Respiratory Syncytial Virus (RSV) is a common respiratory illness, particularly concerning for infants. While most babies experience mild, cold-like symptoms, RSV can lead to severe complications. Millions of children are hospitalized due to RSV worldwide. Death in babies from RSV is uncommon, especially in high-income countries with access to medical care. It remains a leading cause of infant hospitalization.
Understanding Respiratory Syncytial Virus
RSV is a highly contagious virus infecting the lungs and breathing passages. It spreads easily through respiratory droplets released when an infected person coughs or sneezes. These droplets can enter another person’s eyes, nose, or mouth directly, or by touching contaminated surfaces and then their face. The virus can survive on surfaces for hours, contributing to its easy transmission.
Symptoms appear 2-8 days after exposure. For many infants, RSV resembles a common cold, beginning with mild symptoms like a runny nose, sneezing, cough, fever, or decreased appetite. While initial signs are often not alarming, the illness can progress to affect the lower respiratory tract.
Infants at Higher Risk of Severe RSV
Certain infants face an increased risk of severe RSV, sometimes requiring hospitalization. Premature infants are particularly vulnerable due to still-developing lungs and immune systems, and fewer maternal antibodies, making them less equipped to fight infection. Premature babies with RSV are more likely to be hospitalized and experience respiratory failure.
Infants younger than six months old are at heightened risk for severe illness. Smaller airways and less developed immune systems make them more susceptible to serious lung inflammation. Babies with chronic lung conditions (e.g., bronchopulmonary dysplasia) or congenital heart disease face increased complications from RSV. These underlying health issues compromise respiratory or circulatory systems, hindering their ability to cope with RSV.
Infants with weakened immune systems (e.g., cancer, chemotherapy) or neuromuscular disorders affecting mucus clearance are at greater risk. These conditions impair the body’s natural defenses and respiratory function, leading to more prolonged and severe illness.
Identifying Severe Symptoms and When to Get Help
Recognizing severe RSV signs is important for timely medical care. While mild RSV symptoms mirror a common cold, watch for specific indicators of worsening illness.
Difficulty breathing is a primary concern: rapid, shallow breathing, flaring nostrils, or noticeable caving in of the chest and belly. These signs indicate the baby is working harder to breathe. Wheezing (a high-pitched whistling sound) or a persistent, harsh cough signal severe infection. Bluish discoloration of the lips, mouth, or skin (cyanosis) indicates a lack of oxygen and requires immediate emergency attention.
Other concerning symptoms include lethargy, decreased activity, unusual irritability, poor feeding, and dehydration (e.g., fewer wet diapers). If an infant experiences severe symptoms, contact a pediatrician immediately. Seek emergency medical care (e.g., 911) if a baby has pauses in breathing, severe difficulty, or changes in skin color. Prompt medical evaluation ensures appropriate treatment and support.
Protecting Your Baby from RSV
Preventative measures reduce a baby’s risk of RSV. Frequent handwashing by caregivers (soap and water for at least 20 seconds) is an effective strategy to remove virus particles. Avoiding close contact with sick individuals, especially during RSV season, also limits exposure.
Regular cleaning and disinfection of frequently touched surfaces helps eliminate the virus. Protecting infants from cigarette smoke is important, as secondhand smoke irritates airways and increases susceptibility to respiratory infections. Breastfeeding offers immune support by transferring antibodies from parent to baby, providing protection against infections like RSV.
For certain high-risk infants, preventative monoclonal antibodies (e.g., palivizumab or nirsevimab) may be an option to discuss with a healthcare provider, offering additional protection during RSV season. Vaccination against RSV is available for pregnant individuals (providing protective antibodies to the baby) and for infants directly.