Respiratory Syncytial Virus (RSV): Is It Just A Cold?

RSV is a common viral infection that most children have before their second birthday. In most babies and young children, RSV is usually labeled as a ‘bad cold,’ but very young infants and those with lung problems or other medical conditions can become sick enough to require hospitalization. How can you tell if your child has RSV, and what can you do to help them through the illness at home?

What Is RSV?

Respiratory Syncytial Virus, or RSV, is a highly contagious virus that spreads through contact with an infected person’s saliva, mucus, or respiratory secretions (snot). The vast majority of RSV cases are mild and produce cold-like symptoms. However, young infants and children with compromised immune systems can suffer from more severe illness and may require hospitalization.

RSV is usually diagnosed based on the symptoms. Lab tests can differentiate RSV from other viral infections like influenza or COVID-19 but are generally only ordered when a healthcare provider will change their treatment plan based on results. There is no specific antiviral treatment for RSV, so your doctor may not even order the lab test.

RSV Symptoms & Timeline

RSV is characterized by cold-like symptoms such as:

• Low-grade fever
• Coughing
• Runny nose
• Fussiness
• Irritability
• Poor feeding/Decreased appetite
• Decreased sleep

RSV symptoms generally start to appear within 3-8 days after exposure and last about 7-10 days. Days 4-7 are usually the ‘worst’ days for symptoms. Unfortunately, there is no treatment to cure RSV or shorten the duration of illness. The best thing to do is to focus on providing comfort and symptom relief to your little one.

Red Flags

Caring for a sick child can be scary, and RSV infections are no exception. However, even the best care won’t keep all children out of the hospital. Some red flag symptoms to watch for include:

• Difficulty breathing: If it looks like they are ‘sucking in’ air under the ribs or you notice their nostrils flaring open with each breath
• Fast Breathing: More than 60 breaths in one minute indicates your baby is working too hard
• Noisy breathing: wheezing or ‘grunting’ noises are abnormal
• Pauses in breathing
• Dehydration: Less than 1 wet diaper in 8 hours OR refusal to eat, drink, or breastfeed
• Color changes: Pale, gray, or blue tint to the skin
• Lethargy: difficulty arousing your child for feeds
• Feverover 100.4F in an infant less than 3 months, or over 104F at any age

If you are concerned about your child, call your child’s doctor, 911, or seek immediate medical care.

RSV Compared To COVID, Colds, And The Flu

Experts expect infants and young children to ‘catch’ 6-10 colds per year. RSV and COVID-19 are just two of many viruses that cause cold symptoms. Testing isn’t necessary most of the time because it won’t change the treatment plan.

It’s almost impossible to tell by symptoms alone in babies and young children because they can’t tell you what hurts or how they feel. Fussiness, fatigue, and a cough could easily be caused by a cold, COVID-19, the flu, or RSV.

Testing can help distinguish RSV from influenza. Healthcare providers often have a good idea based on the time of year and symptoms, but testing helps prepare caregivers for what to expect. If it’s RSV, we talk about supportive care. If it’s flu, antiviral medications may be prescribed to shorten the duration of illness and hopefully prevent complications.

Treatments For RSV

1. Suction:Babies and toddlers with RSV produce a LOT of snot.
1. Run a cool mist humidifier in your child’s bedroom to keep the snot thin and easy to remove
2. Use saline drops with a bulb syringe to gently remove snot and clear the nostrils. Suction right before feedings and when you notice lots of secretions
2. Hydration
1. Offer small amounts of breast milk or formula more frequently throughout the day
2. If old enough for regular milk or water – make sure your child has a sippy cup and encourage frequent sips
3. Watch for wet diapers – if the diaper is dry more than 8 hours, call your pediatrician’s office
3. Comfort
1. Use fever-reducing medication to promote comfort
2. Allow extra time for rest
3. Get comfy and enjoy some extra snuggles

Home Medicine Cabinet Must Haves

Stock your home medicine cabinet with a few essential items so you’re prepared to support your little one through the most common symptoms of RSV, influenza, and other coughs and colds.

• Fever-reducing medication – acetaminophen and ibuprofen (infants over 6 months old)
• Saline drops
• Suction Device - Bulb syringe, electronic, or parent-powered
• Otoscope to help you watch for ear infection development[MM1] [ADM2]
• Thermometer
• Cool-Mist humidifier

RSV, the flu, and colds all have common symptoms in babies, toddlers, and young children. The main treatments for these common illnesses is to provide comfort and keep little ones hydrated when they don’t feel well. Make sure your home medicine cabinet is well stocked so you are prepared for coughs and sniffles that are inevitable parts of winter.