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Respiratory Syncytial Virus

Respiratory syncytial virus (RSV) is a common cause of respiratory infections, particularly in children.
 It is the most common cause of bronchiolitis, meaning inflammation of the small airways in the lung. It is also a common cause of pneumonia, an infection of the lungs, among infants and young children.

RSV causes outbreaks of respiratory illness each year. In British Columbia, RSV infections often occur between the late fall to the early spring. 

Information for Health Care Professionals
RSV is a respiratory virus that affects the lungs and airways. 
Symptoms can begin about 3 to 5 days after a person is first exposed to the virus. 

Older children and adults usually present with symptoms similar to the common cold and symptoms go away in 1 to 2 weeks. Typical RSV symptoms include:
  • Runny nose
  • Cough
  • Low grade fever (less than 38.5° C or 101° F)
  • Loss of appetite
  • Mild sore throat
In very young infants with RSV, the only symptoms may be irritability, decreased energy, and breathing difficulties. 

Symptoms can worsen if the virus induces inflammation of the lungs. In the case of a more serious infection, symptoms could include:
  • Difficulty breathing or rapid breathing
  • Unusual or prolonged pauses of breathing
  • Wheezing 
  • Difficulty feeding
RSV is highly contagious, meaning it spreads easily from person to person through breathing, coughing, and sneezing. The virus can also spread when a person touches tiny droplets from coughs, or sneezes on another person or on an object, and then touches their own mouth or nose before washing their hands.

People infected with RSV are usually contagious for 3 to 8 days. However, some people with compromised immune systems can continue to spread the virus even after their symptoms have ceased, for as long as 4 weeks.
In older children and healthy adults, illness is usually mild and may manifest only as a common cold. However, in some cases, RSV can cause more severe infections such as bronchiolitis, meaning inflammation of the small airways in the lungs, and pneumonia, an infection of the lungs. 

Premature children, children younger than 6 months, children with chronic respiratory or cardiac conditions, older adults, and patients who are immunocompromised are at increased risk of severe RSV and may need to be hospitalized. 
Healthcare providers suspect and test for RSV infection in young infants and children who have bronchiolitis or pneumonia during RSV season or during an outbreak in their area. 

Testing may be recommended if healthcare providers are trying to identify an outbreak or if a patient requires hospital care. A sample of mucus from the patient’s nose is often used to test for the virus.
For most people, RSV goes away on its own in a week or two, and home treatment is all that is needed. This may include:
  • Fever and pain management with acetaminophen (Tylenol®) or ibuprofen (Advil®). Don’t give acetylsalicylic acid (e.g., Aspirin®) to anyone under age 18
  • Drinking enough fluids to prevent dehydration
  • Clearing your baby's nasal passages with a suction device if breathing difficulties interfere with feeding or sleeping
Antiviral medication is not routinely recommended.

When should I see a doctor?
If you or your child seem to have worsening symptoms, with more rapid breathing, wheezing, high fever or increased feeding difficulty, you should seek medical care. If an adult or child is experiencing severe breathing distress, seek urgent medical care. Call 9-1-1 or go to your nearest emergency department. 
You can reduce the risk of getting RSV or spreading it to others by:
  • Often washing your hands with soap and water or using hand sanitizer
  • Covering your coughs and sneezes with your sleeve
  • Staying home or away from others if you feel sick
  • Keeping away from people who have respiratory tract infections whenever possible
It is also known that keeping your children away from second hand smoke helps prevent RSV infections and reduces its severity. 

Breastfeeding/chestfeeding your baby as long for as you can also offers protection against RSV infections.

A vaccine for RSV was approved by Health Canada in August 2023 for use in adults age 60 and over. The National Advisory Committee on Immunization will issue recommendations for the use of the vaccine. It is not currently available through the publicly-funded immunization program in British Columbia. 

In a select group of babies and children who are at high risk for complications and hospitalization from RSV, medicines may be used to help prevent RSV infection. These antibodies named Palivizumab help prevent and reduce the severity of RSV infection.

Canadian Pediatric Society. (2021). RSV (Respiratory syncytial virus). Caring for kids. https://caringforkids.cps.ca/handouts/health-conditions-and-treatments/respiratory_syncytial_virus

Centers for Disease Control and Prevention. (2023). Respiratory Syncytial Virus Infection (RSV). https://www.cdc.gov/rsv/index.html

Healthwise. (2021). Respiratory Syncytial Virus (RSV) Infection. HealthLinkBC. https://www.healthlinkbc.ca/illnesses-conditions/infectious-diseases/respiratory-syncytial-virus-rsv-infection

Provincial Health Services Authority. (2018). BC RSV Immunoprophylaxis Program. Administrative manual and decision support tool. https://www.childhealthbc.ca/sites/default/files/B.C.%20RSV%20Manual%202018-19.pdf

Tesini, B. L. (2023). Respiratory Syncytial Virus (RSV) Infection and Human Metapneumovirus Infection. Merck Manual. Patient education, professional version and quick facts. https://www.merckmanuals.com/en-ca/home/children-s-health-issues/common-viral-infections-in-infants-and-children/respiratory-syncytial-virus-rsv-infection-and-human-metapneumovirus-infection


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