Respiratory tract infections (RTIs) occur when you develop an infection in areas of the body responsible for breathing. RTIs can develop in the nose, throat, airways, or lungs.

Respiratory syncytial virus (RSV) is a common cause of RTIs in the United States. It affects approximately 5% of adults annually and is responsible for as many as 80,000 hospitalizations in children under 1 year of age.

If left untreated, severe RSV can be fatal. According to the National Foundation for Infectious Diseases (NFID), RSV causes an estimated 100–300 deaths in children under the age of 5 years annually.

RSV symptoms affect everyone differently — including children. Around 90% of children contract the virus by the age of 2, according to research from 2022. However, many never experience severe symptoms.

Among children, infants are particularly vulnerable to developing severe RSV. Smaller airways make it easier for inflammation and mucus to cause obstructions. Babies’ immune systems aren’t usually as strong as those of older children for fighting RSV.

RSV can be challenging to spot in its early stage, even in infants. Symptoms may appear to be those of a mild cold.

symptoms of RSV in childrenShare on Pinterest
Medical Illustration by Bailey Mariner

Some, but not all, children may experience a fever with RSV infection.

For many children, symptoms remain mild and resolve in a few days. Signs that RSV is progressing and medical attention is needed include:

  • wheezing or difficulty breathing
  • nostril flaring
  • rapid, shallow breathing
  • pauses in breathing, known as apnea
  • bluish-colored skin, lips, or nails
  • prolonged or persistent vomiting

Dehydration can become a concern in RSV. Children may express they have a dry mouth or persistent thirst, for example, or they may become unable to produce tears. Discolored and decreased urine output can also be a warning sign.

According to the Centers for Disease Control (CDC), children at the highest risk for developing severe RSV include those:

  • living with neuromuscular disorders, such as those that make swallowing or clearing mucus a challenge
  • born prematurely
  • under the age of 12 months, particularly infants 6 months and under
  • 2 years and younger born with heart disease or chronic lung disease
  • with compromised immune systems

Racial and ethnic disparities

RSV doesn’t discriminate. It can affect any child of any race or ethnicity, but disparities do exist.

Research from 2023 indicates that Black and Hispanic children have an increased risk of infectious respiratory diseases, such as RSV. The researchers note that several factors, such as higher rates of poverty and chronic conditions, may contribute to this increased risk.

A special note

Most of the research on RSV has limited or no participants from underserved populations. More racial diversity in clinical trials is needed to understand how RSV affects these communities.

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Socioeconomic risk factors

Socioeconomic factors can also influence a child’s risk for RSV-related hospitalization.

Limited disease education, poverty, language barriers, and lack of access to culturally and clinically appropriate care can affect health outcomes for children and adults.

A 2021 study suggested that additional socioeconomic factors that might increase a child’s RSV hospitalization risk include:

  • being born to a young mother
  • having a mother with criminal involvement
  • having a mother living with serious mental health or substance misuse challenges
  • being born into a family relying on welfare-based insurance

Other vulnerable populations

Young children aren’t the only ones considered high risk for severe RSV infection. Other high risk groups include people who are:

  • over the age of 65
  • living with chronic heart or lung disease
  • living with immunosuppressive disorders or weakened immune systems
  • staying in long-term care facilities
  • experiencing underlying health conditions

RSV affects almost all children at some point, but there are ways you can reduce the risk of exposure and help protect children who may be at risk for severe RSV.

Simple steps that can prevent RSV include:

  • avoiding contact with people who may have RSV
  • not sharing toys, bottles, cups, or utensils with others
  • regularly washing hands with soap and water
  • covering mouths when sneezing or coughing
  • regularly disinfecting household surfaces
  • teaching children the importance of not touching their face with their hands
  • not touching your child’s face with unwashed hands

To help reduce the chances that RSV will become severe, infants and young children can receive a monoclonal antibody injection that gives the body a temporary immunity boost against RSV infection during peak season when the rate of RSV cases is high.

Monoclonal antibodies aren’t vaccines. They’re products that contain proteins that mimic the body’s natural antibodies to fight off infections.

If you’re concerned about RSV, talk with your doctor about the monoclonal antibody treatment.

RSV is a common cause of respiratory infections for both children and adults.

In children, symptoms may appear like the common cold. Coughing and congestion are typical, and fever is possible. RSV that becomes severe can cause major breathing challenges and dehydration and can be fatal if not treated.

Very young children, older adults, and those living with certain medical conditions are at a higher risk for severe RSV illness, but practical prevention steps and symptom awareness can help lower risk factors.

To learn more about RSV, you can visit the following resources: