What to Know About RSV, Medicine, and Treatments That Can Help

Respiratory syncytial virus infection (RSV) is an illness that affects the lungs and breathing passages. Most children have had RSV by age 2 years . But, it can be serious in infants, children with chronic conditions, and older people.

Respiratory syncytial virus infection (RSV) is a common respiratory illness. It causes mild symptoms in most people , like coughing, runny nose, and fever. But in some individuals, RSV can quickly turn severe and lead to trouble breathing and even death.

RSV is a viral infection. This means it’s passed from person to person through direct contact with substances containing the virus, like saliva droplets or nasal mucus. In babies 12 months old and younger, RSV is the leading cause of potentially life threatening conditions like bronchiolitis and pneumonia.

For most people, RSV resolves on its own without prescription medication within 1 to 2 weeks. During the illness, your doctor or healthcare professional may suggest using over-the-counter (OTC) drugs and other home measures to manage your symptoms.

These may include:

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• pain relievers and fever reducers (acetaminophen, ibuprofen, etc.)
• nonprescription cold medications (for adults, not children)
• drinking plenty of water and other fluids to stay hydrated
• getting enough quality rest to help your body recover

The Food and Drug Administration (FDA) has approved two medications for treating and helping prevent RSV:

Ribavirin

Currently, the only FDA-approved drug for the treatment of active RSV infection is Ribavirin. This medication is an inhaled medication used only for hospitalized pediatric patients who have severe lower respiratory RSV infections.

However, researchers suggest there isn’t much evidence that this medication actually improves a person’s outcome. This drug is also potentially toxic and expensive, so it’s primarily used in very specific circumstances when individuals have conditions that compromise their immune systems.

Palivizumab

Palivizumab (or Synagis) is an FDA-approved medication doctors prescribe to premature babies and children with certain types of heart and lung disease. This medication is made from monoclonal antibodies and given monthly as a series of injections (shots) during the 5 months of RSV season.

This medication may help:

• prevent severe RSV if a child is exposed
• reduce the number of days a child spends hospitalized
• reduce the number of days a child has wheezing

It’s important to understand that this medication is not used to treat active RSV infection. Instead, it is used to help prevent severe disease in children who are most likely to experience complications or hospitalization.

4’-fluorouridine

Researchers are also looking into antivirals — similar to Paxlovid for COVID-19 — that could lessen the severity and shorten the duration of RSV.

4’-fluorouridine is a broad-spectrum antiviral that may be able to treat both RSV and COVID-19 when given once a day as an oral pill. Early studies in mice show it works by stopping the proteins that allow these viruses to copy themselves inside the body.

Besides Palivizumab, there are currently no approved medications or vaccine options to prevent RSV.

Doctors suggest keeping current with your annual flu shot and COVID-19 vaccine to help strengthen and keep your respiratory system and immune system functioning at their best.

Other prevention methods:

• washing hands frequently with soap and water for at least 20 seconds
• cleaning high-touch surfaces (doorknobs, tables, utensils, etc.) often
• coughing or sneezing into your elbow or a tissue
• isolating sick family members, especially babies, young children, and people with chronic health issues or weakened immune systems
• keeping air flowing in indoor spaces, including opening a window for better circulation when possible
• masking in social settings or when around people who may have RSV

Call your doctor or get emergency help if you or your child:

• has trouble breathing
• cannot drink enough fluids (dehydration)
• has symptoms that are getting worse

Some people may need to be hospitalized for a few days to receive intravenous (IV) fluids, oxygen, or in the most severe cases, mechanical ventilation.

If you or your child is diagnosed with RSV, you’ll probably have some questions. Consider writing down these suggestive questions before heading to your doctor’s appointment.

Helpful questions might include:

• How does RSV differ from a common cold?
• How long do symptoms typically last?
• What symptoms indicate I should get emergency help?
• What medications are available (prescription or OTC) to help?
• Is my child eligible for Palivizumab injections?
• How can I prevent the rest of my family from getting sick?
• How long should I stay home from work/school?
• What happens if someone is hospitalized with RSV?

How long is someone with RSV contagious?

People with RSV are contagious in the 1 to 2 days before symptoms start. They remain contagious for between 3 to 8 days after illness onset.

Who is at the highest risk for complications from RSV?

Children who are most likely to experience complications include premature babies and young children with chronic health issues or weakened immune systems. Adults at highest risk include those with compromised immune systems, heart disease, or lung disease and adults over age 65 years .

What time of year is RSV most prevalent?

RSV tends to start in the fall and peak in the winter months. That said, timing and severity can change from year to year, depending on where you’re located.

Most people contract RSV as toddlers. While the virus is common, it can significantly increase the likelihood of adverse effects in young children, older adults, and people with certain heart and lung conditions.

Speak with your doctor if you are at high risk for complications from RSV.

Ribavirin may be a helpful treatment for RSV in some people. Palivizumab may help prevent severe infection when given preventively.

Researchers are continually looking into antiviral drugs that may advance available treatment options for RSV in the future.

Last medically reviewed on March 24, 2023