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RespiratoryICD-10: J21.0Causes approximately 58,000-80,000 hospitalizations in children under 5 annually in the U.S.

Respiratory Syncytial Virus (RSV)

Also known as: RSV, RSV Infection, Respiratory Syncytial Virus Infection

Respiratory syncytial virus (RSV) is a highly contagious virus that infects the lungs and breathing passages, causing symptoms ranging from a mild cold to severe lower respiratory infections such as bronchiolitis and pneumonia. RSV is the leading cause of hospitalization in infants and young children, and also poses a significant threat to older adults and people with compromised immune systems. Nearly all children are infected with RSV by age 2, and reinfection throughout life is common, though subsequent infections are typically less severe.

Symptoms

Runny nose and nasal congestion
Cough that may become wheezy
Low-grade fever
Sneezing and sore throat
Decreased appetite and irritability in infants
Rapid or difficulty breathing (in severe cases)
Wheezing or crackles heard during breathing
Bluish color of the skin (cyanosis) due to lack of oxygen in severe cases

Causes

  • Infection with respiratory syncytial virus (RSV), a single-stranded RNA virus
  • Transmitted through respiratory droplets from coughing or sneezing
  • Direct contact with contaminated surfaces (RSV can survive on surfaces for hours)
  • Close contact with infected individuals, especially in childcare and healthcare settings

Risk Factors

  • Premature birth (before 35 weeks of gestation)
  • Age under 6 months (highest risk for severe disease)
  • Congenital heart disease or chronic lung disease in infants
  • Weakened immune system from medical conditions or treatments
  • Age over 65, especially with underlying heart or lung disease
  • Exposure to secondhand smoke or crowded living conditions

Diagnosis

  • Rapid antigen detection test from a nasal swab
  • RT-PCR testing for RSV RNA (most sensitive diagnostic method)
  • Chest X-ray to assess for pneumonia or bronchiolitis in severe cases
  • Pulse oximetry to monitor blood oxygen saturation levels

Treatment

  • Supportive care with fluids, rest, and fever management (acetaminophen, ibuprofen)
  • Nasal suctioning and saline drops to relieve congestion in infants
  • Supplemental oxygen for patients with low oxygen saturation
  • High-flow nasal cannula or mechanical ventilation for severe respiratory failure
  • Ribavirin antiviral therapy in severe cases in immunocompromised patients
  • Nirsevimab (Beyfortus) monoclonal antibody for prevention in infants

Prevention

  • RSV vaccines (Arexvy, Abrysvo) for adults 60+ and pregnant individuals
  • Nirsevimab immunization for infants and young children during RSV season
  • Wash hands frequently with soap and water for at least 20 seconds
  • Avoid close contact with sick individuals, especially for high-risk groups
  • Clean and disinfect frequently touched surfaces
  • Keep infants away from crowded places during RSV season (fall through spring)

When to See a Doctor

  • An infant or young child has rapid breathing, wheezing, or difficulty breathing
  • Your child is not drinking enough fluids or has significantly fewer wet diapers
  • You notice a bluish color around the lips or fingernails
  • Symptoms worsen after initially improving, suggesting secondary infection

Frequently Asked Questions

Related Conditions

Asthma

Respiratory

Pneumonia

Respiratory

Bronchitis

Respiratory

Chronic Obstructive Pulmonary Disease

Respiratory

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

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