What is respiratory syncytial virus (RSV)?

Respiratory syncytial virus (RSV) is a virus that causes infection in the lungs and airways. It is highly contagious. It is one of the most common causes of respiratory (breathing) infections in children, including the common cold.

RSV can affect people of all ages, but is likely to be more serious for:

• infants aged 12 months or under
• young children or older adults with chronic health conditions

You can get RSV multiple times. Recovery from RSV gives some immunity (protection) against getting it again, but this immunity is not long-lasting.

What are the symptoms of RSV?

In most people, RSV causes mild respiratory illness.

You usually first notice symptoms around 5 days after being exposed to the virus. You may feel increasingly unwell over the first 3 to 4 days of the illness and then start to improve.

Symptoms may include:

• runny nose
• cough
• sneezing
• wheezing
• fever

RSV symptoms in young babies

If your baby is younger than one year, they are more likely to develop breathing problems caused by bronchiolitis or pneumonia.

Young children may develop wheezing and difficulty breathing, especially if they have asthma.

Your baby may have difficulty feeding and may be unsettled. They may need to go to hospital if they have breathing or feeding difficulties.

What causes RSV?

RSV is a highly contagious virus, that causes lung and airway infections. It spreads through tiny droplets released when an infected person talks, coughs, or sneezes. Being in close contact with someone who has RSV increases the likelihood of you getting the virus.

You are usually infectious (can pass on the virus) for up to 8 days from when your symptoms begin. RSV is very contagious. The virus can live on surfaces for several hours or your unwashed hands for 30 to 60 minutes.

It can be difficult to stop the spread of RSV. Practising handwashing and good hygiene can help to avoid passing the virus onto others.

How is RSV diagnosed?

RSV can be diagnosed by:

• a laboratory test on samples taken from your nose and throat
• a blood test to look for antibodies to the virus

Most doctors will be able to diagnose a child with severe RSV infection based on their signs and symptoms.

Home testing kits are also available that can test for a range of viruses including RSV, influenza and COVID-19.

How is RSV treated?

There is no specific treatment for RSV, but having lots of rest and drinking plenty of fluids will help you recover. Most people recover from RSV in about 10 days.

Antibiotics don’t work against RSV, because it is a virus.

How is RSV treated in babies?

You can usually manage mild cases of RSV at home. Often, you won't need to give your baby medicine, and all they will need is rest.

There are some things you can do at home to make sure your baby stays hydrated and comfortable. It may be easier for your baby to drink small amounts often, so offer your baby the bottle or the breast at frequent intervals.

If your baby has a fever, treat your baby with paracetamol or ibuprofen (in doses recommended on the bottle). Young babies, premature babies, babies with pre-existing heart and lung conditions, and babies with severe bronchiolitis may need to go to hospital for help with breathing or feeding.

How is RSV treated in young children?

Treating young children with RSV is similar to treating babies with RSV. It is important to offer your child small amounts of fluid often.

You can bring down your child's fever with paracetamol or ibuprofen. If your child attends day care, it is important not to send them back until they are feeling well. If your child has breathing or feeding difficulties, they may need to go to hospital.

When should I see my doctor?

You or your child should see a doctor if:

• they have a high fever
• they are having difficulty feeding or are refusing to feed
• their cough becomes worse
• you are concerned about your child's breathing

Can RSV be prevented?

It is not possible to prevent RSV infection, but vaccine and other immunisation products can help reduce the severity of illness, particularly in the very young and older people.

RSV vaccination is recommended for:

• pregnant women, to protect their newborn infant
• all people 75 years and older and Aboriginal and Torres Strait Islander people 60 years and older
• people 60 years and older with medical risk factors for severe RSV disease

RSV medicine (monoclonal antibodies) is recommended for:

• young infants whose mothers did not receive the RSV vaccine in pregnancy, or who were vaccinated less than 2 weeks before birth
• young infants who are at increased risk of severe RSV disease, regardless of their mother’s vaccination status
• children who have medical risk factors for severe RSV disease in their 2nd RSV season

Conditions that increase the risk of severe disease in children include:

• children born premature
• cardiac disease
• chronic respiratory conditions
• neuromuscular disorders (including cerebral palsy and spinal muscular atrophy)
• immunocompromising conditions
• Down syndrome

Conditions that increase the risk of severe disease in adults include:

• chronic metabolic disorders, including diabetes
• chronic kidney disease (stage 4 or 5)
• chronic liver disease
• chronic neurological conditions (including seizure disorder)
• living with obesity

Most states and territories in Australia have announced a free access to monoclonal antibody treatments for eligible children. To find out more information speak to your doctor, child health nurse or vaccine provider.

Two monoclonal antibodies are currently available in Australia, Beyfortus (nirsevimab) and Synagis (palivizumab).

These medicines provide passive immunity to RSV. They work by transferring readymade antibodies (that fight infection) to the baby, providing some level of protection and immunity against RSV.

Pregnant women can now be vaccinated with Abrysvo between 24 and 36 weeks of pregnancy. Anti-RSV antibodies will pass from mother to baby and will help protect your baby from birth to 6 months. Abrysvo is part of the National Immunisation Program. To be eligible for a free NIP vaccine, you must hold or be eligible for a Medicare card.

Speak to your doctor, midwife or vaccine provider about getting vaccinated for RSV during pregnancy.

For other people there may be a charge to receive RSV vaccinations.

Other ways to prevent RSV include maintaining good hygiene and teaching older children about personal hygiene. Good hygiene measures include:

• hand washing
• covering your nose and mouth when sneezing and coughing
• regularly cleaning surfaces that may be contaminated
• avoiding sharing cups and eating utensils
• staying at home if you feel unwell

Complications of RSV

Babies and children with RSV can have various complications including bronchiolitis, pneumonia and ear infections. If your child develops these complications, your doctor may recommend you manage their health at home with close follow-up. Your doctor may suggest that they go to hospital if they need help with breathing and feeding.

Older people and people who have problems with their heart, lungs or immune system are also at risk from RSV infections.

Resources and support

For more information about RSV and its symptoms, diagnosis and treatment, speak to your doctor.

You can call the healthdirect helpline on 1800 022 222. A registered nurse is available 24 hours a day, 7 days a week.

You can also find out more information at the following websites:

• The Royal Children's Hospital (RCH) fact sheet on RSV
• NSW Health fact sheet on RSV

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.