RSV in babies & kids: key information for parents

Respiratory syncytial virus (RSV): essential information

What is RSV?

Respiratory syncytial virus (RSV) is a virus that usually causes an infection of the nose and throat.

What is RSV in babies?

In children under 18 months, the RSV infection can move to the small breathing tubes and cause bronchiolitis. The infection can also move to the air sacs in the lungs and cause pneumonia, but this is rare.

RSV can cause severe and even life-threatening illness in babies and young children, and it’s one of the most common reasons for them to be hospitalised.

Babies under 6 months are most at risk of severe illness and hospitalisation, especially if they were born before 37 weeks of pregnancy or with other medical conditions like diseases of the heart, lungs, immune system or nervous system.

How common is RSV?

RSV is very common in kids of all ages. It infects around 90% of children by 2 years and almost all children by 3 years.

It’s common for kids to get the infection more than once. This is because the immune system provides only short-term protection against RSV.

In Australia, RSV is most common in:

autumn and winter in southern states and territories
the rainy season in northern states and territories.

Is RSV contagious?

RSV is very contagious, which means it spreads easily. Children and teenagers with RSV are usually contagious for 3-8 days, including 1-2 days before they show signs of illness.

How does RSV spread?

RSV spreads through coughing, sneezing, breathing, laughing and talking. It can also spread if you touch surfaces contaminated with RSV.

What are the symptoms of RSV?

General RSV symptoms

Most kids with RSV don’t get symptoms, or their symptoms are very mild.

Symptoms usually appear 2-8 days after infection.

RSV symptoms are usually the same as cold symptoms. They include:

runny nose
sore throat
cough
body aches.

Some children and teenagers get fever too, but this isn’t common.

RSV symptoms in babies

In children under 18 months, RSV can also cause symptoms of bronchiolitis. These include:

difficult and fast breathing
wheezing
wet cough
irritability
difficulty feeding.

How long do RSV symptoms last?

In most kids, RSV symptoms tend to go away after 1-2 weeks, but the cough can last up to 4 weeks.

Does your child need to see a doctor about RSV symptoms?

Young babies will probably need to see a doctor, but most older kids won’t. Sometimes you won’t even know your child has RSV.

Here’s when to take your child to a GP or get medical attention.

When to see a GP

Your child:

is breathing very fast or has difficulty breathing
is coughing and distressed
has a cough that’s getting worse
has difficulty feeding or drinking and has fewer wet nappies than usual
is changing colour in the face when they cough
is tired or more sleepy than usual
is irritable.

When to go to hospital or call 000

Your child:

has significant shortness of breath
has pauses in breathing
is turning pale or blue in the skin or lips
is drowsy or hard to wake up.

You know your child best. If your child seems very unwell, seek urgent medical attention.

How is RSV diagnosed and tested?

Self-testing with an RSV test kit

If your child has RSV symptoms or you think your child might have RSV, you can get an RSV test kit from a pharmacy or supermarket. This test will tell you whether your child has RSV. This kit tests for some other viruses too.

To use an RSV home testing kit, follow the instructions provided in the kit. Make sure to check the kit’s expiry date before using it.

Seeing a doctor for diagnosis

If you take your child to a GP or hospital, they’ll diagnose your child by checking your child’s symptoms and examining your child. The doctor might suggest getting an RSV test kit from a pharmacy to confirm the diagnosis.

If the doctor thinks that your child could have bacterial pneumonia, they might order blood tests or a chest X-ray for your child.

How is RSV treated?

If your child has mild RSV symptoms, you’ll be able to treat it at home.

There’s no specific treatment that can make RSV go away more quickly. The best thing is to treat the symptoms. Ask your pharmacist or GP if you aren’t sure about what medicines or treatments are best for your child.

Offer fluids

It’s very important to make sure your child is drinking enough fluids so they don’t get dehydration. Our article on preventing and treating dehydration explains how much fluid children of different ages need and how often they need it.

Keep your child comfortable

If your child has a fever and is in pain or discomfort, give them paracetamol in the recommended dose and frequency. You can also give ibuprofen to children aged over 3 months.
Let your child eat according to their appetite. Your child might not be hungry if they have a fever. Their appetite will come back as they start to feel better.
If your child has a blocked nose, you can try giving them saline nasal drops.
Try one teaspoon of honey at night, which might help to reduce coughing. But don’t give honey to children under 12 months because of the risk of infant botulism.
Encourage your child to take things easy, but there’s no need for them to stay in bed. Let them decide how active they want to be.
Let your child have dairy products if they want them. Dairy products have no effect on mucus.

Things to avoid, unless recommended by a doctor

Cough medicines – your child is coughing because their windpipe is irritated or has a lot of mucus, and cough medicines won’t help with either of these issues.
Decongestants like Benadryl, Bisolvon, Demazin, Dimetapp, Duro-tuss, Logicin, Robitussin and Sudafed – these can cause side effects like rapid heart rate, jitteriness and insomnia. These medicines can also increase the time it takes to recover from RSV.
Antibiotics – RSV is a virus, so antibiotics won’t help and can even cause stomach upsets and diarrhoea.
Alternative medicines and treatments – these probably don’t help children, and some can even have harmful side effects. For example, inhaling eucalyptus can irritate or even burn some children’s airways.

Don’t give aspirin to children under 12 years unless it’s prescribed by a doctor. Aspirin can make children susceptible to Reye’s syndrome. If you’re giving your child any over-the-counter medicines, check with your pharmacist or doctor to make sure these have no aspirin.

Does your child need RSV treatment in hospital?

If your child has more serious RSV symptoms, they’ll probably need to go to hospital.

In hospital, doctors will treat your child’s symptoms and any other medical problems caused by the infection.

Treatment might involve giving your child:

oxygen or breathing support
pain relief like paracetamol or ibuprofen
fluids through a nose tube or drip into a vein.

Can your child be immunised against RSV?

Yes, there is an RSV Mother and Infant Protection Program (MIPP) for immunisation against RSV in Australia.

Under this program, pregnant women and some young children can get immunised against RSV.

Immunisation helps to protect you and your child from RSV illness and hospitalisation.

Pregnancy

If you’re 28+ weeks pregnant, you can get a single dose of an RSV vaccine called Abrysvo.

This vaccine is safe to get in pregnancy and can help to protect your baby against RSV in their first months of life.

Infancy

Your child can get a single dose of an RSV monoclonal antibody (mAb) called Nirsevimab if they’re less than 8 months old and any of the following apply:

Their birthing mother didn’t get an RSV vaccination during pregnancy.
They were born within 2 weeks of their birthing mother getting an RSV vaccination.
They have a condition that increases their risk of serious RSV illness, regardless of whether their birthing mother got an RSV vaccination.

Early childhood

Your child can get the RSV mAb (Nirsevimab) if they’re between 8 months and 2 years old and are:

at high risk of serious RSV illness
in their second RSV season.

The time of year that your child can get the RSV mAb depends on which state or territory you live in. Check your state or territory health department website or ask your GP when your child can get it.

What are effective prevention strategies for RSV?

Here are ways that you can reduce your child’s risk of getting RSV:

Get your child immunised. Immunisation is the best prevention strategy for RSV.
Encourage good hygiene in children and good hygiene in teenagers. This includes washing hands regularly, avoiding contact with people who are unwell, and not sharing bottles, cups, utensils and toys.
Clean surfaces regularly, particularly surfaces that are used often.

If your child has RSV, these tips can prevent them from passing it on:

Keep your child at home so they can recover well and don’t spread RSV to others.
Keep your child away from child care, preschool or school.
Keep your child away from babies under 6 months, children who were born premature, children who have medical conditions and older people like grandparents. If these people get RSV, they can get very sick.