Respiratory Syncytial Virus Infection

Am Fam Physician. 2017;95(2):online

See related article on respiratory syncytial virus bronchiolitis

What is respiratory syncytial virus?

Respiratory syncytial virus (RESS-per-uh-TOR-ee sin-SISH-uhl VIE-russ), or RSV, causes fever, stuffy or runny nose, sore throat, and cough. Your child is more likely to get RSV between November and April. Most children have had at least one RSV infection by two years of age. Most of these infections are mild. Younger children are more likely to get a lung infection and have breathing problems and wheezing. Their skin may turn a bluish color because they don't get enough oxygen. Babies who are younger than three months, who were born early, or who have certain medical problems are more likely to have problems from RSV.

How can I tell if my child has it?

Your doctor will be able to tell by examining your child. An RSV test can be done by swabbing the inside of the nose, but it's not usually needed.

How is it treated?

Treatment is mainly aimed at helping symptoms. Be sure your child drinks plenty of fluids. The hospital or doctor's office may give your child oxygen to help him or her breathe. Gently suctioning your baby's nose may help him or her eat and drink better. RSV is caused by a virus, so antibiotics don't help. Steroids and cool mist aren't helpful either. If your child isn't able to drink, IV fluids may be needed. Babies with a more serious infection may need to be in the hospital. A respirator may be needed to help your child breathe, but this is very rare.

How does it spread?

RSV can be spread by contact with body fluids like saliva and mucus from a sick child's nose or mouth, or by objects that the child has touched. Having your child wash his or her hands or using alcohol-based hand sanitizers may lower the risk of spreading the infection. Children may return to day care when they have no fever and can eat and drink without problems.

When should I take my child back to the doctor?

Talk to your doctor if your child has trouble eating or drinking, gets tired during feeding, or becomes sluggish. You should also see a doctor if your child is younger than 60 days and has a fever of at least 100.4°F (38°C), or if your child is having trouble breathing (such as taking 60 breaths or more per minute). See a doctor if your child seems to be getting worse.

What else can I do to prevent RSV?

Avoid contact with children and adults with cold symptoms or fevers. Avoid large crowds during cold and flu season, especially if your infant is younger than three months. Wash hands frequently. Breastfeed your baby for at least six months. Keep your child away from secondhand smoke. It can increase the risk and severity of an RSV infection. Talk to your doctor about a special medicine to prevent RSV if your baby was born before 29 weeks or was born with heart problems. Toddlers younger than two years may also get the treatment if they were born with certain lung problems.