Respiratory Syncytial Virus (RSV) is a common respiratory virus that can cause lung and airway infections. While often resembling a common cold in adults, RSV can lead to severe outcomes in infants, such as bronchiolitis and pneumonia. Each year in the United States, an estimated 58,000 to 80,000 children younger than five years old are hospitalized because of RSV. This common virus affects nearly all children by age two, making understanding its impact and prevention important for parents.
Understanding RSV in Infants
RSV spreads through respiratory droplets from coughs or sneezes, and via contaminated surfaces or unwashed hands. Infants can contract RSV from family members or older siblings who may have picked up the virus in places like school or daycare.
Some infants face a higher risk of severe RSV infections. Babies born prematurely, those younger than six months, and infants with underlying conditions like chronic lung disease or congenital heart disease are particularly susceptible. Children with weakened immune systems or neuromuscular disorders that affect their ability to clear secretions also have an increased risk. While RSV can lead to hospitalization for healthy, full-term infants, these high-risk groups face a greater chance of complications requiring medical intervention.
Practical Steps to Protect Your Baby
Implementing everyday measures can significantly reduce the risk of RSV infection for your baby. Rigorous hand hygiene is important; caregivers and visitors should wash hands frequently with soap and water for at least 20 seconds, especially before touching the baby. If not available, use an alcohol-based hand sanitizer.
Regularly cleaning and sanitizing high-touch surfaces, such as doorknobs, counters, and toys, helps eliminate the virus from the environment. Avoid close contact with sick individuals, including anyone with cold-like symptoms or fever. Breastfeeding offers passive immunity, as antibodies from breast milk can help protect your baby from RSV and other infections during their most vulnerable period. Additionally, creating a smoke-free environment for the baby is important, as exposure to tobacco smoke increases the risk of severe RSV.
Medical Interventions for RSV Prevention
Medical science offers specific strategies to protect infants from severe RSV. A maternal RSV vaccine, such as Abrysvo, can be administered to pregnant individuals between 32 and 36 weeks of gestation. This vaccine helps the mother produce antibodies transferred to the baby, providing protection from birth through the first six months of life.
Another option is a direct infant immunization, nirsevimab (Beyfortus), a single-dose monoclonal antibody. This provides immediate, passive immunity by delivering ready-made antibodies to the baby, blocking the virus. Beyfortus is approved for newborns and infants entering their first RSV season, and for some children up to 24 months who remain vulnerable in their second RSV season. Unlike a vaccine, which stimulates the body to produce its own antibodies, Beyfortus directly supplies these protective antibodies. Palivizumab (Synagis) is another monoclonal antibody typically reserved for high-risk infants who meet specific criteria, such as very premature babies or those with certain heart or lung conditions. It is given as a monthly injection during RSV season for up to five doses.
Recognizing RSV Symptoms and When to Seek Help
Knowing RSV symptoms is important for timely intervention. Mild RSV symptoms often resemble a common cold and can include a runny nose, cough, sneezing, and sometimes a low-grade fever. Infants may also show irritability, decreased activity, or reduced feeding. Symptoms typically appear about four to six days after exposure and usually resolve within one to two weeks.
Recognize warning signs of severe RSV that require immediate medical attention. These include difficulty breathing, characterized by fast or shallow breaths, struggling to breathe, or muscles pulling inward with each breath (chest retractions). Other concerning signs are wheezing (a high-pitched sound during breathing out), grunting sounds, flaring nostrils, or a bluish color around the lips or skin (cyanosis), indicating a lack of oxygen. A significant decrease in activity, lethargy, or poor feeding that leads to dehydration also warrants prompt medical evaluation. Parents should contact their pediatrician for concerning symptoms or seek emergency care if their child exhibits severe breathing difficulties, bluish skin, or extreme lethargy.