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Respiratory Syncytial Virus (RSV): A Threat to Children

Published on Nov. 22, 2022

Respiratory syncytial virus (RSV) has long been a health threat to children – particularly infants, babies, and toddlers. RSV is so common in children that nearly all kids get RSV by the time they reach two years of age. In many cases, parents and caregivers may be completely unaware their child has the virus. That’s because early symptoms of RSV include runny nose, a cough, and decreased appetite – much like that of a cold.

If so many children get RSV, then what’s the big deal? While RSV is typically mild, it can be highly dangerous – even life-threatening – for children if more severe symptoms develop. RSV can also lead to bronchitis and pneumonia. Approximately 58,000 children under age five each year, including one in 100 babies under age 6 months, are hospitalized with RSV (Source: CDC).

In fall of 2022, Michigan experienced a sharp increase of RSV cases in children.

“We had very low numbers of our usual winter respiratory ailments such as RSV and influenza, last year – likely because of so many of us wearing masks and fewer large group gatherings,” says Dr. Christine Nefcy, MD, FAAP, Munson Healthcare’s Chief Medical Officer. “This year, we aren’t masking nearly as much and most people are back to normal socially, so we are seeing a high rate of spread of RSV in particular. Unfortunately, unlike COVID-19 and influenza, there is no vaccine for RSV and treatment is only supportive.”

Keep reading to learn more about RSV, the symptoms, and how to prevent and treat this common respiratory virus.

What is respiratory syncytial virus (RSV) in children?

RSV is a viral illness that causes many cold-like symptoms. It is spread when a child comes into contact with fluid from an infected person’s nose or mouth. This can happen if a child touches a contaminated surface and touches his or her eyes, mouth, or nose. It may also happen when inhaling droplets from an infected person’s sneeze or cough.

Symptoms of RSV usually start within 2 – 5 days after contact with the virus. The most common symptoms of RSV include:

  • Runny nose
  • Fever  
  • Cough
  • Short periods without breathing (apnea)
  • Trouble eating, drinking, or swallowing
  • Wheezing
  • Flaring of the nostrils or straining of the chest or stomach while breathing
  • Breathing faster than normal, or trouble breathing
  • Turning blue around the lips and fingertips 

Because of the risk of children developing more severe complications from RSV, such as pneumonia, it’s important to make sure your child sees their pediatrician or primary care provider if your child has any concerning symptoms like difficulty eating, drinking, or breathing.

How is RSV diagnosed in a child?

First, your child’s healthcare provider will ask about his/her symptoms and health history. They may also ask about any recent illness in your family or other children in childcare or school.

A physical exam will typically follow. If indicated, your child may also have tests, such as a nasal swab or wash. 

Should you be concerned about RSV?

Children are more at risk for RSV if they’re around other people with the virus. RSV often occurs in yearly outbreaks in communities, classrooms, and childcare centers. RSV is more common in winter and early spring months, though there’s growing concern that RSV is being diagnosed in children unseasonably early and with high frequency this year. 

The Early Phase of RSV. The early phase of RSV in babies and young children is often mild, like a cold. However, in children younger than age 3, or children with other complicating diagnosis, the illness may move into the lungs and cause coughing and wheezing.

Complications from RSV. In some children, RSV-induced infection morphs into a severe respiratory disease. They may require hospitalized treatment, especially for help with breathing. Developing RSV as a baby may be linked to asthma later in childhood.

Which children are most at risk for RSV?

RSV can affect a person of any age but causes the most problems for the very young. RSV infection in older children and adults may seem like an episode of severe asthma.  Babies born prematurely or with heart, lung, or immune system diseases are at increased risk for more severe illness.

“We recognize RSV as a dangerous virus for children, especially for our former preemies we discharge from our NICU,” explains Matthew Arnold, MD, Medical Director of Munson Medical Center's NICU. 

How is RSV treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Because RSV is viral, your child’s doctor won’t prescribe antibiotics. Treatment is focused instead on helping to ease symptoms and varies according to how serious the symptoms are. Treatment may include:

  • More fluids. It's very important to make sure your child drinks plenty of fluids. If needed, your child will get an IV (intravenous) line to give fluids and electrolytes.
  • Oxygen. This is extra oxygen given through a mask, nasal prongs, or an oxygen tent.
  • Suctioning of mucus.  A thin tube is put into the lungs to remove extra mucus.
  • Bronchodilator medicines. These may be used to open your child's airways. They are often given in an aerosol mist by a mask or through an inhaler.
  • Tube feeding. This may be done if a baby has trouble sucking. A thin tube is put through the baby’s nose and down into the stomach. Liquid nutrition is sent through the tube.
  • Mechanical ventilation. A child who is very ill may need to be put on a breathing machine (ventilator) to help with breathing.
  • Antiviral medicine. Some children with severe infections may need treatment with an antiviral medicine.

Talk with your child’s healthcare provider about the risks, benefits, and possible side effects of all treatments.

How can I help prevent RSV in my child?

The best ways to prevent RSV are to consistently wash hands, wear a facemask, avoid large crowds, and keep kids home if they are sick.

To reduce the risk for RSV, the American Academy of Pediatrics (AAP) recommends all babies, especially preterm infants:

  • Be breastfed
  • Be protected from contact with smoke – don’t let anyone smoke around your baby
  • Avoid childcare scenarios that expose your baby to many other children during his/her first winter season
  • Abstain from contact with sick people
  • Make sure that household members wash their hands or use an alcohol-based hand cleaner before and after touching your baby.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms

Do you have a pediatrician?

If you don’t have a pediatrician or primary care physician who specializes in children or family medicine, reach out to Munson Healthcare Find-a-Doctor at 231-935-5886 or Our team will help you find a qualified pediatrician near you. 


Health questions about your child – or you?

We’re here for you, including if you think your child is sick. If you have concerns, call Munson Healthcare Ask-a-Nurse at 231-935-0951 to discuss symptoms. Our nurses are answering health questions daily from 7 am to 11 pm at no charge to you (no insurance is required).

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Munson Healthcare’s Virtual Urgent Care is also available to assist with children over the age of 3.

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