Respiratory syncytial virus (RSV) in babies

This winter has been dreadful for viruses in children, from COVID-19, the flu, hand, foot and mouth disease (HFMD), to gastroenteritis, and the common cold. If your family has managed to dodge any of those, you’re one of the lucky ones.

Another virus that you may not have heard of before having a baby is respiratory syncytial virus (RSV). Children are presenting to hospitals with it at alarming rates this year.

In babies under one year, it is most severe and potentially life-threatening in a minority of cases. For children this young, RSV is a common cause of bronchiolitis, pneumonia, and croup.

Here is everything you need to know about RSV, including what the virus is, how it’s spread, the symptoms to look out for, how to get it diagnosed, and finally, the treatment and prevention.

What is respiratory syncytial virus (RSV)?

RSV is a highly contagious virus, and is the most common cause of respiratory and breathing infections in children.

How is RSV spread?

The infection spreads from an infected person to another person while talking, coughing, or sneezing. It also spreads through hand to hand contact or through contact with items that contain mucus of an infected person. Finally, it can be picked up from hard surfaces (such as toys and cups), and survives for several hours on hard surfaces, and for 30-60 minutes on unwashed hands and tissues.

This means that it can spread easily in environments like childcare centres. 

How do I know my baby has RSV?

Once your baby has been exposed, they may develop symptoms around five days later. Normally, the symptoms in children are mild and cold-like, which can be some or all of the following:

• Runny nose
• Coughing
• Wheezing
• Fever

How do I know it’s not just a cold then?

Most cases of RSV are mild and can be treated at home, as you would a cold. Ear infections are also common. You know your baby best, so trust your instincts if they don’t seem well. Take your baby to a doctor if:

• They have a fever and don’t look well
• They are having difficulty feeding and their nose is filled with mucus
• Their cough becomes worse, or they start coughing up mucus
• They are dehydrated (eg. fewer wet nappies, drowsy)
• They are refusing to feed and are irritable

Call an ambulance or go immediately to emergency if your baby is having trouble breathing, is breathing very quickly, or is turning blue. 

My baby is under 6 months. Should I be worried?

Some babies will need to go to hospital if they contract RSV. There is currently no vaccine for it but trials are underway. If your baby has a fever or is having any of the above symptoms, see your doctor immediately or go straight to emergency. You can’t be too cautious.

How is RSV diagnosed?

Your doctor will confirm the diagnosis through blood tests or through tests of the mucus from their airways or nasal passages.

How do I care for my baby at home?

• Keep them home and get plenty of rest.
• Lots of fluid: breast or bottle feed on-demand. Offer regular sips of water to babies over 6 months.
• Use paracetamol for fever (check with your GP first).
• Remove nasal fluids with a bulb syringe (AKA a snot sucker) and saline drops.
• Follow safe sleeping guidelines. Bassinets or cots should not be elevated.

How long will it take for them to recover?

Children can take from 8-15 days to recover from RSV.

How can I prevent RSV, or stop my older child from giving it to my baby?

Children with RSV can be contagious for 8 days from the start of their symptoms. It can be difficult to stop the spread, however practicing good hygiene will help avoid passing any virus onto others:

• If you have an infected child, try to keep them away from newborns, or at least discourage them from kissing them or touching their hands.
• Wash everyone’s hands regularly with soap and water to kill the virus, particularly after wiping someone’s nose, or before eating.
• Throw out tissues as soon as they’ve been used.
• Avoid sharing toys, cups etc. with children with cold symptoms. Ensure all of these items are cleaned thoroughly with soap and water between uses.