Since the pandemic began we have learned a great deal about viruses. More than most people want to know about these organisms that can cause so much trouble. It seemed that suddenly there was a new virus making babies, the elderly, and the immunocompromised really sick. Respiratory syncytial virus (RSV) was and is making the headlines.
RSV was first identified by Dr. Morris Hilleman in 1956 in a sample taken from a child with a respiratory infection. Interestingly it was originally called “chimpanzee coryza agent” because we thought it originated from chimpanzees. Later it was found to be primarily a human virus.
Using the initials “RSV” is easier than respiratory syncytial virus. Syncytial formation is the virus causing a cell-to-cell fusion or sticking together of the cells lining the respiratory tract. This formation can be seen with a microscope.
RSV spreads like a cold virus from person to person. It enters the body through the nose or eyes usually from contact with infected saliva, mucus or nasal discharge. The virus is the most common cause of hospitalizations in children under the age of one year. For most children RSV is like a cold but for some it causes a “chest cold” or bronchiolitis. This is an inflammation of the smaller lung tubes. This can cause increased work of breathing and wheezing.
Two to three out of every 100 infants with RSV infections may require a hospital stay. They will need oxygen and fluids if they are having trouble eating or drinking. Most children get better in a couple of days and go home. For some the fusion of the infected cells hurt the airway lining and makes it hard to clear the mucous and damaged cells. As a result mucus and secretions accumulate leading to coughing, wheezing and difficulty breathing.
Caregivers should seek help if their baby is working hard to breathe. Watch while your baby breaths in and if there is an upside-down “V” shape under the neck, if the baby pauses while breathing, has a gray or blue color or has significantly decreased activity, call
Healthychildren.org gives updated guidelines for the care of children with RSV. First of all prevent the baby from becoming infected by limiting exposure to crowds and other children. Wash your hands for at least 20 seconds, disinfect objects and surfaces in your home regularly and avoid smoke from tobacco or other sources. Breast milk has unique antibodies which may help prevent and fight infections.
There are new vaccines available that help prevent serious illness from RSV. One dose of nirsevimab should be given just before RSV season (usually fall/winter) to all babies younger than 8 months. One dose should be given between 8-19 months to those who are entering their second RSV season and have a higher risk for serious illness due to premature birth, congenital heart disease or chronic lung infection.
Persons older than 60, pregnant women (32-36 week gestation) and immunocompromised should get their vaccine after talking to their doctor.
By Sally Robinson, MD
Keeping Kids Healthy
University of Texas Medical Branch (UTMB)
Published September 2023