Respiratory syncytial virus (RSV) infection - including symptoms, treatment and prevention

Respiratory syncytial virus (RSV) infection is the most common cause of bronchiolitis and pneumonia among infants under 1 year of age.

Bronchiolitis is inflammation of small air passages in the lungs and pneumonia is inflammation of the lung tissue itself. Almost all children will get RSV infection at least once by 2 years of age.

RSV infection may cause respiratory (lung) disease at any age and can be severe among the elderly and people of any age with heart, lung or immune system problems.

Infections may recur throughout life. In South Australia, infections are most common during winter and early spring.

How RSV infection is spread

RSV is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby. Infection may be spread by contact with hands, tissues and other articles soiled by infected nose and throat discharges.

The virus survives outside of the body for a few hours and is easily killed by soap and water or disinfectants.

Signs and symptoms of RSV infection

The first symptoms are usually:

• fever
• runny nose
• cough
• wheezing. 

Ear infections are common. Pneumonia and bronchiolitis often follow, especially in infants. Most children recover from the illness in 8 to 15 days, but some require hospitalisation, mostly in the very young age group (below 6 months of age).

Diagnosis of RSV infection

Diagnosis can be made by direct detection or isolation of the virus from respiratory secretions or by blood tests.

Incubation period

(time between becoming infected and developing symptoms)

The average incubation period is 5 days, with a range of 2 to 8 days.

Infectious period

(time during which an infected person can infect others)

The infectious period is unclear but is probably from before symptoms start until recovery. Most people recover from the infection within about 10 days.

Treatment for RSV infection

There is usually no need for treatment other than paracetamol for fever and maintaining adequate fluid intake. Aspirin should not be given to children under 12 years of age unless specifically recommended by a doctor. 

Very ill children and elderly people may require admission to hospital (less than 3% of children with RSV require this) and treatment is supportive. Because RSV is a virus, antibiotics do not help. There are no safe and effective antiviral drugs for routine use for RSV.

Prevention of RSV infection

• Exclude people with RSV from childcare, preschool, school and work until they are well.
• Frequent hand washing is the most effective means of preventing spread, as the virus is easily killed by soap and water.
  
• Avoid sharing cups, glasses and eating utensils with people who have respiratory infections.
• Cover a cough or sneeze with a tissue or your arm. Drop used tissues immediately into a rubbish bin, and then wash your hands.
• Immunisation products are available – for more information visit the National Centre for Immunisation Research and Surveillance (NCIRS) Australia website.
  

Useful links

• Hand hygiene
• Exclusion periods from childcare, preschool, school and work