RSV symptoms are mild but can lead to serious illness in some children. Washing hands, wearing masks, and cleaning surfaces can help keep your kids safe.
Respiratory syncytial virus (RSV) is a common respiratory virus that can affect people of any age. It can cause cold-like symptoms that are often mild.
But it can lead to more severe symptoms, such as difficulty breathing, in infants, older adults, and people with certain medical conditions.
RSV cases dropped at the start of the pandemic as communities put in place face mask policies and other measures to slow the spread of the coronavirus that causes COVID-19.
As these mitigation measures were lifted in the spring of 2021, RSV cases returned and persisted through the fall.
A rise in RSV cases can put additional stress on hospitals and medical offices.
Healthline asked three medical experts whether RSV cases are rising and to provide advice for parents of young children.
Dr. Daniel Ganjian is a pediatrician at Providence Saint John’s Health Center in Santa Monica, California.
Dr. Jonathan Maynard is a pediatrician at Providence Mission Heritage Medical Group in Orange County, California.
Dr. Juanita Mora is an allergist/immunologist and National Volunteer Medical Spokesperson for the American Lung Association in Chicago.
Here’s what they had to say.
Ganjian: During the pandemic, many people were masking and doing a good job with hygiene, so most of them haven’t gotten RSV over the past few years.
Because of that, people’s antibody levels for RSV were very low, so people were more prone to getting RSV — that includes adults, kids, and babies.
Generally, when RSV surges happen, they are short-lived because many people get the virus during a short period, and it goes away.
Mora: Part of [the reason for the RSV surge in 2022] was because we were coming out of the pandemic. COVID restrictions were being lifted in school settings or even in public places, such as airports.
We also had children doing a lot of virtual schooling at home [during the pandemic], so they didn’t get sick as often. Usually, most kids will have RSV by age 2.
So, we had a whole population of younger children who had never seen RSV because they were at home often and wearing masks when in school.
On top of that, many kids who had RSV before were getting reinfected.
Ganjian: There’s no special medication for RSV. You treat it like a common cold — nasal saline, suctioning the nose, vaporizer, acetaminophen, or ibuprofen for any pain or fever, and plenty of TLC.
The symptoms usually worsen on days three to four, then they start dissipating. It takes about a week or sometimes 2 weeks for symptoms to go away completely.
Maynard: There’s no proven treatment for the RSV virus itself. RSV care, therefore, focuses on the type and severity of symptoms.
In severe cases — especially those complicated by bronchiolitis, pneumonia, or apnea — patients may need to be hospitalized for respiratory support and treatment of dehydration.
Most children, however, are able to rest and recover at home without requiring medication.
Mora: Because we’re living in a tri-demic with COVID-19, RSV, and the flu — which often have similar symptoms initially — one quick thing you can do at home is a COVID-19 test of your child.
Then, start giving medication to relieve their symptoms and provide supportive therapy — lots of fluids, ibuprofen if needed for fever, etc.
If the symptoms worsen, call your child’s pediatrician. They can do a nasal swab to test for … flu, and RSV, with an answer within minutes.
A word of caution
Don’t give acetaminophen to a child under 12 weeks of age or ibuprofen to a child under 6 months old unless recommended by your child’s doctor.
Maynard: RSV often starts with nasal congestion and a runny nose. After a few days, people develop cough, fever, and wheezing. For most patients, the symptoms are mild and resolve over a few weeks. For a small number of patients, the respiratory symptoms may become more severe and lead to difficulty breathing.
Parents should take their child to the emergency department if the child shows signs of difficulty breathing, which may include rapid breathing, flaring of the nostrils, the skin sinking between the ribs during breaths (intercostal retractions), wheezing and decreased activity or body tone.
Mora: RSV begins with mild cold-like symptoms — runny nose, sneezing, etc. — but once it hits the lungs, babies can start having trouble breathing.
So if there is any sign of respiratory distress — their chest wall is moving up and down, or they start having a worsening cough — parents should definitely take the child to the emergency department.
The same with signs of dehydration. I tell parents to watch the number of diapers they’re changing, especially in babies. If the number of diapers starts to decrease, this might be a sign of dehydration. If so, seek medical care right away.
Ganjian: Kids generally do well with RSV. It’s the very young children and premature infants who are at higher risk for having more severe illness.
Also, older adults and adults with certain medical conditions have a higher risk of more severe illness with RSV. These conditions include heart disease, lung disease, and immune deficiency.
Maynard: For young children (under 5 years old) and children with underlying health problems (lung and heart disease, immunosuppression, etc.), severe RSV infections can sometimes lead to significant difficulty breathing.
Along with breathing difficulty comes the risk of significant dehydration, as children are unable to drink adequately due to feeling short of breath. A small number of infants with severe RSV may even develop episodes of apnea, where they briefly stop breathing.
Mora: Children who are born prematurely — those born less than 32 weeks of gestational age — are at higher risk for complications from RSV because their lungs are not well developed.
Also at higher risk are children with congenital heart disease, lung problems such as severe asthma, or a neuromuscular disorder that affects their breathing.
Ganjian: If your child has RSV or cold-like symptoms, don’t send them to school without first seeing a doctor, especially if the child has had a fever in the last 24 hours or their cough is worsening. You can ask your child’s doctor how long to keep them out of school.
Mora: If a child is sick, we want parents to not send their child to school or day care. I tell them, “Keep the germs at home.”
Ganjian: To help keep your child healthy, you want to make sure their immune system is working optimally. That means making sure they get good sleep and good nutrition. Also, they should practice good hygiene, such as washing their hands before they eat.
If there’s a baby at home with an older child who goes to school, have your older child shower and change their clothes when they come home from school. Then, they can play with the baby.
Also, keeping a happy environment at home can support the immune system and help children fight off common viruses.
Maynard: RSV is highly contagious. It’s mostly spread by direct contact with the respiratory secretions of an infected individual or with an object those secretions have contaminated.
It can also spread up to 6 feet away when an infected individual coughs or sneezes. Wearing masks, washing hands frequently, and cleaning common surfaces are very effective ways to prevent infection.
Mora: Helping children wash their hands frequently — or use hand sanitizer — will be important. Also, if a child is sick at home, especially in a multigenerational home, have them wear a mask.
This is especially important if someone in the house is immunocompromised, such as a grandparent or an aunt or uncle who might be on chemotherapy or have diabetes, COPD, or anything that puts them at high risk of complications.
Mora: Families will be gathering over the coming months for Halloween, Thanksgiving, and other holidays. To protect children and their family members, children who are eligible should get an updated COVID-19 booster and the influenza vaccine.
A word on vaccinations
Children 6 months or older are eligible for the
Note that the bivalent COVID-19 booster is only for children who have not received one before. There’s no current recommendation for a “seasonal” COVID-19 booster like there is for influenza.
Respiratory syncytial virus (RSV) commonly affects people of all ages. It’s one of the most common causes of colds in the winter. Symptoms are usually mild and go away within a few weeks.
Infants, older adults, and those with weakened immune systems have an increased risk for more severe symptoms, such as trouble breathing and dehydration.
If your child has mild symptoms, you can manage it at home with over-the-counter treatments. If your child’s symptoms don’t improve or worsen, contact a doctor right away or take your child to the emergency room.
You can take steps to prevent RSV or stop it from spreading to others, such as frequent handwashing and limiting contact with people or surfaces that are contaminated with the virus.