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RSV (Respiratory Syncytial Virus) Infection

RSV (respiratory syncytial virus) is a common cause of respiratory infections in people of all ages. RSV occurs more often in the winter and early spring. RSV is so common that almost all children have had the virus by age 2. Older adults and people who have weak immune systems can get RSV again later in life. This is because their immunity to RSV goes down over time. RSV symptoms are often mild. But RSV can be a serious problem for high-risk infants, young children, and older adults. These groups may have more serious infections and trouble breathing.

How RSV spreads

RSV spreads easily when a person with the infection coughs or sneezes. It spreads by direct contact with an infected person. For example, kissing a child with RSV spreads the virus. And the virus can live on hard surfaces. A person can get RSV by touching something with the virus on it. These can include crib rails and door knobs. It spreads quickly in group settings, such as daycare and schools.

Symptoms of RSV

Most babies and children with RSV have the same symptoms as a cold or flu. These include a stuffy or runny nose, a cough, headache, and a low-grade fever. Older adults may get pneumonia.

Treating RSV

RSV most often goes away on its own. There is no treatment for RSV in most cases. Antibiotics are not used unless your child has a bacterial infection. To ease some of your child's symptoms:

  • Ask your child’s healthcare provider or nurse about lowering your child's fever. You should know what medicine to use and how much and how often to use it. Make sure your child isn't wearing too much clothing. 

  • If your child is old enough, give him or her fluids, such as water and juice.

  • Remove mucus from your baby’s nose with a rubber bulb suction device. Be gentle so you don't cause more swelling and mild pain. Ask your child’s provider or nurse for instructions.

  • Don’t let anyone smoke around your child.

Babies and children with severe symptoms need to be treated in the hospital. They are watched closely. They may have treatment such as:

  • IV (intravenous) fluids

  • Oxygen 

  • Suctioning of mucus

  • Breathing treatments

  • Anti-inflammatory medicine such as steroids

Children with very serious breathing problems have a breathing tube. The tube is put in the throat and down into the lungs. This is called intubation. The tube is attached to a machine (ventilator) that helps them breathe.  

When to call the healthcare provider

Call your child's provider right away if your child has any of these:

  • Fever (see "Fever and children" below)

  • A seizure with a high fever

  • A cough

  • Wheezing, breathing faster than normal, or trouble breathing

  • Flaring the nostrils or straining the chest or stomach while breathing

  • Skin around the mouth or fingers turns a blue color

  • Restlessness or grouchiness, can't be soothed

  • Trouble eating, drinking, or swallowing

  • Shortness of breath

  • Needing to sit upright (in bed or in a chair) to catch his or her breath

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead temperature of 100.4°F (38°C) or higher, or as directed by the provider.

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider.

Child age 3 to 36 months:

  • Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider.

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider.

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider.

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.


Preventing RSV infection

To help prevent the infection:

  • Clean your hands before and after holding or touching your child. Use alcohol-based hand cleaners. Or wash your hands with warm water and soap for at least 15 to 30 seconds.  

  • Clean all surfaces with disinfectant cleaners or wipes.

  • Teach your child to keep his or her hands clean. Have your child wash his or her hands often. Teach them wash their hands for as long as it takes to sing the ABC song or the Happy Birthday song. Or have them use an alcohol-based hand cleaner.

  • Have all family members or caregivers clean their hands before holding or touching your child.

  • Closely watch your own health and that of family members and your child’s friends. Try to prevent contact between your child and those with a cold or fever.

  • Don’t smoke around your child.

  • Ask your child's healthcare provider if your child is at risk for RSV. If your child is at risk, he or she may get shots (injections) during RSV season. These are to help prevent the illness.

Online Medical Reviewer: Barry Zingman MD
Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Date Last Reviewed: 6/1/2019
© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.