Respiratory syncytial virus (RSV) is one of the most commonly contracted viruses. The majority of children will have been infected with RSV by the time they are toddlers.

So, what is RSV, and is RSV contagious?

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What Is RSV?

RSV is a common virus that typically causes cold-like symptoms, though it can cause more important infections involving the lungs as well. Most children have had it by the time they are 2 years old and recover from the illness within a week or two.

Prior infection does not prevent you from getting infected again, though subsequent episodes tend to be milder. But for very young children or infants, or for children and adults with weakened immune systems, RSV can be very dangerous. Adults over 60 also are at higher risk.

People with the virus experience many of the same symptoms as those of the common cold, according to the American Lung Association. Those include:

  • Congestion
  • Cough
  • Fever
  • Runny nose

Sometimes, the symptoms can progress and a person can experience difficulty breathing, lethargy, and apnea. These symptoms indicate that RSV has developed into RSV bronchiolitis. This is a lung infection that can be caused by the virus. Premature infants are especially susceptible to this.

“RSV is a real threat to young children,” says Donald Yealy, MD, chief medical officer and senior vice president, Health Services, UPMC. “It causes many, many emergency department visits and hospitalizations. For many years we didn’t appreciate that it also caused harm in adults — particularly adults who are either more mature, and that’s over the age of 60, or have underlying health conditions, notably those with lung disease.”

Is RSV Contagious?

The National Institutes of Health warns that RSV is very contagious and spreads quickly in crowded households or daycare centers. Outbreaks of RSV typically start in the fall when cold and flu season begins and continue until sometime in the spring.

The respiratory syncytial virus can live on hard surfaces, like desktops, crib rails, and toys, for many hours. It can easily spread through a sneeze or cough. If a person touches a hard surface where the virus is present and then touches their own mouth or nose, they can contract the virus. Sharing objects like toys with an infected child can lead to transmission. A person can also contract it simply by shaking an infected person’s hand.

People infected with RSV are usually contagious for about three to eight days. But some people with weakened immune systems can continue to spread the virus for longer and have symptoms for up to four weeks, according to the Centers for Disease Control and Prevention (CDC).

RSV is especially dangerous for those at higher risk, including:

  • Older adults.
  • People with weakened immune systems.
  • Premature infants.
  • People with heart or lung disease.

RSV may evolve into a more serious condition for these people. In fact, RSV in children younger than 5 years old accounts for more than 2 million doctor and emergency department visits every year. Anywhere from 5% to 20% of those cases will require hospitalization. The majority of these patients will be younger than 6 months old, according to the American Lung Association.

How to Prevent RSV

The best way to prevent respiratory syncytial virus is by getting vaccinated, especially for older adults and pregnant people. Other preventive measures like keeping good hand hygiene and avoiding contact with people who are sick also can prevent the spread of RSV.

Adults 60 and older are eligible to receive an RSV vaccine. The FDA has approved two RSV vaccines for older adults: Abrysvo™ and Arexvy. Talk to your doctor to see if you should get vaccinated.

“The most important group for the RSV vaccination are people over the age of 60, particularly if they have another underlying condition, whether that’s a lung or a heart condition, or an immunocompromised state,” Dr. Yealy says.

If you’re between 32 and 36 weeks of pregnancy and it’s RSV season, you also are eligible for Abrysvo vaccination to protect your child. The antibodies your body creates from the vaccine get passed on to your child. Talk to your ob-gyn to see if you are eligible for vaccination.

The FDA has approved a preventive monoclonal antibody called nirsevimab-alip (Beyfortus™) for babies younger than 8 months who are born during or are entering their first RSV season. Children up to 24 months who are at increased risk from RSV can receive another dose of nirsevimab before their second RSV season. However, nirsevimab is in short supply nationwide and may not be as readily available. Talk to your provider for more information.

The CDC recommends using a drug called palivizumab in children under 24 months old who have conditions that put them at higher risk for severe RSV illness. This includes young children with a history of prematurity or those with heart disease, lung disease, or abnormal immune systems. Children who are eligible receive monthly doses during RSV season.

In addition to vaccination and other preventive medicines, you can prevent the spread of RSV by covering coughs and sneezes properly. Use a tissue or a shirt sleeve, not your hands, and teach children to do so, also. Do not sneeze into your hands. It is also important to wash your hands frequently with soap and water or alcoholic hand gel and avoid close contact, like handshaking, hugs, and kisses.

“It’s really important as we touch surfaces, we can get viruses from the surfaces that we touch,” says Tracey Conti, MD, chair, Family Medicine, UPMC. “We can get viruses from the environment, and so we want to make sure we’re having the best hygiene possible.

“We want to make sure that we are keeping ourselves as distanced as possible, especially in large crowds. If you see people that are having illness, that’s probably not a good group to be around, so keep yourself as safe as possible.”

If you or your child is sick with any respiratory illness, avoid contact with others. Stay home from work or school to protect others.

To learn more about how you can prevent or treat RSV, as well as to learn about the symptoms, contact UPMC.

Editor's Note: This article was originally published on , and was last reviewed on .

About Pediatrics

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