Respiratory Syncytial Virus (RSV)

Grandfather holding baby

What You Need to Know

Respiratory Syncytial Virus (RSV) is recognized as one of the most common causes of childhood illness. More specifically, RSV is the leading cause of bronchiolitis and pneumonia in U.S. children aged less than one year, and especially infants born prematurely. Each year in the United States, approximately 75,000 to 125,000 children aged <5 years are hospitalized because of RSV complications.

For information on RSV circulation in Montana, visit our Influenza webpage and click on Montana Influenza Weekly Summary. This report is updated every Friday during flu season. 

  • An infected person coughs or sneezes
  • You get virus droplets from a cough or sneeze in your eyes, nose, or mouth
  • You have direct contact with the virus, like kissing the face of a child with RSV
  • You touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands

People infected with RSV are usually contagious for 3 to 8 days and may become contagious a day or two before they start showing signs of illness.

People infected with RSV usually show symptoms within 4 to 6 days after getting infected. Symptoms of RSV infection usually include

  • Runny nose
  • Decrease in appetite
  • Coughing
  • Sneezing
  • Fever
  • Wheezing

In very young infants (less than 6 months old), the only symptoms of RSV infection may be

  • Irritability
  • Decreased activity
  • Decreased appetite
  • Apnea (pauses in breathing more than 10 seconds)

Fever may not always occur with RSV infections.

Call your healthcare professional if you or your child is having difficulty breathing, not drinking enough fluids, or experiencing worsening symptoms.

There is no vaccine yet to prevent RSV infection, but scientists are working hard to develop one. Here are steps you can take to help prevent the spread of RSV. Specifically, if you have cold-like symptoms you should

  • Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands
  • Wash your hands often with soap and water for at least 20 seconds
  • Avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others
  • Clean frequently touched surfaces such as doorknobs and mobile devices
  • Stay home if you are sick

Parents of children at high risk for developing severe RSV disease should help their child, when possible, do the following

  • Avoid close contact with sick people
  • Wash their hands often with soap and water for at least 20 seconds
  • Avoid touching their face with unwashed hands
  • Limit the time they spend in childcare centers or other potentially contagious settings during periods of high RSV activity. This may help prevent infection and spread of the virus during the RSV season
  • How to protect your child from RSV infographic 

Most RSV infections go away on their own in a week or two. There is no specific treatment for RSV infection, though researchers are working to develop vaccines and antivirals (medicines that fight viruses).

Take steps to relieve symptoms

  • Manage fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. (Never give aspirin to children.)
  • Drink enough fluids. It is important for people with RSV infection to drink enough fluids to prevent dehydration (loss of body fluids).
  • Talk to your healthcare provider before giving your child nonprescription cold medicines. Some medicines contain ingredients that are not good for children.

People at highest risk for severe disease include:

  • Premature infants
  • Young children with congenital (from birth) heart or chronic lung disease
  • Young children with compromised (weakened) immune systems due to a medical condition or medical treatment
  • Children with neuromuscular disorders
  • Adults with compromised immune systems
  • Older adults, especially those with underlying heart or lung disease

Palivizumab (Synagis®) is a monthly prophylactic treatment that has reduced the incidence of RSV infections in high risk infants and children by about half during a typical RSV season. Palivizumab is not typically covered by insurance companies without prior authorization of eligibility criteria brought forth from organizations such as The American Academy of Pediatrics (AAP).

Montana RSV testing data may lead to improved clinical decision making for Palivizumab authorization at the local level for several reasons:

  • Detecting unusually early, or late, RSV season onset/offset, and providing urgent or unnecessary Palivizumab authorization or declination.
  • Detecting an unusually late RSV season so Palivizumab use can be conserved for those infants who have received <5 doses after RSV season begins.
  • More accurately describing RSV season onset and offset for future planning.

RSV Burden Estimates

RESPNET platform graphics RSVNET

Each year in the United States, RSV leads to approximately:

  • 2.1 million outpatient (non-hospitalization) visits among children younger than 5 years old.
  • 58,000-80,000 hospitalizations among children younger than 5 years old.
  • 60,000-160,000 hospitalizations among adults 65 years and older.
  • 6,000-10,000 deaths among adults 65 years and older.
  • 100–300 deaths in children younger than 5 years old. 

(CDC, 2023)