What is RSV?
RSV or Respiratory syncytial virus is a common seasonal and highly contagious virus that can causes respiratory disease. While most people recover in a week or two, RSV can be dangerous. Severe RSV is more common in older adults and infants. The CDC estimates that between 60,000-160,000 older adults in the United States are hospitalized and 6,000-10,000 die due to RSV infection, and 58,000-80,000 children younger than 5 years are hospitalized due to RSV infection each year.
Symptoms:
- Coughing
- Sneezing
- Fever
- Wheezing
- Runny nose
- Decrease in appetite
- Usually, these symptoms develop gradually rather than all at once
- The only signs of RSV in very young infants can be irritability, decreased activity, and breathing problems.
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Transmission:
RSV spreads when an infected person coughs or sneezes and the virus droplets get in your eyes, nose or mouth, if you have direct contact with the virus such as kissing the face of an infected person or if you touch a virus contaminated surface and then touch your face. People infected with RSV may be contagious for up to two days before they have symptoms and may continue to spread RSV for 8 days after symptoms develop. The RSV virus may survive on hard surfaces for hours where it can be picked up and infect a healthy person after they touch their face.
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Prevention:
- Stay at home when you are sick.
- Wash your hands frequently. Effective handwashing means scrubbing with soap and water for at least 20 seconds or using an alcohol-based hand rub if soap and water aren't available.
- When you sneeze or cough, cover your mouth and nose with a tissue. As soon as possible, dispose of the tissue and wash your hands.
- Avoid touching your eyes, face, nose.
- Frequently clean and sanitize surfaces, especially frequently touched surfaces like phone screens, door handles, and faucets.
- Avoid close contact with others.
- Talk to your healthcare about whether you are eligible for a RSV vaccine or antibody immunization. See Special Populations for RSV vaccine/antibody immunization information for specific age groups.
Special Population (Children):
Most children will be infected with RSV by their second birthday. RSV is a common childhood illness and hospitalization in infants. RSV usually causes mild illness but some children are at greater risk of developing severe illness. Those at greatest risk for severe RSV disease include babies who were born prematurely, very young infants (those 6 months or younger), children under 2 who have a chronic lung disease or who were born with heart condition, children who have a weakened immune system, and children with neuromuscular disorders, those who may have difficulty swallowing or clearing mucus.
Symptoms of RSV infection infection may include: runny nose, decreased appetite, coughing, wheezing, difficulty breathing. Symptoms in very young babies (under 6 months old) may include: irritability, decreased activity, eating or drinking less, apnea. Fever may or may not be present.
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Emergency warning: Seek medical attention right away if your child has difficulty breaking, is not drinking fluids or has fewer than 1 wet diaper every 8 hours, is pale, gray or blue-colored skin lips or nail beds depending on skin tone, becomes less active or alert, or symptoms worsen.
RSV vaccination administered during weeks 32-36 of pregnancy during RSV season or an RSV immunization given to infants or older babies after birth will protect your baby from getting severely ill from RSV disease. Your baby may be eligible for RSV immunization, if they are younger than 8 months and born during, or entering, their first RSV season. Children between the ages of 8-19 months old who have chronic lung disease from being born prematurely, severely immunocompromised, have cystic fibrosis, may be eligible for a dose of RSV antibody when entering their second RSV season.
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Special Population (Pregnant People):
One RSV vaccine (Abrysvo by Pfizer) has been licensed by the FDA for use in pregnant people during weeks 32 through 36 of pregnancy to protect infants. The maternal RSV vaccine protects against severe RSV illness in the baby for up to 6 months after birth and the baby should not need an RSV immunization in most cases when the mother received their RSV vaccine at least 2 weeks prior to delivery. The Abryzvo vaccine is recommended for pregnant people who will be 32-36 weeks pregnant September and January.
Special Population (Older Adults, 60 years+):
Adults who develop RSV infection may have mild cold-like symptoms but certain adults may develop severe RSV disease. The CDC estimates that between 60,000 and 160,000 older adults are hospitalized and 6,000-10,000 die due to RSV infection in the United States each year. Adults that are at higher risk for experiencing severe RSV disease include: older adults, adults with chronic lung or heart diseases, those with weakened immune systems, adults with underlying medical conditions, or who are living in nursing homes or long-term care facilities.
Vaccines against RSV can help prevent serious RSV illness in adults 60 years or older. Immune systems deteriorate with age, meaning older adults are more vulnerable to severe complications from RSV than younger adults. Underlying medical conditions may raise the likelihood of developing severe RSV illness, such as weakened immune systems or heart disease. RSV Vaccines are available for Individuals 60 years old and older. There are two RSV vaccines licensed by the U.S. Food and Drug Administration (FDA) for use in adults 60 and older in the United States: Arexvy and Abrysvo. Who should get the RSV vaccination? Adults 60 years and older should talk with their health care provider about RSV vaccination. If you are 60 years or older, your healthcare provider may recommend RSV vaccination if you have certain medical conditions or are at higher risk of severe disease associated with RSV infection. Getting vaccinated against RSV can help prevent respiratory diseases from RSV. One dose of RSV vaccine provides protection against RSV disease in adults ages 60 years and older for at least two winter seasons. In adults 60 years and older with heathy immune systems RSV vaccines were 83-89% effective in preventing lung infections due to RSV in the first season. The RSV vaccine Arexvy was 56% effective against lung infections during the second RSV season after vaccination. If you are eligible for RSV vaccination you can get it at the same time as other season vaccines, like the flu or COVID-19 vaccine. When should I get an RSV vaccine? While it is difficult to predict when the RSV season will begin each year, RSV season typically begins in October and ends in April. Getting vaccinated before the RSV season starts will ensure you are protected when RSV begins circulating in your community. If you are 60 years or older and your health care provider recommends RSV vaccination for you, you should get an RSV vaccine when it becomes available in your community, before RSV cases start to increase.
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Community Resources:
RSV Prevention PDF for Infants and Young Children
AAP Video: Signs and Symptoms of RSV in Infants and Young Children
Fact Sheet: Older Adults are at High Risk for Severe RSV Illness
Fact Sheet: New Immunizations to Protect Against Severe RSV