RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lungs) and pneumonia in babies. It is an illness that often occurs in yearly outbreaks in communities, school classrooms, and day care centers. In the United States, RSV is more common in winter and early spring months.
RSV is spread from respiratory secretions through close contact with infected people or contact with contaminated surfaces or objects. Infection can occur when infectious material contacts mucous membranes of the eyes, mouth, or nose, and possibly through the inhalation of droplets generated by a sneeze or cough. The incubation period (time from exposure to symptoms) is about 2 to 5 days.
RSV can affect a person of any age, although sever symptoms usually only occur in very young infants. Most babies have been infected at least once by the time they are 2 years old. Babies can also be re-infected with the virus. Recurrence throughout life is common. Babies born prematurely or with chronic lung disease are at increased risk of developing more severe illness.
In babies born prematurely, or who have certain heart, lung, and neuromuscular diseases, infection with the virus can lead to severe respiratory illness and pneumonia, and may become life-threatening. RSV in infancy may be related to development of asthma later in childhood.
The early phase of RSV in infants and young children is often mild, somewhat like a cold. In children younger than 3, the disease may progress into the lower airways and cause coughing and wheezing. In some, the infection progresses to a severe respiratory disease requiring hospitalization to help the child breathe.
The following are the most common symptoms of RSV. However, each baby may experience symptoms differently. Symptoms may include:
Apnea (periods without breathing)
Trouble eating, drinking, or swallowing
Flaring of the nostrils or straining of the chest or stomach while breathing
Breathing faster than usual, or trouble breathing
Turning blue around the lips and fingertips
The symptoms of RSV may resemble other conditions or medical problems. Always consult your baby's doctor for a diagnosis.
Diagnosis is sometimes difficult because the symptoms of RSV can resemble other infections. Illness in other family members, other babies in the hospital nursery, or the time of year may provide clues. In addition to a complete medical history and physical examination of your child, a test (nasal swab or nasal wash) of the baby's respiratory secretions may show the presence of a virus.
Specific treatment for RSV will be determined by your baby's doctor based on:
Your baby's age, overall health, and medical history
The extent of the condition
Your baby's tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
There are no medications used to treat the virus itself. Care of a baby with RSV involves treating the effects of the virus on the respiratory system. Because a virus causes the illness, antibiotics are not useful. Treatment may include:
Intravenous fluids (to prevent dehydration)
Tube feedings (if the baby has difficulty sucking)
Bronchodilator medications (to open the airways, although these are rarely effective in bronchiolitis)
Antiviral medications (for very sick or high-risk babies)
The American Academy of Pediatrics (AAP) recommends that babies at high risk for RSV receive a medication called palivizumab. Ask your child's health care provider if your child is at high risk for RSV. Ask about monthly injections during RSV season to help prevent RSV.
To reduce the risk for RSV and other viral infections, the AAP recommends all infants, especially preterm infants, should be offered breast milk, should not be exposed to smoke, should avoid high-volume child care settings during the first winter season, and avoid contact with people who are sick. The AAP also recommend that other members of the household get a flu shot.