What is Respiratory Syncytial Virus in Children

Respiratory syncytial virus is a common childhood viral illness. It causes breathing problems along with other symptoms such as fever and cough. It is often the cause of a viral infection of the small airways of the lungs (bronchiolitis).

RSV infection is one of the most frequent reasons infants are admitted to the hospital. RSV spreads very easily from person to person (is very contagious). Your child can be re-infected with RSV even if they have had the infection before. RSV infections usually occur within the first 3 years of life, but can occur at any age.

What are the causes?

This condition is caused by respiratory syncytial virus (RSV). The virus spreads through droplets from coughs and sneezes (respiratory secretions). Your child can catch the virus by:

• Having respiratory secretions on his or her hands and then touching the mouth, nose, or eyes. The virus can live on things that an infected person touched.
• Breathing in (inhaling) respiratory secretions from an infected person.

What increases the risk?

Your child may be more likely to develop severe breathing problems from RVS if he or she:

• Is younger than 2 years old.
• Was born early (prematurely).
• Was born with heart or lung disease, or other long-term (chronic) medical problems.

RVS infections are most common between the months of November and April, but can happen during any time of the year.

What are the signs or symptoms?

Symptoms of this condition include:

• Making loud noises when breathing (wheezing).
• Making a whistling noise when inhaling (stridor).
• Brief pauses in breathing (apnea).
• Shortness of breath.
• Frequent coughing.
• Difficulty breathing.
• Runny nose.
• Fever.
• Decreased appetite or activity level.
• Eye irritation.

How is this diagnosed?

This condition is diagnosed based on your child’s medical history and a physical exam. Your child may have tests, such as:

• A test of nasal secretions to check for RSV.
• Chest X-ray. This may be done if your child develops difficulty breathing.
• Blood tests to check for worsening infection and loss of too much body fluid (dehydration).

How is this treated?

The goal of treatment is to improve symptoms and support recovery. Since RSV is a viral illness, typically no antibiotic medicine is prescribed. Your child may be given a medicine (bronchodilator) to open up airways in the lungs in order to help him or her breathe.

If your child has severe RSV infection or other health problems, he or she may need to be admitted to the hospital. If your child is dehydrated, he or she may need IV fluids. If your child develops breathing problems, oxygen may be needed.

Follow these instructions at home:

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• Do not give your child aspirin because of the association with Reye syndrome.
• Try to keep your child’s nose clear by using saline nose drops. You can buy these drops over the counter at any pharmacy.

General instructions

• You may use a bulb syringe as directed to suction out nasal secretions and help clear stuffiness (congestion).
• Use a cool mist vaporizer in your child’s bedroom at night. This is a machine that adds moisture to dry air in the room. It helps loosen secretions.
• Have your child drink enough fluids to keep his or her urine clear or pale yellow. Fast and heavy breathing can cause dehydration.
• Keep your child away from smoke. Infants exposed to people who smoke are more likely to develop RSV. Exposure to smoke also worsens breathing problems.
• Carefully monitor your child’s condition and do not delay seeking medical care for any problems. Your child’s condition can change quickly.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

How is this prevented?

RSV is very contagious. To prevent catching and spreading the RSV virus, your child should:

• Avoid contact with people who are infected. 
• Avoid having contact with others until his or her symptoms go away. Your child should stay at home and not return to school or daycare until symptoms have cleared.
• Wash his or her hands often with soap and water. If soap and water are not available, he or she should use a hand sanitizer. Everyone in your child’s household should also wash his or her hands often. Clean all surfaces and doorknobs as well.
• Not touch his or her face, eyes, nose, or mouth during treatment.
• Cover his or her nose and mouth with an arm (not hands) when coughing or sneezing.

Contact a health care provider if:

• Your child’s symptoms do not improve after 3-4 days.

Get help right away if:

• Your child’s skin turns blue.
• Your child has difficulty breathing.
• Your child makes grunting noises when breathing.
• Your child’s ribs appear to stick out when he or she is breathing.
• Your child’s nostrils widen (flare) when he or she breathes.
• Your child’s breathing is not regular or you notice any pauses in his or her breathing. This is most likely to occur in young infants.
• Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.
• Your child has difficulty feeding, or he or she vomits often after feeding.
• Your child’s mouth seems dry.
• Your child urinates less than usual.
• Your child starts to improve but suddenly develops more symptoms.

Summary

• Respiratory syncytial virus (RSV) is a common childhood viral illness.
• RSV spreads very easily from person to person (is very contagious). The virus spreads through droplets from coughs and sneezes (respiratory secretions).
• Frequent handwashing, avoiding contact with infected people, and covering the nose and mouth when sneezing will help prevent catching and spreading RSV.
• Using a cool mist humidifier, having your child drink fluids, and keeping your child away from smoke, will support recovery.
• Carefully monitor your child’s condition and do not delay seeking medical care for any problems. Your child’s condition can change quickly.