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Respiratory Syncytial Virus

What is a respiratory syncytial virus infection?

A respiratory syncytial virus (RSV) infection is a condition that causes your child's airways to become inflamed and swollen. This virus is the most frequent cause of lung infections in infants and young children. An RSV infection often leads to other lung problems, such as bronchiolitis or pneumonia. An RSV infection can happen at any age, but happens more often in children younger than 2 years old.

How does RSV spread?

RSV is a highly contagious virus. An infected person may spread germs to others by coughing, sneezing, or close contact. He may leave germs on objects such as beds, tables, cribs, and toys. Your child may get infected by breathing in the virus. He can get RSV by putting objects that carry the virus into his mouth or by touching the object and then rubbing his eyes. Your child may have more frequent contact with RSV in certain situations. He may get RSV from a school-aged brother or sister or at a daycare center. RSV infections usually occur in outbreaks (clusters of infected people), where 2 or more children are infected.

What may increase my child's risk of a severe RSV infection?

  • He was born prematurely (less than 37 weeks) or at a low weight (less than 5 pounds).

  • He is younger than 6 months.

  • He has a medical condition, such as a heart problem or cystic fibrosis.

  • He has a weak immune system caused by certain conditions, such as HIV or bone marrow transplants.

  • He is exposed to high levels of secondhand cigarette smoke.

What are the early signs and symptoms of an RSV infection?

RSV infection begins like a common cold. When your child first gets ill, he may have any of the following:

  • Breathing faster than usual

  • Cough

  • Fever

  • Not eating or sleeping as well as usual

  • Runny or stuffy nose

  • Wheezing

What are the signs and symptoms of severe RSV infection?

Your child may have any of the following if the infection worsens:

  • Trouble breathing:

    • Very fast breathing (60 to 70 breaths or more in 1 minute)

    • Grunting and increased wheezing or noisy breathing

    • Increased coughing

    • Nostrils become wider when breathing in

    • Pale or bluish skin, lips, fingernails, or toenails

    • Pauses in breathing for at least 15 seconds

    • Pulling in of the skin between the ribs and around the neck with each breath

  • Other signs and symptoms:

    • Fast heartbeat

    • Loss of appetite or poor feeding

    • More irritable or fussy than before

    • More sleepy than usual, has trouble staying awake, or does not respond to you

    • Urinating little or not at all

    • Coughing that causes vomiting

How is an RSV infection diagnosed?

Your child's caregiver will examine your child and ask about his signs and symptoms. He will ask about how your child has been eating, drinking, sleeping, and acting. Tell your child's caregiver about your child's activities and if he has been around any sick people. Tell him if your child has other medical problems. Your caregiver will watch how your child is breathing. Your child may need any of the following tests:

  • Pulse oximeter: A pulse oximeter is a machine that can tell your caregiver how much oxygen is in your child's blood. A cord with a clip or sticky strip is placed on your child's foot, toe, hand, finger, or earlobe. The other end of the cord is hooked to the machine.

  • Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.

  • Chest x-ray: This is a picture of your child's lungs and heart. A chest x-ray may be used to check for pneumonia.

  • Culture: This is a test to grow and identify the germ that is causing your child's condition. A culture may be done from swab samples taken from your child's throat or nose.

  • Nasal wash: A nasal wash is a test to find out what is causing your child's condition. A sample of mucus from your child's nose may be taken with a suction tube. This sample will be sent to a lab for tests.

How is an RSV infection treated at home?

An RSV infection usually lasts 5 to 15 days. Most RSV infections go away on their own. The following can help ease your child's symptoms:

  • Prevent dehydration: Encourage your child to drink liquids often. Ask your caregiver how much liquid your child should drink each day and which liquids are best for him.

  • Ibuprofen or acetaminophen: These medicines are given to decrease your child's pain and fever. They can be bought without a doctor's order. Ask how much medicine is safe to give your child, and how often to give it. Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.

  • Nasal mucus removal: Use a bulb syringe to suck out mucus from your child's nose. Do this before you feed him so it is easier for him to drink and eat. Ask your child's caregiver how to use a bulb syringe. Ask for information about nose drops that help thin your child's mucus.

How is an RSV infection treated in the hospital?

Your child may need to receive hospital treatment if he is at risk for severe illness:

  • Breathing treatments and support: Caregivers will remove the mucus from your child's mouth or nose. He may also need saline drops or treatment with a suction machine to remove the mucous. He may need bronchodilator medicine to help open his airway. He may also need to receive extra oxygen. He may need to be put on a ventilator. This is a machine that breathes for your child if he cannot breathe on his own.

  • Medicines: Your child may need medicine to treat or prevent a severe infection. Medicines may be given to decrease your child's fever or discomfort. He may also need medicine to help him breathe more easily if he is on a ventilator.

  • Liquids and nutrition: Your child may need more liquids to decrease the risk of dehydration. He may need an IV if he is having trouble eating or drinking. An IV is a tube placed in your child's vein. A feeding tube may be passed through your child's mouth or nose and into his stomach.

What are the risks of RSV?

  • Your child can get an RSV infection more than once. Even with treatment, RSV may cause severe, life-threatening illness if your child has heart or other lung problems. Without treatment, your child's condition may get worse. Fast breathing may cause feeding problems. A cough can cause him to vomit after he eats. This may cause your child to lose weight or not gain weight as he should. Your child may also get dehydrated. Dehydration can lead to problems with his organs, such as his heart, brain, or kidneys.

  • Your child's breathing problems may become worse and the amount of oxygen inside his body may decrease. When your child's body does not get enough oxygen, organs such as the kidneys, heart, and brain can be damaged. These problems can be life-threatening.

How can a RSV infection be prevented?

  • Wash your hands frequently: Keep your and your child's hands clean. This is the most important thing you can do to prevent spreading RSV and other germs. Wash often with soap and water to remove germs from your hands. A germ-killing hand lotion or gel may be used when no water available.

  • Avoid people who are ill: Try to keep your child away from people with colds or other respiratory infections.

  • Clean toys and other objects: These include toys that are shared with other children and items touched by sick children or adults. Clean surfaces with soap and water, or with a disinfectant (germ-killing solution).

  • Do not expose your child to smoke: Never smoke around or allow others to smoke around your child.

  • Ask about medicine that protects against getting severe RSV: Your child may need to receive antiviral medicine to help protect him from severe illness. This may be given if your child has a high risk of becoming severely ill from RSV. When needed, your child will receive 1 dose every month for 5 months. The first dose is usually given in early November. Ask your child's caregiver if this medicine is right for your child.

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • Your child has a fever and is wheezing.

  • Your child is not eating, has nausea, or is vomiting.

  • Your child is very tired or weak, or he is sleeping more than usual.

  • Your child is breathing fast:

    • More than 50 breaths in 1 minute if he is 6 months or younger.

    • More than 40 breaths in 1 minute if he is 6 to 11 months old.

    • More than 30 breaths in 1 minute if he is 1 year or older.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your child has a hard time breathing, or pauses in his breathing.

  • Your child has signs of dehydration:

    • Crying without tears

    • Dry mouth or cracked lips

    • More irritable or sleepy than normal

    • Sunken soft spot on the top of the head, if he is younger than 1 year old

    • Urinating less than usual, or not at all

  • Your child's lips or nails turn blue.

  • Your child's symptoms do not get better, or they get worse.

Where can I find more information?

  • American Academy of Pediatrics
    141 Northwest Point Boulevard
    Elk Grove Village , IL 60007-1098
    Phone: 1- 847 - 434-4000
    Web Address:
  • Centers for Disease Control and Prevention
    1600 Clifton Road
    Atlanta , GA 30333
    Phone: 1- 404 - 6393311
    Phone: 1- 800 - 3113435
    Web Address:

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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