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Ask a Nurse: What Should Parents and Guardians Know About RSV This Year?

Joelle Y. Jean, FNP-C, BSN, RN
Updated February 10, 2023
    With the current surge of RSV, many parents and guardians are concerned. Learn more about RSV and how you can take steps to protect yourself and your family.
    Credit: FatCamera / Getty Images

    In our Ask a Nurse series, experienced nurses provide an insider look at the nursing profession by answering your questions about nursing careers, degrees, and resources.

    Question: Rates of respiratory syncytial virus (RSV) are rising across the U.S. As a parent, I’m concerned. What should I know about RSV?

    With the current surge of RSV, it is understandable to be a concerned parent. As a parent myself, and nurse practitioner with experience in pediatrics, I know this concern well.

    The Centers for Disease and Control Prevention (CDC) reports that virtually all children under 2 years old will get RSV. Mild symptoms include a runny nose, decrease in appetite, and cough. Many children recover after a week or two.

    But RSV can be dangerous for some children and older adults, leading to more severe infection and hospitalization. Discover more about RSV and how you can take steps to protect yourself and your family.

    What Is RSV and Why Is It on the Rise?

    RSV is a respiratory virus. It is transmitted through droplets from the nose and throat through coughing and/or sneezing by an infected person. People are usually contagious for 3-8 days.

    People with weakened immune systems can continue to spread the virus even if they don’t have symptoms. According to the CDC, this can last up to four weeks.

    The rise in RSV cases is unusual for this time of year. Experts report the seasonal pattern of RVS as typically peaking in late December to mid-February, but this pattern has changed since the start of the COVID-19 pandemic. The recent rise in RSV cases can also be due to the loosening of COVID-19 restrictions like social distancing, travel, and masking.

    The symptoms of RSV are similar to the common cold. Symptoms include:

    • Runny nose
    • Cough
    • Fever
    • Appetite loss
    • Sneezing
    • Wheezing

    In very young infants, symptoms may vary. Your child may:

    • Be Irritable
    • Have decreased activity
    • Have difficulty breathing

    Symptoms don’t come all at once. Your child may start with a runny nose and refuse to eat. Then 1-3 days later, they usually develop a cough, sneezing, and fever. They might even start to wheeze. But many children start feeling better after a week or two.

    There are a group of children who have a greater risk for severe illness. They include:

    • Premature infants
    • Children with a weakened immune system
    • Children born with heart disease or lung disease
    • Children with neuromuscular disorders
    • Children who have difficulty swallowing or clearing mucus

    Severe illness can lead to bronchiolitis, when the small airways in the lungs become inflamed, or pneumonia. Hospitalized children may need help breathing with oxygen, intubation (a breathing tube), or mechanical ventilation (a machine that helps you breathe).

    Most children improve with this care and are discharged home after a few days.

    How Bad Is RSV Right Now?

    The CDC reports in the United States an estimated 58,000 children under the age of 5 years old are hospitalized because of RSV infections each year.

    According to PCR tests tracked by the CDC, record-high cases of RSV have been documented. Between the beginning of September to the end of October, RSV-positive PCR tests jumped from over 2,000 to over 7,000.

    Cases are being reported daily, and many experts cannot predict how severe the number of cases will be.

    What Should I Do if I Think My Child Has RSV?

    If you suspect your child has RSV, remember RSV infections usually last a week or two. The most important step to take to care for your RSV-positive child is to manage their symptoms.

    Ways to manage their symptoms include:

    • Treating fever/pain with over-the-counter medication (never give your child aspirin)
    • Giving warm showers
    • Using nasal sprays
    • Keeping your child hydrated with water, energy drinks, and/or Pedialyte
    • Talking to your child’s primary care provider

    The American Academy of Pediatrics does not recommend routine testing for RSV. This is because the virus usually clears on its own. But it is recommended for children under 6 months and adults older than 65 years of age to get tested.

    The test is performed by putting a gentle nasal swab into the nose.

    High-risk and young children may be given an RSV agent called palivizumab to prevent serious illness.

    Antibiotics are not routinely given to children who are RSV-positive. If your child does develop an infection like pneumonia or an ear infection, then antibiotics will be given.

    What Can I Do to Avoid RSV?

    There are ways you can decrease the risk of getting RSV. Some ways include:

    • Wash your hands often with soap and water for at least 20 minutes
    • Wear a mask while caring for your RSV-positive child or family member
    • Cough or sneeze into a tissue or your arm
    • Avoid kissing and or shaking hands
    • Avoid sharing cups and or food
    • Clean frequently used areas
    • Get your flu shot

    Pfizer has been testing its RSV vaccine for pregnant individuals. On Nov. 1, the pharmaceutical company reported encouraging results from a trial test. The test found that the vaccine protects infants from RSV at least six months after birth.

    Can Adults get RSV?

    Yes, adults can get RSV. Symptoms are similar to RSV-positive children, but adults may complain of headaches, sore throat, and fatigue. Symptoms typically last no more than five days.

    Some high-risk adults may develop a severe illness due to RSV. Those adults include:

    • Adults over 65 years old
    • Adults with chronic conditions like chronic lung disease or chronic heart disease
    • Adults with weakened immune systems

    Be aware that RSV can worsen conditions in adults with serious conditions such as chronic obstructive pulmonary disease, asthma, or congestive heart failure.

    In Summary:

    • According to PCR tests tracked by the CDC, record-high cases of RSV have been documented. This can be due to the loosening of COVID-19 restrictions and the seasonal pattern change of RSV since the start of the COVID-19 pandemic.
    • Many children start feeling better after a week or two after having RSV.
    • RSV can be dangerous for some children and older adults, leading to more severe infection and hospitalization.
    • Ways you can avoid getting RSV include washing your hands, wearing a mask while caring for an RSV-positive child or family member, and getting the flu vaccine.