include:

  • Nasal congestion so severe the child can’t eat

  • Breathing rapidly

  • Breathing that is so labored that the skin and the abdominal muscles are pulling or working hard

According to the Centers for Disease Control and Prevention, these symptoms usually appear in stages and not all at once. In young infants, the only symptoms may be irritability, decreased activity and breathing difficulties. If children experience problems breathing or their lips turn blue, parents should take them to the pediatrician or emergency room immediately.

“RSV is actually the most common infection that leads to hospitalization because of severe disease in children less than 1 year of age,” Mejias said.


Complications of RSV

Babies with RSV can develop bronchiolitis, which causes coughing, wheezing and labored breathing. It can also lead to pneumonia, an infection of the lungs. These babies should be seen by a doctor.

“When the disease (spreads) to the lower respiratory tract those children will present to the emergency department or the pediatrician with restrictions when they breathe and a subset of them will be hospitalized,” Mejias said.

Treating RSV

Most RSV infections go away on their own in a week or two. There’s no vaccine for RSV and parents really can’t tell if a child has RSV, flu or another cold. Doctors can test for RSV to be sure. But there are no treatments specifically for RSV, other than helping babies to breathe and stay hydrated in the hospitals. For mild cases where parents are caring for their children at home, it’s important to make sure the children are well hydrated. And, if possible, try to keep their noses clear.

“Suction the secretions from the respiratory tract in the nose, (it) helps a lot because little infants that are that are younger than six months of age are by definition nose breathers, meaning that they do not know how to breathe with the mouth,” Mejias said. “So if their nose is (blocked) then they struggle.”