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How to prevent RSV in infants and young children, according to experts

Infant in a ball pit
RSV infection can become serious in infants and young children, but there are ways to protect against severe illness. MaaHoo/Stocksy
  • Respiratory syncytial virus (RSV) is a common virus that may cause severe symptoms in infants, young children, and even older adults. 
  • RSV is the most common cause of infant hospitalizations in high-income countries. 
  • In 2019, about 1.4 million infants ages 0–6 months globally were hospitalized for episodes of RSV-associated acute lower respiratory infection. 
  • RSV infection can become serious, but there are ways to protect infants and young children from severe illness.

Respiratory syncytial virus (RSV) commonly presents with cold-like symptoms, such as a runny nose and cough.

However, in infants and young children Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source , RSV can be much more severe, leading to hospitalizations and even death. RSV may also cause severe illness among older adults.

RSV is the most common cause Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of infant hospitalizations in high-income countries. 

In 2019, about 6.6 million infants Trusted Source The Lancet Highly respected journal, Expert written journal, Peer reviewed journal Go to source ages 0-6 months globally had RSV-associated acute lower respiratory infection episodes, with 1.4 million needing to be hospitalized and 45,700 RSV-attributable overall deaths. 

What can be done to protect infants and small children from severe illness due to RSV? Medical News Today spoke with pediatricians to learn more. 

How does RSV affect a baby? 

According to Dr. Danelle Fisher, a board certified pediatrician and Chair of Pediatrics at Providence Saint John’s Health Center in Santa Monica, CA, while RSV will cause symptoms of the common cold in older children and adults, it may affect infants and young children differently. 

“The younger you are, the more chance you have of this virus causing severe respiratory issues, including wheezing and difficulty breathing,” Dr. Fisher told MNT.

“A lot of times, even the little babies will go apneic, which means they pause or stop breathing for a little while. The younger you are, the more dangerous it can be.”

Dr. Mohamed Zebda, a board certified pediatrician at the UH Health Family Care Center and clinical associate professor at the Tilman J. Fertitta Family College of Medicine at the University of Houston, explained to MNT:

“Most children have had RSV at least once by the age of 2 Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source . Many children will have mild symptoms. Common symptoms include cough, congestion, runny nose, and fever.”

“Infants who are born prematurely Trusted Source National Institute of Child Health and Human Development Governmental authority Go to source , babies who have a history of congenital heart disease, children who are immunocompromised, children who have a history of chronic lung disease, and infants less than 1 year of age have an elevated risk of complications and hospitalization.

Complications of RSV include bronchiolitis — inflammation and irritation of the small airways that lead to narrowing of the airways — and pneumonia.”

— Dr. Mohamed Zebda, board certified pediatrician

How do babies get RSV?  

RSV spreads Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source both through respiratory droplets when a person coughs or sneezes, as well as contaminated surfaces. 

“RSV can spread from person to person, just like colds and other respiratory viruses,” Dr. Kris Bryant, a pediatric infectious diseases physician at Norton Children’s in Louisville, Kentucky, and a member of the American Academy of Pediatrics Committee on Infectious Diseases explained to MNT

“The virus can also live on hard surfaces for many hours, and touching a surface contaminated with the virus and then touching the eyes, nose, or mouth is one way infections can occur,” Dr. Bryant continued.

“RSV can also live on hands for 30 minutes or more, so handwashing is important in reducing the spread of this virus.” 

“RSV is spread when a baby inhales droplets from an infected person’s cough or sneeze,” added Dr. Moses Olorunnisola, a pediatrician with Hackensack Meridian Children’s Health Medical Group in New Jersey.

“A baby can also contract RSV from direct contact — if an infected person kisses them on the face, for example. Additionally, If a baby touches a toy or surface that is contaminated, and then touches his or her eyes, mouth, or nose, they can contract RSV,” Dr. Olorunnisola continued.

“The problem with this virus is that it spreads very quickly throughout places where children are,” Dr. Fisher said. “If you have multiple children in the family, oftentimes the older kids who go to preschool, daycare, or elementary school will bring it home to their baby siblings and that is a big mode of transmission.”

— Dr. Danelle Fisher, board certified pediatrician

How is RSV treated in babies? 

If an infant contracts RSV, Dr. Olorunnisola told MNT the treatment may depend on the symptoms.

“Babies may need IV fluids if they are unable to drink adequately and become dehydrated,” he detailed.

“Saline and nasal suction may also be used if the baby has significant nasal congestion and mucus production. Some babies may need medication to help manage fevers. Some babies also require oxygen and breathing support if they have severe respiratory problems. Overall, the goal is to manage whatever symptoms are present,” Dr. Olorunnisola explained. 

Antibiotics are not helpful for RSV since RSV is a viral infection and not a bacterial infection,” Dr. Zebda said.

“RSV symptoms tend to peak (on) day 3-5 of (the) illness and gradually get better. It is important for parents to seek immediate help for any increased work of breathing,” he added. 

How can you reduce a baby’s risk of RSV?

Dr. Zebda said there are several ways to help minimize a baby’s exposure to RSV. 

“Good hand hygiene can help reduce the spread of RSV,” he explained. “(Make) sure that surfaces, including toys, are disinfected. It is recommended to cover coughs and sneezes. (Make) sure visitors coming to see the baby are not sick. Outside visitors should avoid holding and kissing the baby,” Dr. Zebda noted.

“To the extent feasible, parents should keep their babies away from people with cold and flu symptoms and avoid crowds during RSV season,” Dr. Bryant added.

“For my families who have children in day care and preschool, during RSV season, which is usually October through April, I often advise that when these children come home from day care or preschool, the families kind of wash them down,” Dr. Fisher said.

“They could even do their bath or at the very least washing hands and face and changing clothes can minimize the spread,” Dr. Fisher continued.

Should you get an RSV vaccine during pregnancy? 

In addition to limiting an infant’s exposure after they are born, the maternal RSV vaccine can protect Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source a newborn from severe illness. baby can be protected Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source from RSV. 

The maternal RSV vaccine is administered during pregnancy and is currently recommended by the Centers for Disease Control and Prevention (CDC) Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source and the American College of Obstetricians and Gynecologists (ACOG).

“If you are pregnant, you should definitely consider getting the RSV vaccine to help protect your baby from RSV,” Dr. Olorunnisola said.

“Pregnant individuals at 32 to 36 weeks Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source gestational age during the months of September through January should get the RSV vaccine as their antibodies are passed on to their baby. This will significantly reduce the likelihood that the baby, once born, will get severe disease or be hospitalized from RSV.”

— Dr. Moses Olorunnisola, a pediatrician

“The RSV vaccine helps produce maternal antibodies against RSV, and those maternal antibodies are then passed to the baby and help protect the baby,” Dr. Zebda explained.

“According to the CDC Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source , the RSV vaccine reduces the risk of hospitalization due to RSV by 57%. If you are currently pregnant, it is important to discuss the RSV vaccine with your OB-GYN or current healthcare provider,” Dr. Zebda added.

Other ways to protect infants from RSV

Dr. Bryant said that pregnant people unable to receive the maternal RSV vaccine can immunize the baby after birth.

Nirsevimab Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source is not a vaccine but rather a monoclonal antibody Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source shot that protects infants against RSV infections that are severe enough to require a healthcare visit or hospitalization,” she explained.

“Most babies born to people who received the RSV vaccine during pregnancy do not need nirsevimab too,” Dr. Bryant noted.

Dr. Fisher added the monoclonal antibody shot is given to infants 8 months or younger during RSV season. 

“It floods the baby’s system with antibodies directly against RSV,” Dr. Fisher continued.

So it’s not a vaccine per se — the baby’s immune system doesn’t have to kick up. But it’s really great passive protection that we love to give these babies. It does not prevent RSV from happening, but it does prevent the most serious complications, including ER visits and hospitalizations — that’s what we’re all about,” she concluded.

This article originally appeared on Medical News Today.

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