What is required to maintain contact precautions and prevent the spread of RSV?

Respiratory syncytial virus (RSV) infection is the most common cause of bronchiolitis and pneumonia among infants under 1 year of age.

Bronchiolitis is inflammation of small air passages in the lungs and pneumonia is inflammation of the lung tissue itself. Almost all children will get RSV infection at least once by 2 years of age.

RSV infection may cause respiratory (lung) disease at any age and can be severe among the elderly and people of any age with heart, lung or immune system problems.

Infections may recur throughout life. In South Australia, infections are most common during winter and early spring.

How RSV infection is spread

RSV is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby. Infection may be spread by contact with hands, tissues and other articles soiled by infected nose and throat discharges.

The virus survives outside of the body for a few hours and is easily killed by soap and water or disinfectants.

Signs and symptoms of RSV infection

The first symptoms are usually:

  • fever
  • runny nose
  • cough
  • wheezing. 

Ear infections are common. Pneumonia and bronchiolitis often follow, especially in infants. Most children recover from the illness in 8 to 15 days, but some require hospitalisation, mostly in the very young age group (below 6 months of age).

Diagnosis of RSV infection

Diagnosis can be made by direct detection or isolation of the virus from respiratory secretions or by blood tests.

Incubation period

(time between becoming infected and developing symptoms)

The average incubation period is 5 days, with a range of 2 to 8 days.

Infectious period

(time during which an infected person can infect others)

The infectious period is unclear but is probably from before symptoms start until recovery. Most people recover from the infection within about 10 days.

Treatment for RSV infection

There is usually no need for treatment other than paracetamol for fever and maintaining adequate fluid intake. Aspirin should not be given to children under 12 years of age unless specifically recommended by a doctor. 

Very ill children and elderly people may require admission to hospital (less than 3% of children with RSV require this) and treatment is supportive. Because RSV is a virus, antibiotics do not help. There are no safe and effective antiviral drugs for routine use for RSV.

Prevention of RSV infection

  • Exclude people with RSV from childcare, preschool, school and work until they are well.
  • There is currently no vaccine available.
  • Frequent hand washing is the most effective means of preventing spread, as the virus is easily killed by soap and water.
  • Avoid sharing cups, glasses and eating utensils with people who have respiratory infections.
  • Cover a cough or sneeze with a tissue or your arm. Drop used tissues immediately into a rubbish bin, and then wash your hands.
  • Hand hygiene
  • Exclusion periods from childcare, preschool, school and work

What is required to maintain contact precautions and prevent the spread of RSV?

Respiratory syncytial (sin-SISH-uhl) virus (RSV) is a common respiratory virus that infects the nose, throat, lungs, and breathing passages. RSV spreads through contact with respiratory droplets (coughing, sneezing, or kissing) from an infected person or touching surfaces contaminated with the virus and then touching your eyes, nose, or mouth. RSV can survive for many hours on hard surfaces such as tables and crib rails. The virus typically lives on soft surfaces such as tissues and hands for shorter amounts of time. Children are often exposed to RSV outside the home, in school or daycare centers. They can then transmit the virus to other members of the family.

RSV is so widespread that almost all children will have had an RSV infection by their 2nd birthday. RSV can be serious and can lead to severe illness among both children and older adults. While certain groups including premature and very young infants (6 months), individuals with chronic heart or lung disease, immunocompromised individuals, and older adults (65+), are at increased risk for severe disease, the potential for dangerous complications is a concern for all age groups.



Burden

In the US, RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children <1 year, and leads to approximately 1.5 million outpatient visits, 520,000 emergency department visits, 58,000 hospitalizations, and an estimated 100 to 500 deaths among children younger than age five years annually. The virus is also increasingly recognized as a significant cause of respiratory illness in older adults in the US and is estimated to cause 177,000 hospitalizations, and 14,000 deaths in adults age 65 years and older annually. The actual burden among all age groups is likely even higher due to underreporting of RSV infections.

Individuals of all ages can get an RSV infection but those at highest risk for severe disease include:

  • premature infants and infants age 6 months and younger
  • individuals with chronic heart or lung disease
  • individuals with compromised immune systems
  • older adults (65+).

Symptoms

Like other respiratory viruses like influenza (flu) or COVID-19, symptoms of RSV infection usually include runny nose, coughing, sneezing, fever, decreased appetite, and wheezing. The symptoms usually appear in stages. In very young infants, the only symptoms may be irritability, decreased activity, and breathing difficulties. Those infected with RSV usually show symptoms within 4 to 6 days after getting infected. Healthy adults infected with RSV may have few symptoms but can still spread virus to others.

Individuals infected with RSV are usually contagious for 3 to 8 days and recovery usually takes 1 to 2 weeks. However, some infants, and those with weakened immune systems, can continue to spread the virus even after they stop showing symptoms, for as long as 4 weeks.

RSV typically circulates with other seasonal respiratory viruses, like flu. However, the COVID-19 pandemic has impacted normal transmission patterns of RSV, leading recently to more unusual, “out of season” exposures and infections. Given its similarities in symptoms and co-circulation with other viral infections, the only way to determine if someone has an RSV infection is through clinical laboratory testing.

Prevention

The best ways to help prevent the spread of RSV include the following:

  • Cover coughs and sneezes
  • Wash hands often with soap and water for at least 20 seconds
  • Avoid close contact with others who are sick
  • Avoid touching the face, particularly eyes, nose, and mouth
  • Clean frequently touched surfaces (such as doorknobs)
  • Consult a healthcare professional if you have cold-like symptoms that linger or worsen.

Researchers are currently working to develop new tools to prevent RSV including vaccines and monoclonal antibodies targeted for specific populations, including infants/young children, older adults, pregnant mothers, and adults with compromised immune systems.

Treatment

An antiviral drug called palivizumab (pah-lih-VIH-zu-mahb) is available to prevent severe RSV illness in high-risk infants (born prematurely or with congenital heart disease or chronic lung disease). However, the use of palivizumab is limited as it can only be used in certain children considered at high risk for complications, does not help cure or treat children already suffering from serious RSV disease, and cannot prevent RSV infection.

Updated February 2022

What precautions are needed for RSV?

RSV Prevention.
Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands..
Wash your hands often with soap and water for at least 20 seconds..
Avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others..

Does RSV require contact precautions?

BACKGROUND: RSV, spread by contaminated secretions, is an important cause of respiratory illness among children, particularly in winter months. To prevent nosocomial spread, infants and young children with suspected RSV infection should be placed on contact isolation.

What are the precautions for RSV nursing?

Protect the high-risk populations, do not visit when you are sick, wash your hands frequently, do not take these infants, children, and adults to highly populated areas during the cold and flu season. Taking these precautions should help reduce the number of hospital visits and poor outcomes from RSV.