Facts about Respiratory Syncytial Virus (RSV)

By Dr. Holly Mintz, Chief Medical Officer, Elliot Ambulatory Care Services

Respiratory Syncytial Virus (RSV) is one of the many viruses that is present in our communities, especially during cold and flu season. RSV is the most common reason infants under 12 months are admitted to the hospital. For older adults, an estimated 60,000-120,000 are hospitalized each year due to RSV. Dr. Mintz answers common questions about how to prevent and manage RSV.

Q. What are the symptoms of RSV?
A. Symptoms of RSV include fever, cough, runny nose, and difficulty feeding. In some infants, symptoms can progress to fast breathing, working hard to breathe, wheezing, and dehydration.

Wheezing and fast breathing usually improve over two to three days, but the wheezing can last up to a week and the cough could last up to three weeks. Children who are exposed to RSV tend to develop symptoms in four to six days and are contagious for seven to 10 days. Your child can return to school or daycare when they have not had a fever in 24 hours, without the use of fever-reducing medicine, and when the wheezing has stopped.

Q. How do you prevent RSV?
A. There are many ways to limit the transmission of RSV. Limit your exposure to crowded areas and people who are sick, cover coughs and sneezes, disinfect surfaces, and wash your hands! Be sure to stay home if you are sick and keep sick children home from school or daycare.

Q. Is there a vaccine against RSV? Who can get vaccinated against RSV?
A. RSV vaccinations are available for adults over 60 years and pregnant women. Arexvy and Abrysvo are the two RSV vaccines available for adults 60 years and older. The immune system weakens with age, making adults in this age group at higher risk of serious complications from RSV. If you are over age 60, talk to your primary care provider to find out if the RSV vaccine is right for you.

There is a monoclonal antibody injection available to children aged 19 months and younger. Nirsevimab, Beyfortus, is a monoclonal antibody that was recently approved by the FDA to prevent severe symptoms of RSV in young children. It is recommended by the CDC and the American Academy of Pediatrics that all infants under eight months old receive a dose of Beyfortus prior to the start of RSV season.

We will provide Arexvy and Beyfortus at our primary care offices within Elliot Health System.

Abrysvo is also approved for women who are 32-36 weeks pregnant from September through January. Receiving this vaccine during pregnancy will help pass immunity to your baby. Please reach out to your OB for any questions regarding Abrysvo. Abrysvo is available at retail pharmacies.

Q. How will I know when to take my child to the doctor if I suspect RSV? As an adult, when should I see a doctor?
A. You should seek immediate medical care for your child if you notice any of the following symptoms:

• Struggling for each breath
• Unable to cry or speak
• Grunting sounds with each breath
• Severe retractions (ribs pulling in with each breath) 
• Slow, shallow, weak breathing
• Child is unconscious
• Bluish or gray lips or face
• Breathing sounds labored
• Wheezing
• Breathing fast
• You feel that your child needs emergency medical care

For most adults, RSV symptoms are the same as the common cold, but for those who are older or have chronic heart or lung conditions, symptoms can become severe enough to require a hospital stay. Seek emergency medical care for these symptoms:

• Shortness of breath
• Fever
• Blue skin
• Wheezing
• Worsening cough

Q. How can I relieve symptoms for my child at home?
A. For cough, use warm mist and warm liquids. This will help relax your child’s airway and will help to loosen mucus. For a blocked or stuffy nose, use nasal saline to help remove dry, sticky mucus that cannot come out on its own. Babies can’t nurse or drink a bottle if the nose is blocked with mucus. Fever-reducing medicine is only needed if your child has a fever of 102 degrees Fahrenheit or higher. Temperatures under 102 degrees Fahrenheit help to turn on the baby’s immune system. The fever helps to fight the infection.

For more information about RSV, visit the links below for additional resources.

RSV Vaccination: What Parents Should Know | CDC

RSV Vaccination: What Older Adults 60 Years of Age and Over Should Know | CDC

RSV Vaccination for Pregnant People | CDC

RSV: When It's More Than Just a Cold | HealthyChildren.org

RSV in Adults | American Lung Association