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Respiratory Syncytial Virus


A respiratory syncytial virus (RSV) infection

is a condition that causes swelling in your child's lower airway and lungs. The swelling may cause your child to have trouble breathing. The RSV virus is the most common cause of lung infections in infants and young children. An RSV infection can happen at any age, but happens more often in children younger than 2 years. An RSV infection usually lasts 5 to 15 days. RSV infection is most common in the fall and winter. An RSV infection often leads to other lung problems, such as bronchiolitis or pneumonia.

Common early symptoms:

RSV infection begins like a common cold. Your child may have any of the following:

  • Runny nose
  • A cough or wheezing
  • Fever
  • Breathing faster than usual
  • Not eating or sleeping as well as usual

Symptoms of a severe RSV infection:

  • Very fast breathing (60 to 70 breaths or more in 1 minute), or pauses in breathing of at least 15 seconds
  • Grunting and increased wheezing or noisy breathing
  • Nostrils become wider when breathing in
  • Pale or bluish skin, lips, fingernails, or toenails
  • Pulling in of the skin between the ribs and around the neck with each breath
  • A fast heartbeat
  • Loss of appetite or poor feeding, or being fussier or more irritable than before
  • More sleepy than usual, trouble staying awake, or not responding to you
  • Having less wet diapers than usual or urinating less than usual

Seek care immediately if:

  • Your child is 6 months or younger and takes more than 50 breaths in 1 minute.
  • Your child is 6 to 11 months old and takes more than 40 breaths in 1 minute.
  • Your child is 1 year or older and takes more than 30 breaths in 1 minute.
  • Your child pauses between breaths.
  • Your child is grunting and has increased wheezing or noisy breathing
  • Your child's nostrils become wider when he or she breathes in.
  • Your child's skin, lips, fingernails, or toes are pale or blue.
  • The skin between your child's ribs and around his neck is pulling in with each breath.
  • Your child's heart is beating faster than usual.
  • Your child has signs of dehydration such as:
    • 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
    • Urinating less than usual or not at all

Contact your child's healthcare provider if:

  • Your child is younger than 2 years and has a fever for more than 24 hours.
  • Your child is 2 years or older and has a fever for more than 72 hours.
  • Your child's nasal drainage is thick, yellow, green, or gray.
  • Your child's symptoms do not get better, or they get worse.
  • Your child is not eating, has nausea, or is vomiting.
  • Your child is very tired or weak, or he is sleeping more than usual.
  • You have questions or concerns about your child's condition or care.

Treatment for an RSV infection:

Young children with a severe infection may need to be monitored and treated in the hospital. Children at risk for a severe infection may also need to be monitored and treated in the hospital. Most children can be given medicine at home to help manage symptoms. Do not give over-the-counter cough or cold medicines to children under 4 years. Your child may need any of the following:

  • Acetaminophen may help decrease your child's pain and fever. This medicine is available without a doctor's order. Ask how much medicine is safe to give your child, and how often to give it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
  • 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.
  • Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.

Manage your child's symptoms:

  • Have your child rest. Rest can help your child's body fight the infection.
  • Give your child plenty of liquids. Liquids will help thin and loosen mucus so your child can cough it up. Liquids will also keep your child hydrated. Do not give your child liquids with caffeine. Caffeine can increase your child's risk for dehydration. Liquids that help prevent dehydration include water, fruit juice, or broth. Ask your child's healthcare provider how much liquid to give your child each day.
  • Remove mucus from your child's nose. Do this before you feed your child so it is easier for him or her to drink and eat. Place saline (saltwater) spray or drops into your child's nose to help remove mucus. Saline spray and drops are available over-the-counter. Follow directions on the spray or drops bottle. Have your child blow his or her nose after you use these products. Use a bulb syringe to help remove mucus from an infant or young child's nose. Ask your child's healthcare provider how to use a bulb syringe.
    Proper Use of Bulb Syringe
  • Use a cool mist humidifier in your child's room. Cool mist can help thin mucus and make it easier for your child to breathe. Be sure to clean the humidifier as directed.
  • Keep your child away from smoke. Do not smoke near your child. Nicotine and other chemicals in cigarettes and cigars can make your child's symptoms worse. Ask your child's healthcare provider for information if you currently smoke and need help to quit.

Prevent an RSV infection:

  • Wash your hands and your child's hands often. Use soap and water. Use gel hand cleaner when soap and water are not available. Wash your child's hands after he or she uses the bathroom or sneezes. Wash your child's hands before he or she eats. Wash your hands after you change your child's diaper. Wash your hands before you prepare food.
  • Keep your child away from others who are sick. Separate your child from siblings who are sick. Ask friends and family not to visit if they are sick.
  • Clean toys and surfaces. Clean toys that are shared with other children. Use a disinfectant solution to clean common surfaces.
  • Ask about medicine that protects against 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 healthcare provider if this medicine is right for your child.

Follow up with your child's healthcare provider as directed:

Ask your child's healthcare provider when your child can return to school or daycare. Write down your questions so you remember to ask them during your visits.

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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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Respiratory Syncytial Virus (Ambulatory Care)

Associated drugs

IBM Watson Micromedex

Symptoms and treatments

Mayo Clinic Reference