Respiratory syncytial virus

Respiratory syncytial virus (RSV) is one of the main causes of respiratory illness in babies and young children – in fact it’s so common that most children have had it by the time they reach 2 years of age.

When RSV affects older children and adults the symptoms are usually mild, and resemble the common cold. In babies, however, symptoms can be severe, especially in preemies, babies under 6 months of age, and babies with underlying health conditions, such as heart or lung problems.

What are the symptoms?

If you or your older child gets RSV you’ll likely suffer from cold-like symptoms, including a runny or stuffy up nose, a sore throat and couch, a headache and a mild fever. In babies, RSV can result in ear infections, pneumonia or bronchiolitis (inflammation of the tiny airways in the lungs).

Symptoms of these complications may include a high fever, wheezing, a severe cough and rapid, shallow or labored breathing. Shortness of breath can cause cyanosis, where your baby’s lips may take on a bluish tinge due to lack of oxygen in her blood and you should immediately seek medical attention if this happens. In rare cases, and if your baby was premature or has chronic heart or lung problems, she might need to be admitted to hospital (each year, up to 125,000 infants in the US are hospitalized with severe RSV).

Treatment

• Try to distract your baby or child from the symptoms with a cuddle, quiet game or story.
• Use a humidifier to keep the air around her moist, as this will ease her breathing. 
• Keeping her as upright as possible can also help – carry her in her sling or sit her in her car seat when she is awake. At night, prop up the head end of her crib by placing a couple of thick books (phone books are ideal) under the legs. 
• Give her plenty of fluids, especially if she has a fever. Breast or bottlefeed as usual (though you may find her appetite isn’t as good as usual).
• Try saline nasal drops to ease congestion – these are suitable even for very young children (check with your pediatrician if you’re unsure). They can loosen mucus, enabling it to be removed with a bulb syringe – it’s a good idea to do this before feeds and at bedtime.
• A fever reducer, such as infant ibuprofen, can help ease your baby’s discomfort but check with your pediatrician before giving it and don’t give any additional cold and cough remedies along with it.
  

If your baby is at high risk for complications if she gets RSV, your pediatrician may prescribe protective medication via a monthly injection, to stimulate your baby’s immune system to produce antibodies against RSV. This can decrease the frequency and length of hospitalization for RSV but won’t treat it once your baby already has it. 

Prevention

RSV is spread by droplets from infected people coughing or sneezing, which are either inhaled or transmitted via your hands (RSV can survive for several hours on objects such as toys, countertops and doorknobs). This means that the simple precaution of frequently washing your hands, and your child’s, can be one of the most effective ways to protect you from infection. If you have an older child, make sure he know he too must wash his hands often, and always before touching or playing with his baby brother or sister.

Babies who go to daycare or who have older siblings who go to daycare or school are at highest risk of RSV, so if your older child is showing symptoms (peak season for RSV is from fall through to spring), try to minimize his contact with your baby. You should also keep your baby well away from anyone with a cold or fever, particularly in the first few months after her birth. It’s also vital that your child isn’t exposed to cigarette smoke as this has been shown to increase the risk and severity of RSV.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.