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RSV – Symptoms, Causes and Treatment

RSV (Respiratory Syncytial Virus) is a common respiratory virus that primarily affects infants, young children, and older adults, causing symptoms similar to a cold or flu.

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RSV (Respiratory Syncytial Virus) is a common respiratory virus that primarily affects infants, young children, and older adults, causing symptoms similar to a cold or flu.

What is RSV?

RSV stands for Respiratory Syncytial Virus. It is a widespread RNA virus belonging to the family Pneumoviridae that infects the respiratory tract. RSV is one of the most common causes of respiratory illness in infants and young children worldwide. Older adults and individuals with weakened immune systems or chronic health conditions are also at heightened risk of severe disease.

Causes and Transmission

RSV spreads through direct contact with infectious respiratory secretions, including:

Droplet transmission (coughing, sneezing)
Contact with contaminated surfaces followed by touching the mouth, nose, or eyes
Close physical contact with an infected person

The virus is most active during autumn and winter, causing seasonal outbreaks. The incubation period is typically 2 to 8 days.

Symptoms

Symptoms of RSV infection vary depending on the age and health status of the individual:

In older children and adults

Runny or stuffy nose
Mild fever
Cough
Sore throat
General feeling of illness

In infants and young children

Wheezing or whistling sounds during breathing
Rapid or labored breathing
Bluish discoloration of the lips or fingernails (cyanosis) – a medical emergency
Difficulty feeding and irritability
Bronchiolitis: inflammation of the small airways – a common and serious complication in infants

In older adults and immunocompromised individuals

Pneumonia (lung infection)
Worsening of underlying conditions such as COPD or heart failure

Diagnosis

RSV infection is primarily diagnosed based on clinical presentation and physical examination. The following tests may be used to confirm the diagnosis:

Rapid antigen test: Detects RSV antigens in a nasopharyngeal swab – fast and easy to perform
PCR test (Polymerase Chain Reaction): Highly sensitive detection of viral genetic material, especially recommended for adults and immunocompromised patients
Blood count and inflammatory markers to assess the severity of the illness

Treatment

There is no specific antiviral treatment available for most patients with RSV. Management is primarily symptomatic and supportive:

Adequate fluid intake to prevent dehydration
Fever-reducing medications (e.g., paracetamol or ibuprofen)
Nasal decongestant drops to ease breathing
In severe cases: supplemental oxygen, nebulized therapy, or hospitalization

Prophylaxis with Palivizumab

Palivizumab is a monoclonal antibody used as passive immunization in high-risk infants (e.g., premature babies, children with congenital heart defects) to prevent severe RSV disease.

RSV Vaccination

Since 2023, new RSV vaccines have been approved in Europe and the United States for older adults (aged 60 and above). In addition, a monoclonal antibody called Nirsevimab is available for prophylaxis in newborns and infants. Vaccination of pregnant women can also protect newborns by transferring maternal antibodies to the unborn child.

High-Risk Groups

Individuals at greatest risk of severe RSV disease include:

Premature babies and newborns
Infants under 6 months of age
Children with congenital heart or lung conditions
Older adults (aged 65 and above)
Individuals with immunodeficiency or chronic illnesses

References

World Health Organization (WHO): Respiratory syncytial virus (RSV). www.who.int
Centers for Disease Control and Prevention (CDC): RSV in Infants and Young Children. www.cdc.gov
Simoes EAF et al. – Respiratory syncytial virus. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Elsevier, 2020.

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