Understanding How RSV, Respiratory Syncytial Virus, Affects Children

NICU infant

Respiratory syncytial virus, or RSV, is one of the most common causes of seasonal illness in children, and this year it has come on strong.

Christopher Wilhelm, MD
Christopher Wilhelm, MD

“We usually see RSV cases peak between February and March, but this year it’s come early,” said Christopher Wilhelm, MD, a pediatrician at MU Health Care who practices at Battle Avenue Medical Building. “The main spread is in daycares and at school.”

Wilhelm also said MU Health Care doctors are seeing more cases than they would expect during a normal seasonal surge.

In many cases, RSV causes symptoms similar to a cold. But it can be a serious infection for children with a compromised immune system, including children younger than 6 months, those born prematurely or children with asthma, lung or heart conditions.

“The kids we’re most concerned about are those who are at risk, the ones who are under 6 months or have an underlying medical condition. If a 6-year-old gets RSV, it’s usually just a bad cold,” Wilhelm said.

Does my child have RSV?

During cold season, many illnesses can look, sound or feel similar. RSV diagnosis can only be confirmed by a lab test, but the illness has specific symptoms. Common symptoms of mild RSV that develop in the first days after infection include:

  • Cough that may develop into wheezing (breathing that creates a sound different from normal breathing)
  • Runny nose, post-nasal drip and sore throat
  • Decrease in appetite or activity
  • Irritable or fussy behavior

One indicator of RSV infection is severe nasal congestion that is not allergy related. In some cases, RSV infection leads to a mild fever (approximately 100.4 F or 38 C) and headaches. Symptoms can last for as long as two weeks. RSV does not lead to chills or body aches like flu, or a loss of taste and smell like COVID-19.

When should my child see a doctor?

If you have a sick infant who is very young, was born prematurely, or has other lung or heart conditions, you should speak with their doctor. Wilhelm recommends seeking medical attention from a Mizzou Urgent Care clinic or MU Health Care’s Children’s Emergency Room if your child is less than 4 weeks old and shows any of the following symptoms:

  • Has a fever of 100.4 F (38 C)
  • Dehydration (dry lips and tongue, no tears when crying, blotchy and cool hands or feet)
  • Extreme fussiness
  • Respiratory distress or difficulty breathing, including belly breathing or displayed ribs during breathing, or pauses while breathing

Can I treat RSV at home?

In many cases, yes. If you or your child has mild symptoms, you can manage them from home using age-appropriate, over-the-counter medications. There is no specific medication or vaccine for RSV.

In children younger than 4, avoid managing nasal congestion with medication and use suction or nasal saline to relieve congestion.

“If your infant is sick, clearing nasal congestion with a bulb or other device is the main thing,” Wilhelm said. “If they have trouble feeding, have a fever or have any signs of respiratory distress, we recommend bringing them in to their pediatrician’s office or the emergency department.”

How do I avoid getting RSV?

Because RSV is highly contagious, you should stay home if you feel sick and avoid close contact with sick people. According to Dr. Wilhelm, it’s best to avoid kissing, holding or other contact with infants if you feel sick. Good hygiene habits go a long way in keeping RSV from spreading.

  • Wash your hands regularly.
  • Cover your coughs and sneezes with the crook of your arm and wash your hands after coughing or sneezing.
  • Try not to touch your face with unwashed hands.
  • Clean commonly used surfaces in shared spaces regularly with disinfectant. RSV can survive on hard surfaces like tables and counters for hours.
RSV Infographic