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Respiratory syncytial virus (RSV) is a common respiratory virus, and is one of the causes of seasonal common cold. Most of the time, RSV infection is mild and passes off as a usual viral upper respiratory tract illness. However, in some individuals, RSV infection may have a more severe and protracted course. Young infants, premature babies, adults with chronic lung conditions or heart diseases are particularly at higher risk for severe disease. Other risk factors for severe disease include overcrowded living conditions, indoor air pollution including exposure to cigarette smoke and a family history of atopy or asthma.

Which is the peak RSV season?

In tropical countries like India, RSV outbreaks occur during the rainy season, as temperatures begin to fall.

How does RSV spread?

RSV is highly contagious. It mainly spreads via droplets of secretions from an infected person, through hands, shared utensils or via surfaces touched by the person. The virus can survive on contaminated surfaces for up to 6 hours. These droplets are generated when the infected person coughs, sneezes or laughs. The virus usually enters a healthy individual through the nose or eyes, less commonly the mouth.

How does RSV affect young children?

RSV is one of the leading causes of lower respiratory tract infection in infants and young children, causing bronchiolitis and pneumonia. Nearly 95% of children have been infected by RSV by the time they turn five, however, not all of them exhibit lower respiratory tract disease. Nevertheless, in some children, the disease may be severe enough to mandate hospitalisation, oxygen therapy and other necessary treatment.

Re-infection with RSV occurs frequently, although the subsequent illness is usually less severe because the infant has acquired some immunity from previous exposure. 

What is the relation between RSV and wheezing?

Involvement of the lower respiratory tract with RSV infection (known as bronchiolitis) is often associated with wheezing. After an acute severe RSV infection, children may continue to have recurrent wheezing episodes for several years, but the episodes usually reduce gradually.

How can I protect my child from RSV infection?

While there is no vaccine currently available for RSV, general hygiene measures go a long way in prevention. These include frequent hand washing, especially after touching surfaces in public spaces, avoiding touching your face, eyes and nose in public areas and maintaining a distance of at least 6 feet from sick individuals. Those who are suffering from a cold should observe basic etiquettes such as coughing or sneezing in the fold of your elbow or a napkin, avoiding visiting crowded areas or touching surfaces with contaminated hands, and using a mask around infants.

If my child gets an RSV infection, how do we identify and treat it?

The symptoms of an RSV infection are usually non-specific and similar to any other viral illness- fever, running nose, sore throat and cough. The treatment is mainly supportive in the form of adequate rest, good hydration and fever medications. As RSV is a virus, there is no role of antibiotics, unless your pediatrician diagnoses a super-added bacterial infection. 

What are the signs of a severe disease?

Fast breathing or difficulty in breathing, chest indrawing, wheezing, extreme lethargy, refusal to take feeds, persistent vomiting or bluish discolouration of lips or nails are some signs that indicate severe disease and need for immediate medical attention. 

While RSV sparks panic in the minds of most parents, largely the illnesses are mild and manageable. Parents need to be vigilant to prevent exposure during the peak season. In case of infants and young children, it is best to visit a pediatrician or a pediatric pulmonologist whenever in slightest doubt.