So What Exactly Is RSV?

By Alison Adduono, Director of Marketing Communication

The Pediatric Intensive Care Unit (PICU) was not exactly where neighbor Randy thought he and his wife would be spending their time with their six-week-old daughter during the holidays. Baby’s first Christmas should have been a happy occasion, but Randy and Jennifer found themselves praying over their little girl who had contracted RSV.

How did she get it at just 6 weeks old? Her older brother brought it home from daycare. Thankfully, after four tense and stressful days everything turned out okay for the family, but RSV has moved to the top of the viral concern list for many over the last couple of months.

Photo Credit: iStock by Getty Images

Unless you work in the healthcare environment, manufacture medical devices, vaccines or pharmaceuticals, or have had a family member diagnosed with RSV (like the above family), you may never have given it much thought or even heard of it until now. With the “tripledemic” (Covid19, Influenza and RSV) being constantly in the news and actors (such as Amy Schumer) sharing their family experiences, RSV has received a lot of coverage.

Known as the Respiratory Syncytial (pronounced sin-sish-uhl) Virus, or RSV for short, it is a common respiratory virus that usually causes mild, cold-like symptoms. Historically, RSV was considered a pediatric “rite of passage” virus, like chicken pox: you would contract it, develop immunity to it, and likely never contract it again.  But for a small percentage of the pediatric population, RSV does prove much more serious, resulting in hospitalization and in some case, ventilation or prolonged oxygen supplementation. The challenge:  there is no anti-viral developed specifically to counter the upper-respiratory symptoms nor to prevent its progression into the lungs. In rare cases, it can prove fatal for pediatric patients.  

RSV isn’t just a pediatric illness, however.  Nursing homes and assisted living facilities have long kept vigilance for RSV outbreaks among the immunity-suppressed elder population as well. COVID-19 brought this to the forefront of concern when patients would develop COVID-like symptoms but consistently test negative for the SARS-CoV-2 virus. Even internal medicine physicians started testing older adults routinely to measure RSV incidence where previously people had felt they just had a bad “chest cold”.

Almost everyone recovers within a few weeks from RSV, but infants and adults with chronic heart or lung diseases, diabetes, elderly individuals (especially those over 65 years old), and individuals with weakened immune systems are at highest risk for severe RSV infections, according to the US Centers for Disease Control and Prevention.

An RSV infection can increase in severity developing bronchiolitis (an inflammatory condition of the bronchioles) and can cause pneumonia (an infection that fills the air sacs in one or both lungs with fluid) and can also exacerbate other conditions such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and asthma.

Clinical facts about RSV

According to some Fast Facts compiled by Sanofi, two out of three children under the age of 1 will get RSV. Infants are 16 times more likely to experience a hospitalization due to RSV than as a result of the flu.

Between 60,000 and 120,000 older Americans are hospitalized with RSV each year, and between 6,000 and 10,000 die from the disease, according to the CDC. As for children under the age of 5, between 58,000 and 80,000 are hospitalized with RSV infections.

Until recently, physicians believed adults and elderly patients were immune to RSV since they already had it as children.

RSV kills over 100,000 children worldwide every year, primarily in countries with lower access to healthcare.

What are the symptoms and how does it spread?

Mimicking flu or a common cold, RSV symptoms can range from mild to severe and can last about 2 weeks. They are:

• Fever

• Sore throat

• Cough

• Congestion

• Runny nose

• Headache

• Fatigue

• Decreased appetite

• Labored breathing/wheezing

Since no vaccine or target-specific antiviral has been developed yet for RSV the best course of protection is to follow these recommendations:

• Learning who is at risk of severe complications and avoid them if possible if you are sick or have been exposed

• Avoid contact with sick people

• Cover your coughs and sneezes

• Wash your hands and/or use sanitizer often

• Avoid touching your face

• Clean and disinfect surfaces such as counters, sinks, faucets, doorknobs, etc.

• Differentiate between infectious diseases and other conditions in which a specific treatment may be available, such as strep throat, bacterial pneumonia, influenza, and Covid-19, etc.

RSV is an infection that people can get multiple times throughout their life if they are unlucky enough. Coughs and sneezes produce airborne viral-laden droplets that can easily spread RSV, just as they can with other respiratory infections. Generally, people are contagious for 3-8 days. However, contagiousness can last up to 4 weeks, especially for those with weakened immune systems.

What to do?

If you or a family member are experiencing symptoms, are part of an at-risk population, and may have been exposed to RSV, consult your physician for their best recommendations for your case and/or to be tested to rule out another infection or ailment.

Since there is no specific treatment for RSV, manage the symptoms. Keep hydrated, manage any fever with OTC pain relievers such as acetaminophen, and clear a stuffy nose by blowing, suctioning or using nasal saline drops. As always, before giving an infant or child any non-prescription medications, check with your doctor.

When should you go to the hospital?

While many RSV infections go away on their own within a week or two and most healthy adults and children typically do not require hospitalization, some patients may experience problems breathing (and require oxygen, intubation, or a ventilator) or become severely dehydrated (and need IV fluids). RSV can be quite severe and even fatal to infants and young children, so seek medical care immediately.

Ideally, the best thing to do is be proactive and educate yourself about RSV before you or a family member get it so you can spot the signs and symptoms. The CDC has a great online resource to learn more about RSV.