Preparing for RSV Season
UT Health Austin pediatrician offers valuable insights on effectively managing the anticipated surges in respiratory syncytial virus (RSV)
Reviewed by: Lisa Doggett, MD, MPH, FAAFP, DipABLM; and Alefiyah Malbari, MD
Written by: Kaylee Fang
Respiratory Syncytial Virus (RSV) is a prevalent respiratory virus affecting both adults and children. While adults may experience cold or flu-like symptoms, such as fever, nasal congestion, and a cough that may linger for several days afterward, RSV is particularly concerning for children under the age of one, as RSV is a common cause of lower respiratory tract infections.
“Pediatrician offices, urgent care centers, emergency departments, and hospitals are seeing record numbers of patients with respiratory viruses including RSV in the past several weeks. The season for respiratory viruses, such as RSV, used to begin in October, but many areas across the U.S. have witnessed patients beginning to get sick from respiratory viruses during the Summer season,” explains UT Health Austin pediatrician Alefiyah Malbari, MD, who serves as the Chief of Dell Children’s Medical Group Pediatrics Mueller, a clinical partnership between Dell Children’s Medical Center and UT Health Austin.
RSV generally lasts 5-7 days. Symptoms tend to peak between 3-5 days and then begin to improve. Your child should stay home until they are fever-free for more than 24 hours without fever-reducing medication and their symptoms have begun to improve. “If your child has a fever that has been coming and going for more than 2 days, is experiencing poor feeding, or producing fewer wet diapers, they should be seen by their pediatrician,” warns Dr. Malbari.
In the first 3-5 days of RSV, symptoms may include:
- Fever
- Wet or dry cough
- Nasal congestion
- Runny nose
- Irritability or fussiness
- Poor feeding
“If your child develops symptoms, including fever, cough, runny nose, and congestion, call your pediatrician’s office in the early stages of symptom onset to determine whether they need to be seen,” advises Dr. Malbari.
RSV vs. Flu
Although RSV and flu are both caused by viruses, the conditions are associated with slightly different symptoms. A distinct symptom of RSV is wheezing. This can lead to bronchiolitis, which is inflammation of the small airways in the lung. If bronchiolitis is present, you may notice hard and fast breathing, nasal flaring, or audible wheezing sounds.
The following children are at higher risk for RSV and RSV-associated bronchiolitis:
- Infants less than 2 years old (especially those less than 6 months of age)
- Premature infants born at less than 35 weeks
- Children with asthma
- Children who are immunocompromised (taking immunosuppressive medications, including chemotherapy, have had a transplant, etc.)
- Children with underlying lung disease (chronic lung disease, cystic fibrosis, etc.)
- Children with congenital heart disease
- Children with Down syndrome
- Children exposed to secondhand smoke
- Children who are exposed to other children in daycares or schools
“Older children and adults who do not have any underlying medical issues are less likely to experience any health complications,” notes Dr. Malbari.
Watch out for any of these signs of respiratory distress if you suspect you or your child have RSV:
- Deep sucking in of the chest with each breath
- Fast breathing
- Abnormally slow breathing
- Flaring of the nostrils
- Inability to speak in full sentences if your child can talk already
If you are worried about respiratory distress, hydration status, or any other concerning symptoms, seek medical attention immediately.
In addition to monitoring your child’s health, consider implementing the following practices to provide comfort and aid recovery from RSV:
- Staying hydrated: Pay close attention to ensure your child stays hydrated. Children with RSV often will not have an appetite due to congestion and fever. They may be eating and drinking a lot less. Encourage them to drink liquids throughout the illness. They should urinate at least 3 times in 24 hours and at least once in 12 hours.
- Clearing nasal congestion: Make sure your child is breathing comfortably. Steam can help relieve nasal congestion and sinus pressure. Run a hot shower and sit in the steamy bathroom with your child. Have cool mist humidifiers in their room.
- Relieving a cough: Honey can be given to help with a cough for children over the age of one. Babies younger than the age of one should NOT be given honey.
- Seeking support: Ask your pediatrician if acetaminophen or ibuprofen can be given to your child to reduce fevers. Stay in touch with your pediatrician if your child is sick. They can address your concerns and guide you on the next steps.
Learn more about the latest CDC guidelines and recommendations regarding flu and COVID-19.
<br>RSV Vaccination
RSV vaccines are most effective when administered during infancy, providing protection to children at their highest risk of severe illness. “RSV vaccination of the expectant parent or administration of RSV antibody (nirsevimab) to infants under the age of 8 months is recommended to prevent severe RSV infections,” suggests Lisa Doggett, MD, MPH, FAAFP, DipABLM, a board-certified family and lifestyle medicine specialist in UT Health Austin’s Multiple Sclerosis and Neuroimmunology Center. “Most infants will not need both.”
Administration of the RSV monoclonal antibody is recommended shortly before the RSV season begins in the fall or within the first week after birth for babies born between October and March in most parts of the U.S.
“Older adults also are at risk for severe illness if they are infected with RSV,” adds Dr. Doggett. “The CDC now recommends a single dose of the RSV vaccine for all adults aged 75 and older as well as for adults aged 60 to 74 who are at increased risk of poor outcomes.”
Eligible adults can receive the RSV vaccine at any time, though late summer or early fall is optimal to ensure protection before RSV typically begins to spread. “This is currently a one-time vaccine,” emphasizes Dr. Doggett. “That could change as we learn more about the long-term effectiveness of the vaccine, but for now, it’s not required annually.”
RSV Testing
RSV can be tested using a nasal swab. Rapid tests and lab tests are available. Some pediatrician offices, urgent care, clinics, emergency departments, and hospitals will provide RSV testing.
“There is no specific treatment for RSV, and since knowing the diagnosis does not change recommendations for management, for the most part, testing is not conducted routinely in all patients,” explains Dr. Malbari.
Prevention Tips
RSV is transmitted primarily through viral particles spread through nasal and oral discharge. These particles linger on food and objects and can easily be passed from person to person.
Follow these preventative measures to help keep you and your loved ones safe from RSV:
- Wash your hands frequently
- Avoid close contact with those who are sick
- Avoid sharing food with others
- Disinfect toys and other commonly shared objects
- Stay home if you or your child is feeling sick
“RSV particles can also transmit into the air,” says Dr. Malbari. “Masking can help to prevent the transmission of respiratory viruses from person to person.”