Respiratory Syncytial Virus (RSV) is a common, highly contagious respiratory virus that infects the lungs and breathing passages. It can cause serious illness in infants and certain vulnerable groups. Understanding how RSV spreads, what symptoms to look out for, and how to protect your baby is key to keeping your family safe.
What is RSV and why does it matter?
- RSV is one of the most common causes of respiratory tract infections in children, and a leading cause of hospitalisation in young children.
- Almost all children will get RSV by the time they turn two years old, and for most, it only causes mild, coldlike symptoms. But in some infants – especially those under six months old, premature babies, or those with underlying heart or lung problems – the infection can be more serious and may require hospital care.
- While RSV tends to peak during the winter months in temperate countries, it circulates throughout the year in Malaysia and other tropical regions.
How does RSV spread?
- RSV spreads through respiratory droplets when an infected person coughs or sneezes.
- It can spread through direct contact (like kissing) or indirect contact (touching a contaminated surface, like a toy or doorknob, and then touching the eyes, nose, or mouth).
- The virus can survive on hard surfaces for several hours.
- People are usually contagious for three to eight days, but infants and those with weakened immune systems can shed the virus for weeks, even after symptoms improve.
What are the symptoms of RSV?
Symptoms usually appear 4 to 6 days after exposure and can range from mild to severe.
- Mild symptoms (often like a common cold in older children/adults):
- Runny or stuffy nose
- Cough
- Low-grade fever
- Sneezing
- Sore throat
- Irritability or lethargy
- Severe symptoms (especially in infants):
- High fever
- Persistent or worsening cough
- Wheezing (a high-pitched sound when breathing out)
- Fast, or laboured breathing (you may see the chest muscles pulling in with each breath)
- Bluish lips or fingernails (a sign of low oxygen)
- Poor feeding or reduced fluid intake,leading to dehydration
- Unusual tiredness, drowsiness or pauses in breathing (apnoea)
Who is most vulnerable to severe RSV?
- Infants, especially those under 6 months old
- Premature infants
- Children with congenital heart disease or chronic lung diseases
- Children with weakened immune systems (e.g. due to chemotherapy or immune deficiency)
- Older adults, particularly those over 65
What are the potential complications?
The most severe complication for infants is the spread of the virus to the lower respiratory tract, which can cause:
- Bronchiolitis: Inflammation and blockage of small airways in the lungs, causing breathing difficulty.
- Pneumonia: Infection and inflammation of the lungs.
- Otitis media: A middle ear infection that occurs when RSV spreads to the space behind the eardrum.
When these complications occur, some children may need hospitalisation for oxygen support, intravenous (IV) fluids, or even ventilatory support in the intensive care unit in more severe cases.
How is RSV treated?
There is no specific medicine to treat the RSV virus itself; antibiotics do not work against RSV since it is a virus. Treatment focuses on supportive care.
- Home care (for mild cases):
- Ensure plenty of fluids to prevent dehydration (offer small, frequent feeds for babies).
- Use a saline nose spray and bulb syringe to clear mucus, especially before feeding and sleeping.
- Manage fever with age-appropriate doses of paracetamol.
- Use a cool-mist humidifier to ease breathing.
- Prevention is key:
- Wash hands frequently and thoroughly.
- Avoid crowded places and sick people, especially during RSV peaks.
- Keep babies away from smoke (from cigarettes or vaping), as it can irritate their airway.
- Disinfect frequently touched surfaces such as toys, doorknobs and tables.
- New RSV immunisations options are now available. Speak to your healthcare provider to learn more during your next visit.
