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Respiratory syncytial virus (RSV)

RSV; Palivizumab; Respiratory syncytial virus immune globulin; Bronchiolitis - RSV; URI - RSV; Upper respiratory illness - RSV; Bronchiolitis - RSV

Respiratory syncytial virus (RSV) is a very common virus that leads to mild, cold-like symptoms in adults and older healthy children. It can be more serious in young babies and older adults, especially those in certain high-risk groups.

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Bronchiolitis

Causes

RSV is the most common germ that causes lung and airway infections in infants and young children. Most infants have had this infection by age 2. Outbreaks of RSV infections most often begin in the fall and run into the spring.

The infection can occur in people of all ages. The virus spreads through tiny droplets that go into the air when a sick person blows their nose, coughs, or sneezes.

You can catch RSV if:

RSV often spreads quickly in crowded households and day care centers. The virus can also live for many hours on hard surfaces such as countertops and doorknobs. It can live on soft surfaces such as tissues and hands for shorter amounts of time.

Symptoms

Symptoms appear in 4 to 6 days after infection with the virus. Symptoms can vary, depending on age.

Adults and older children most often have cold-like symptoms, including:

In young infants, the only symptoms may be:

Young infants may also have more severe symptoms and often have the most trouble breathing:

Any breathing problems in an infant are a medical emergency. Seek medical help right away.

RSV can develop into a severe respiratory infection:

RSV can also make existing medical conditions worse, such as asthma, COPD, and heart failure.

Exams and Tests

Many hospitals and clinics can rapidly test for RSV using a sample of fluid taken from the nose with a cotton swab.

Treatment

In most cases, mild RSV infections go away in a week or two without treatment. To help relieve symptoms:

Antibiotics and bronchodilators are NOT used to treat RSV. Antibiotics kill bacteria. They won't work on the virus that causes RSV.

Infants, children, and adults with a severe RSV infection may be admitted to the hospital. Treatment will include:

A breathing machine (ventilator) may be needed. Hospitalization usually lasts only a few days.

Outlook (Prognosis)

Most adults and children recover from RSV.

Risk factors for severe RSV in adults include:

Risk factors for severe RSV in infants include:

Rarely, RSV infection can cause death in infants and older adults. However, this is unlikely if the person is seen by a health care provider in the early stages of the disease.

Children who have had RSV bronchiolitis may be more likely to develop asthma.

Possible Complications

In young children, RSV can cause:

When to Contact a Medical Professional

Contact your provider right away if you or your child have:

Any breathing problems in an infant are an emergency. Seek medical help right away.

Prevention

RSV tends to spread during the fall and winter months in the United States. RSV vaccines help protect children and older adults against RSV infection. The vaccine is recommended for:

To help prevent spreading RSV when you are sick, stay home and away from others both inside and outside of your household.

You can go back to your normal activities if both of the following things are true:

Even though you feel better, you may still be able to spread the virus to others for several days. For this reason, once you go back to your normal activities, continue to protect others from illness by taking these steps for 5 days:

If your fever returns after resuming normal activities, you should go back to staying home and away from others. Once your fever and symptoms improve for more than 24 hours, you can resume activities while taking steps to protect others for 5 more days.

Related Information

Respiratory
Acute
Community-acquired pneumonia in adults
Bronchiolitis
Croup
Antibody
Otitis
Bronchiolitis - discharge

References

Centers for Disease Control and Prevention website. Respiratory syncytial virus infection (RSV).  About RSV. www.cdc.gov/rsv/about/index.html. Updated June 5, 2024. Accessed June 19, 2024.

Centers for Disease Control and Prevention website. Respiratory syncytial virus infection (RSV). RSV vaccines. www.cdc.gov/rsv/vaccines/. Updated June 5, 2024. Accessed June 19, 2024.

Centers for Disease Control and Prevention website. Respiratory syncytial virus infection (RSV). Symptoms of RSV. www.cdc.gov/rsv/symptoms//. Updated June 5, 2024. Accessed June 19, 2024.

Centers for Disease Control and Prevention website. Respiratory virus guidance. www.cdc.gov/respiratory-viruses/guidance/. Updated March 1, 2024. Accessed March 6, 2024.

Talbot HK, Walsh EE. Respiratory syncytial virus and human metapneumovirus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 330.

Walsh EE, Englund JA. Respiratory syncytial virus. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 158.

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Review Date: 2/17/2024  

Reviewed By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 03/13/2024.

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