Published on November 11, 2021

RSV Returns from Pandemic Break

children with backpacks

Last winter, precautions against COVID-19 forced the Respiratory Syncytial Virus (RSV) to take a vacation. Everyone was masking, washing their hands and socially distancing. We saw maybe one or two patients in the entire normal RSV season, which is unheard of.

Nearly all children will be exposed to RSV during their first 24 months of life. For most, it causes a few days of fever, runny nose and cough, but it can be life-threatening for premature babies and other vulnerable infants and toddlers.

Usually RSV season runs from mid-October until about mid-May, peaking between late January and early February. For 2021, RSV had a warm weather peak when people relaxed masking, handwashing and social distancing during a lull in the pandemic. Right now, hospitals are not seeing a consistent increase in RSV, and that’s not typical for this time of year. But as winter arrives, cases are likely to rise and bring another RSV surge before 2021 ends.

In addition to fever, runny nose and cough, RSV can cause labored breathing as it invades the upper respiratory system. Lower respiratory tract symptoms can include faster breathing, difficulty breathing and maybe even chest pain. RSV can also affect other areas outside of the respiratory tract. Some patients present with just vomiting and diarrhea. They can have red eyes or middle ear infections.

Premature infants with RSV can develop a separate set of symptoms. They may not have any fever or typical respiratory symptoms. Instead they may be irritable, show a decrease in activity or appetite and/or have apnea – where the body forgets to breathe.

If RSV is suspected, see your child’s doctor. Like COVID-19, RSV can be diagnosed with a PCR test using a sample taken with a nasal swab in the pediatrician’s office. It’s quick and accurate.

There are no specific medications to treat RSV. Antibiotics are not useful unless a secondary infection develops. Children with RSV need extra fluids, rest and medications to manage symptoms like fever. They need to stay home, away from others until symptoms go away, usually three and eight days.

About 30% of children with RSV will develop lower respiratory disease, like pneumonia. About 3% will need to be hospitalized. In the hospital, treatment usually includes IV fluids, supplemental oxygen and time for their lungs to heal. A very small percentage of RSV patients will go into acute respiratory failure and require a ventilator to breathe.

Some children are more likely to get RSV - those who attend daycare or school or have siblings who do, those who live in crowded conditions at home or in a shelter and children who are exposed to cigarette smoke.

RSV spreads very similarly to coronavirus, which is why mask wearing, hand washing and social distancing were so effective this past winter. RSV can be found on objects like handrails, doorknobs, grocery carts or toys. Children pick up the virus by touching the objects then touching their mouth or noses to introduce it into their system. Less commonly, RSV can spread by breathing in respiratory droplets from an infected person.

Parents can reduce the risk of RSV by using masks, frequent, thorough hand washing and social distancing. If your child is exposed to someone with RSV and/or develops symptoms, keep them home until they are well to avoid sharing RSV with others.

As winter arrives, cases are likely to rise and bring another RSV surge before 2021 ends.