Respiratory Syncytial Virus (RSV)

Respiratory Syncytial Virus (RSV) 

Respiratory Syncytial Virus (sin-SISH-uhl), better known as RSV, is a common respiratory virus that often causes mild, cold-like symptoms. It is also the major cause of pneumonia and bronchiolitis among infants and young children. Those with the highest risk of severe RSV and needing hospitalization are infants, older adults, and adults with chronic medical conditions. . Almost all children will be infected with RSV by the age of 2 years old, and symptoms will vary with age. Historically, preventative healthcare was not available for RSV, but as of this year, there are now preventive options available for infants, young children, and older adults found here: https://www.cdc.gov/vaccines/vpd/rsv/index.html

Transmission

RSV spreads through fomites (objects like door handles or clothing) and person-to-person contact. Common ways to RSV spreads include:

  • Touching your face after touching an infected surface such as door handles, clothing, tables, and electronics before washing your hands
  • An infected person coughs or sneezes and droplets get in your eyes, nose or mouth
  • Direct contact with an infected person such as kissing the face of an infected individual

While most people are infected with RSV before their second birthday, re-infection is possible later in life, even as an adult.

Am I contagious if I have RSV and if so for how long?

RSV is very contagious as it lives on objects and can be spread by person-to-person contact. The virus can continue to live on hard surfaced objects for hours and can survive on soft objects like clothing for shorter periods of time. To avoid spreading any respiratory virus, persons who are sick should disinfect objects often and always wash their hands!

If infected with RSV, an individual is typically contagious for 3-8 days after symptoms start but may have been contagious 1-2 days before symptom onset. Usually, an individual is no longer contagious after symptoms stop. However, those with weakened immune systems and infants can continue to be contagious for up to 4 weeks. Please keep this in mind if your infant has had RSV in the last 4 weeks to prevent infecting others (especially other at-risk individuals like infants and older adults), and keep in mind that children are often infected with RSV when they are outside of the house in settings like daycare or school.

Symptoms

Symptoms typically appear in people infected with RSV 4-6 days after being infected. These symptoms in toddlers (over 2 years of age) and healthy adults are typically cold-like and include, but are not limited to:

  • Runny nose
  • Decrease in appetite
  • Coughing
  • Sneezing
  • Fever
  • Wheezing

Infants younger than 6 months of age, particularly premature infants (born before 37 weeks gestation, or at least one month early), generally have the more severe symptoms and often require hospitalization. Symptoms in these children may not be as easy to diagnose and can include:

  • Irritability
  • Decreased activity
  • Breathing difficulties

Whether you suspect your child may have RSV based on these symptoms, please seek care from your healthcare provider if your child is having difficulty breathing, not drinking enough fluids, or is having worsening symptoms.

Care

Most people infected with RSV get better on their own within about 1-2 weeks, antivirals are not commonly prescribed. Those with severe RSV infections may be given antivirals or may require more serious care.

Severe symptoms typically only affect infants and older adults but can happen to anyone. Sometimes they require hospitalization. Medical providers may provide IV fluids (for dehydration), additional oxygen, or intubation with mechanical ventilation to assist an individual breathe. Hospitalizations typically last a few days but can be longer. Severe RSV should be taken seriously as it can be fatal.

What can I do to relieve my or my child’s symptoms at home if they are not severe?

  • Drink plenty of fluids to prevent dehydration. This can be through plain water, drinks with added electrolytes, and options for younger children such as Pedialyte.
  • Manage fever and/or pain with over-the-counter fever and pain relievers such as ibuprofen or acetaminophen. Never give aspirin to children and be aware of allergies/counteractions with other medications to NSAIDs (which includes but is not limited to ibuprofen and aspirin).
  • Discuss other nonprescription medications you can use for your children with your healthcare provider. Some medications you may take yourself/other adults are not good for children.

What should I do if the RSV infection worsens or becomes severe?

Seek medical care if the sick individual continues to worsen or has severe symptoms such as:

  • Issues breathing
  • Dehydration that persists even after drinking plenty of fluids.

RSV Prevention

CDC has recommended multiple, new immunizations to protect those most at risk of getting very sick with RSV. For others who are less likely to get a severe RSV illness, everyday preventive actions can reduce the likelihood of spreading RSV.

RSV vaccines help protect adults 60 years and older from severe RSV illness. Older adults are at greater risk than young adults for serious complications from RSV because immune systems weaken with age. Older adults with underlying conditions may especially benefit from getting the RSV vaccine. If you are 60 years and older, talk to your healthcare provider to see if RSV vaccination is right for you.

For information about where to find vaccines in your area, visit Vaccine Information for Adults | Where to Find Adult Vaccines | CDC.

There are two options available to protect infants and young toddlers:

Getting an RSV vaccine if you are 32-36 weeks pregnant during RSV season. This vaccine is recommended during September through January for most of the United States because RSV is typically a fall and winter virus. The seasonality of RSV season may vary depending on where you live, and state, local, or territorial health departments may recommend different timing for administration for their area.

Getting an RSV antibody immunization for your baby if they are younger than 8 months and born during, or entering, their first RSV season. In rare cases, a healthcare provider may determine an RSV immunization is needed for an infant even though the mother received an RSV vaccine.

A dose of RSV antibody is also recommended for children between the ages of 8 and 19 months entering their second RSV season who have underlying conditions and/or are immunocompromised.

You can take everyday prevention measures to help reduce the spread of RSV and other respiratory illnesses.

  • Stay home when sick.
  • Cover your coughs and sneezes with a tissue or your shirt sleeve, not your hands.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Avoid touching your face with unwashed hands.
  • Avoid close contact with others, such as kissing, shaking hands, and sharing cups and eating utensils.

Clean frequently touched surfaces such as doorknobs and mobile devices.

RSV Surveillance

Seasonal epidemics of RSV occur yearly in Georgia and other temperate areas, during the fall and winter months. The Georgia Department of Public Health (DPH) tracks RSV trends through laboratory reporting to the National Respiratory and Enteric Virus Surveillance System (NREVSS). In this system, each week, participating medical laboratories statewide report the number of RSV tests performed and the number of positive tests, providing useful information for RSV prevention.

To be consistent with the CDC, DPH has modified the RSV surveillance definition to reflect changes made to the calculation of RSV season onset and end. Season onset is defined as the first week of two consecutive weeks when the percent positive of ALL laboratory-confirmed tests are greater than or equal a certain threshold. The end is defined as the first week of two consecutive weeks when the percent positive of ALL laboratory-confirmed tests are less than a certain threshold. For antigen-based testing, the threshold is 10% and for PCR the threshold is 3%.

Participating Medical Laboratories

The Georgia Department of Public Health would like to thank the following Georgia medical laboratories that provide information for RSV surveillance by participating in the National Enteric and Respiratory Virus Surveillance System (NREVSS), which is coordinated by the Centers for Disease Control and Prevention (CDC). If you would like more information about participation in NREVSS, please visit http://www.cdc.gov/surveillance/nrevss/

Participating Medical Laboratories (Last updated October 20, 2023)

  • Bacon County Hospital, Athens, GA
  • Children's Healthcare of Atlanta at Scottish Rite, Atlanta, GA
  • Columbus Regional Hospital, Columbus, GA
  • Fort Moore (formerly Fort Benning), Columbus, GA
  • Georgia Public Health Laboratory, Decatur, GA
  • Medical Center of Central Georgia, Macon, GA
  • NE Georgia Medical Center, Gainesville, GA
  • Piedmont Athens Regional Center, Athens, GA
  • Stephens County Hospital, Toccoa, GA
  • West Georgia Medical Center, LaGrange, GA

Page last updated 10/23/23