Respiratory syncytial virus infection

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 28, 2016
StartDiseasesRespiratory syncytial virus infection

Respiratory syncytial virus infection is a viral infection that affects the lungs and upper respiratory tract. It causes mild cold-like symptoms in most people, but it can be serious for infants and older adults. It is highly contagious, but most people recover completely within a few weeks.


Definition & Facts

Respiratory syncytial virus (RSV) is a viral infection that affects the upper respiratory system. Many people simply have symptoms that resemble the common cold. Most children over age two and adults do not have severe symptoms when they contract RSV, but it can be serious for infants, especially premature ones, and senior adults with heart disease and lung disease.

Those that have more severe cases may also get bronchiolitis or pneumonia. RSV is the number one cause of both in children under one years of age. Most children will have had the RSV virus by the time they have turned two years old. Also, most people recover completely within a week or two.

Symptoms & Complaints

Symptoms of RSV may start off in a similar manner to a common cold. The symptoms usually start within four to six days after exposure to the virus though it can be anywhere from two to eight days when they appear. At first, an individual may have a stuffy or runny nose and a decreased appetite.

Within a day or two, more symptoms may begin to appear. These may include a headache, dry cough, mild sore throat, and a low grade fever. While some may experience higher fevers, it is uncommon and does not necessarily indicate that the course of the infection will be more severe. The fever is typically only present at the beginning of the illness.

Babies may also experience further symptoms including listlessness and a decreased interest in their surroundings, excessive sleepiness, disinterest in feeding, and irritability. They may also experience sleep apnea, where they stop breathing while sleeping.

In addition, RSV can lead to bronchiolitis and pneumonia. These both cause symptoms that can become severe. These symptoms can include a cough that seems to worsen, difficulty breathing, shallow or rapid breathing, wheezing, and a bluish tinge to the skin (cyanosis), indicating oxygen deprivation.


RSV is caused by direct or indirect contact with the virus. The virus enters one’s body through the eyes, nose, and mouth. Therefore, a person who has direct contact with another person who has the infection may contract the infection by actions such as shaking their hand and then touching their own face.

Moreover, the illness can be spread through the air. Coughs and sneezes can cause droplets to circulate in the air. These droplets can then land on the face or hands, causing the person to inhale the virus.

Indirect contact with the virus is possible because the virus can live on surfaces. It can live on hard surfaces such as tables, doorknobs, and toys for many hours. Anyone touching these infected surfaces may come down with the illness.

Diagnosis & Tests

When one thinks that they or their child has RSV, the first step is to contact the family doctor or pediatrician. The doctor is likely to ask a number of questions relating to the symptoms and their duration and severity. In addition, a complete physical examination is likely to take place. The exam is likely to concentrate on the upper respiratory system.

A stethoscope can be used to listen for wheezing or other unusual sounds in the chest. Further, a pulse oximeter, a device that painlessly clips on the patient’s finger, can be used to determine if the amount of oxygen circulating in the blood is adequate.

Lab tests may include blood testing to check white cell counts which indicate infection. Bacteria and viruses can also sometimes be detected from blood testing. A chest X-ray may be taken to rule out the possibility of pneumonia if that is suspected.

Finally, a swab of the nasal secretions may be taken. The sample can then be tested in a lab for the presence of the RSV infection. This is the most definitive way to ascertain if the symptoms are caused by RSV.

Treatment & Therapy

Since RSV is a virus, there is no actual cure for it. It typically runs its course in a week or two and then the person feels fine again. Nonetheless, there are some measures that can be taken to be sure that the patient is as comfortable as possible.

An over-the-counter fever reducer such as ibuprofen can be administered if the individual has a fever or headache. Fluids should be encouraged to help keep the patient hydrated and to thin the mucus secretions for easier expulsion. Sitting upright can also help to ease congestion and help make breathing easier.

In the event that breathing becomes labored, it may be necessary to hospitalize the patient. In the hospital, breathing can be monitored and oxygen can be given if needed. In addition, inhaled medications can be administered via nebulizer, the patient may undergo respiratory therapy, and a mechanical breathing machine (a respirator) can be used. The main goal is to make breathing easier and the patient comfortable.

Prevention & Prophylaxis

Prevention of RSV is difficult since there is no vaccine. Scientists are working on one, but it does not yet exist. Nonetheless, there are some steps that one can take to help control the spread of RSV. For example, a person with cold-like symptoms should:

  • Cover all coughs and sneezes
  • Wash hands frequently and properly with soap and warm water
  • Avoid sharing cups and eating utensils
  • Avoid kissing others

In addition, if one has a cold, they should avoid all contact with newborns and other high risk individuals when at all possible. Moreover, disinfecting all surfaces touched by a potentially contagious individual may help prevent RSV.