As a seasonal illness, respiratory syncytial virus (RSV) generally makes it first appearance in most parts of the U.S. in the fall and peaks in the winter. But this year, much of the country is experiencing a massive early wave of the common lung infection.
The 2022 RSV surge has been called “the worst pediatric-care crisis in decades” by some media outlets due to the high volume of emergency department visits with RSV. Texas saw a peak of about 1,300 positive nasal swab tests for RSV in mid-October – more than double the 500 from last year at this time.
COVID-19 mitigations such as wearing masks and physical distancing helped reduced the spread of the novel coronavirus and also limited nearly all respiratory viruses the last couple years. But as masking declined and kids returned to daycares and schools, RSV has made a resurgence.
Most children will catch and recover from RSV by the time they’re 2; for most, symptoms are similar to a mild cold and resolve in a week without treatment. But for premature infants, babies younger than six months, and those with immune, heart, or lung problems, RSV can cause severe illnesses such as pneumonia and bronchiolitis that may require hospitalization. The risks increase when other seasonal viruses are making their rounds, such as influenza.
RSV is highly contagious and is spread through close contact with a person who has the virus. This can be through droplets sprayed by a sneeze or cough, or by touching an infected hard surface and then touching your face.
The risk increases during the holiday season, when friends and family are likely to gather in large groups – with many looking forward to seeing you and meeting your new baby. While concerns about RSV shouldn’t keep you from attending those family events, there are sensible precautions you can take to help protect your little one from respiratory viruses.
Spot RSV symptoms
Because RSV is a virus, there is no quick medicine or treatment to make it go away. We just have to let it run its course over a week or so and do what we can to relieve symptoms, which can appear two to eight days after exposure. Symptoms start out resembling a mild cold:
- Congested or runny nose
- Low-grade fever
- Sore throat
Talk with your child’s doctor about how to treat symptoms of mild RSV. Depending on the baby’s age and severity of symptoms, they may recommend over-the-counter fever reducing medication or other soothing strategies.
If RSV spreads to the lower respiratory track, it can cause more severe problems. Seek immediate medical care if your child has any of these symptoms:
- High fever
- Severe cough
- Rapid, labored breathing
- Extreme fatigue
- Bluish color to the skin, lips, or nails
Babies with severe RSV may need breathing support in the hospital or medications to manage high fever. About 2% of babies younger than 6 months who have RSV need to be hospitalized; most go home in a few days. In the hospital, we can provide IV fluids and breathing support from an oxygen machine or ventilator.
Follow good hygiene habits
Reinforcing good hygiene habits learned during the COVID-19 pandemic can help prevent the spread of RSV:
- Wash your hands frequently with soap and water for at least 20 seconds each time, and remind your older children of the importance of handwashing
- Cover coughs and sneezes with a tissue or shirtsleeve
- Don’t share drinking glasses or silverware
- Clean and disinfect high-touch surfaces, such as doorknobs, phones, and toys
- Avoid contact with people who have cold-like symptoms
- Stay home as much as possible when you or your children are sick
SYNAGIS is a medication that can help protect babies at high risk for severe RSV, such as premature infants and young children with certain heart and lung conditions. SYNAGIS is given as a series of monthly shots during RSV season. While it may not entirely prevent RSV, it can prevent these babies from getting extremely sick.
If your baby was born prematurely, has chronic lung or heart disease, or has a weakened immune system, take extra steps to avoid RSV.
Stay within your family bubble as much as possible until your baby can get their first round of vaccinations around 2 months old. During this time, RSV and illnesses such as whooping cough (pertussis) are a particular concern. Ask older siblings to wash their hands before touching the baby and avoid kissing the baby’s face – we suggest telling them to kiss the baby’s feet instead.
If friends or family visit, ask them to wash their hands before touching or holding the baby. If you’re not sure about a visitor’s health status, ask them to wear a mask. While this can be an uncomfortable topic, don’t let that keep you from advocating for your child. If you are going to be around a lot of people, consider wearing a mask yourself to help avoid bringing germs home to your baby.
Related reading: 10 tips for handling and holding a newborn
RSV vaccine may be coming soon
There is no vaccine currently approved to prevent RSV infection, but the first one – intended for pregnant women to protect their newborns – may be on its way.
A recent clinical trial showed a new vaccine was highly effective at protecting newborns when the shot is given to expectant mothers late in their pregnancy. In a study of 7,400 pregnant women and infants, the vaccine was 82% effective at preventing severe lower respiratory tract illnesses due to RSV that required hospitalization or assisted breathing in the first three months of the baby’s life, and 70% effective in the first six months of life.
Pfizer, which developed the vaccine, has announced plans to apply for U.S. Food and Drug Administration (FDA) approval by the end of the year. Clinical trials have included pregnant women so far; additional studies are expected to see whether it is effective in young children.
Between work, daycare, and social activities, it’s almost impossible to entirely avoid RSV exposure. All you can do is the best you can to protect your children. If someone in your family gets sick, call your health care provider. We are here to offer guidance on how to make them feel better or provide advanced care if the illness becomes severe.