Respiratory Syncytial Virus (RSV) is a common virus that affects the respiratory tract, particularly in infants, young children, and older adults. While most cases of RSV cause mild, cold-like symptoms, it can lead to serious complications in vulnerable groups. Here, we look at what RSV is, its symptoms, and why it requires special attention in certain groups of people.
What is RSV?
RSV is a highly contagious virus that primarily infects the lungs and breathing passages. It is a leading cause of respiratory illness in young children, but it is also common to see RSV in adults. In most cases, it will cause mild symptoms, but in severe cases, it can lead to pneumonia or bronchiolitis, a condition where the small airways in the lungs become inflamed.
Signs and symptoms of RSV
The symptoms often resemble those of a common cold, including:
- Runny nose
- Decreased appetite
- Coughing
- Sneezing
- Fever
- Wheezing
In very young infants, the only signs may be irritability, decreased activity, and difficulty breathing. For elderly people, symptoms can progress to severe respiratory distress.
Who is most at risk?
RSV can affect anyone, but it is particularly dangerous for:
- Babies, especially those under six months old
- Premature infants
- Children with weakened immune systems or chronic lung/heart conditions
- Older adults, particularly those with underlying health issues, such as COPD or asthma
- Immunocompromised people
How is RSV spread?
It spreads through:
- Direct contact with respiratory secretions, such as saliva or mucus
- Touching contaminated surfaces like doorknobs, toys, or medical equipment
- Airborne droplets from coughs or sneezes
The virus can survive on hard surfaces for several hours and on hands for about 30 minutes, making it easy to catch in settings like nurseries or care homes.
Treatment for RSV
Most RSV infections resolve on their own within one to two weeks. Supportive care includes:
- Staying hydrated: Encourage fluids to prevent dehydration.
- Relieving symptoms: Use saline drops for nasal congestion and a cool-mist humidifier for easier breathing.
- Monitoring fever: Paracetamol can be given to manage fever, but always follow age-appropriate guidelines.
Severe cases, especially those involving breathing difficulties, may require hospitalisation for oxygen therapy, fluids, or ventilation.
Potential complications
While it is usually mild, it can sometimes lead to serious complications, including:
- Bronchiolitis
- Pneumonia
- Respiratory failure
- Hospitalisation: According to the NHS, RSV is the most common reason for hospital admission in children under one year old in the UK.
- Long-term respiratory issues: Severe RSV infections in early life may increase the risk of asthma and recurrent wheezing.
For elderly people, RSV can exacerbate existing conditions like COPD or heart failure, significantly impacting their overall health.
UK statistics
RSV is a significant health concern in the UK:
- In 2021, an estimated 29,000 children under five were hospitalised due to RSV-related conditions.
- The virus accounts for a large percentage of winter hospitalisations among children.
- RSV in adults contributes to thousands of hospital admissions annually, with a higher mortality risk in those over 65.
Spotting RSV in babies and the elderly
Early identification can prevent complications. Here’s what to look out for:
In babies
- Laboured breathing, including flaring nostrils or chest retractions (where the skin pulls in between the ribs during breathing)
- Persistent wheezing or coughing
- Difficulty feeding or signs of dehydration (e.g., fewer wet nappies)
- Bluish tint to the lips or fingernails, indicating oxygen deficiency
In the elderly
- Severe shortness of breath or wheezing
- Rapid decline in physical ability or sudden fatigue
- Confusion or disorientation (a possible sign of low oxygen levels)
- Worsening symptoms of existing conditions like asthma or heart disease
How to prevent RSV
Preventing RSV involves simple hygiene measures:
- Wash your hands frequently with soap and water.
- Avoid close contact with people who have cold-like symptoms.
- Disinfect surfaces that are frequently touched.
- Practice respiratory hygiene: Cover coughs and sneezes with a tissue or your elbow.
- Limit exposure: Keep babies away from crowded places during RSV season, typically autumn and winter.
For high-risk babies, your GP may recommend palivizumab, a prevention medication.
Protect yourself
RSV is a common yet potentially serious virus, particularly for babies and the elderly. By recognising the symptoms early, understanding who is most at risk, and taking preventative measures, families and healthcare workers can help reduce the impact of RSV.
If you suspect severe RSV in your child or an elderly relative, ring NHS 111 for urgent advice, or ring 999 for emergency medical treatment.
