The human respiratory syncytial virus (RSV) is one of the most common viral infections affecting both children and the elderly worldwide.¹ Adults with certain chronic medical conditions are at increased risk for severe disease and hospitalization. RSV season in the United States typically begins in the fall and peaks during the winter months.² The virus spreads through respiratory droplets, with an incubation period of two to eight days following exposure. Globally, RSV is responsible for 33 million cases of lower respiratory tract illness, 3 million hospitalizations, and up to 199,000 childhood deaths, the majority of which occur in underdeveloped countries.¹

Preventing RSV

RSV can be prevented through vaccination, particularly for high-risk groups. Vaccination is recommended for expecting mothers between 32 and 36 weeks of pregnancy,³ as well as for older adults aged 60 and older.⁴ For infants whose mothers did not receive the maternal RSV vaccine, experts recommend administering a dose to infants younger than eight months just before the RSV season or within one week of birth during the RSV season. For high-risk children, a second dose is recommended for babies aged 8 to 19 months, especially if they were born prematurely, have chronic lung disease, or suffer from severe immunocompromisation.³

Symptoms and Complications

RSV is contagious for 3 to 8 days, but infants and individuals with weakened immune systems can continue to spread the virus for up to four weeks after symptoms resolve. Infections limited to the upper respiratory tract often present with a runny nose, nasal congestion, coughing, and sneezing. For high-risk patients under two years old, RSV can progress to the lower respiratory tract and cause more severe symptoms, including rattling or whistling breathing sounds, rapid and shallow breathing, and wheezing.¹

High-risk patients may require longer hospital stays and mechanical ventilation. In rare cases, RSV can lead to pneumonia, respiratory failure, apnea, and even death.¹

Diagnosing and Treating RSV

Testing for RSV is important for differentiating it from other respiratory illnesses. The two most common diagnostic tests are rapid antigen testing and polymerase chain reaction (PCR) testing. Treatment for RSV primarily focuses on supportive care, immune prophylaxis, and antiviral medication. High-risk patients may require hospitalization, especially if they need supplemental fluids or respiratory support. Severe cases may necessitate ventilatory support using a high-flow nasal cannula, intubation, or mechanical ventilation.¹

Sources 

1. Jain H, Schweitzer JW, Justice NA. Respiratory syncytial virus infection in children. [Updated 2023 Jun 20]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459215/
2. Center for Disease Control and Prevention. Clinical overview of RSV. Updated 30 Aug 2024. Accessed 1 Nov 2024. https://www.cdc.gov/rsv/hcp/clinical-overview/
3. Center for Disease Control and Prevention. Immunizations to protect infants. Updated 30 Aug 2024. Accessed 1 Nov 2024. ​​https://www.cdc.gov/rsv/vaccines/protect-infants
4. Center for Disease Control and Prevention. Vaccines for older adults. Updated 30 Aug 2024. Accessed 1 Nov 2024. https://www.cdc.gov/rsv/vaccines/older-adults