Children's health

RSV can spread when an infected person coughs or sneezes and the virus droplets get in your eyes, nose or mouth. You can also get it from direct contact with the virus, e.g., from kissing the face of a child with RSV. If you do touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands, you can also get the virus.

Children are often exposed to and infected with RSV outside the home such as in school or childcare centres. RSV can survive for many hours on hard surfaces such as tables and cot rails. On soft surfaces such as tissues and hands, the virus lives for a shorter time.

The symptoms of RSV infection are typical symptoms of a cold, such as a runny nose, coughing, sneezing, fever (high temperature), wheezing and not feeling like eating. These symptoms usually appear in stages and not all at once.

In very young infants with RSV, the only symptoms may be irritability, decreased activity and breathing difficulties. However, RSV can also cause serious illness, including bronchiolitis and pneumonia (infections in the lung).

People of any age can get another RSV infection, but infections later in life are generally less serious. People at highest risk for severe symptoms include:

• Premature babies
• Young children with congenital (from birth) heart or chronic lung disease
• Young children with compromised (weakened) immune systems due to a medical condition or medical treatment
• Adults with compromised immune systems
• Older adults, especially those with underlying heart or lung disease.

Your doctor will ask about the following: the child’s symptoms: whether other close contacts have similar symptoms: the home environment and how long they have been sick. They will also do a clinical examination and, possibly a throat swab or other tests.

There is currently no vaccine readily available for RSV. Immunity to RSV develops over the first couple of years of life, but it is never fully complete, and tends to decline again with age. This means that, older adults can also be seriously affected with the virus.

Some home remedies can help relieve some signs and symptoms:

• Create moist air to breathe. Keep the room warm but not overheated. If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing. 
• Drink fluids. Continue breastfeeding or bottle-feeding your infant as you would normally. For older children and adults, keep a steady supply of cool water at the bedside. Offer warm fluids, such as soup, which may help loosen thickened secretions. Ice pops may be soothing as well.
• Try saline nasal drops. Over-the-counter (OTC) drops are a safe, effective way to ease congestion. If you speak to the pharmacist, they will be able to provide advice on the correct way to use the drops.
• Use over-the-counter pain relievers. OTC pain relievers such as paracetamol may help reduce fever and relieve a sore throat. Ask the local pharmacist for advice.

Most RSV infections go away on their own in 1 to 2 weeks. There is no specific treatment for RSV infection. Care involves relieving symptoms, such as:

• Manage fever and pain with Paracetamol
• Drink enough fluids to prevent dehydration (loss of body fluids).

Talk to your healthcare provider before giving your child cold and cough medicines. Some medicines contain ingredients that are not good for children.

A medicine called palivizumab (pah-lih-VIH-zu-mahb) is available by injection to prevent severe RSV illness in infants and children who are at high risk of severe illness, such as babies born prematurely or with congenital heart disease or chronic lung disease. The medicine can help prevent serious RSV disease, but it cannot help cure or treat children already suffering from serious RSV, and it cannot prevent infection with RSV. This must be administered regularly to be effective.

Breastfeeding – Breastfeeding your baby protects them from getting RSV infection by boosting their infection-fighting (immune) system. Breastfeeding beyond 4 months of age offers the best protection.

Smoke-free environment – Make sure your child's environment is smoke-free. 

Vaccinations – Make sure your child is up to date with all their vaccinations. There is currently no vaccine for RSV but vaccination can prevent bacterial infections following RSV infection.

A warm house – Keeping the house warm and well insulated will also decrease your baby's risk of developing RSV infection.

Stay away from people with coughs and colds – It is sensible to keep young babies away from people who have colds and coughs.

Parents of children at high risk for developing severe RSV disease should help their child when possible do the following:

• Avoid close contact with sick people.
• Wash their hands often with soap and water for at least 20 seconds.
• Avoid touching their face with unwashed hands.
• Avoid their sharing drink containers and toothbrushes.

Limit the time they spend in childcare centres or other potentially contagious settings, especially during autumn, winter and spring. This may help prevent infection and spread of the virus during the RSV season.

If you have cold-like symptoms, you should:

• 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
• clean frequently touched surfaces such as doorknobs and mobile devices
• Wash solid toys and consider getting rid of soft ones.
• Ideally, people with colds should avoid close contact with new-born babies: infants born prematurely (before 37 weeks): children under 2 years born with heart or lung conditions and those with weakened immune systems.
• Smoking around young children is also a risk factor for severe RSV infection

Children can be at higher risk of severe illness from common respiratory infections like RSV.

Most cases are not serious and clear up within 2 to 3 weeks, but the symptoms can be very worrying for parents.

For some infants and babies, such as those born prematurely or with a heart condition, respiratory infections can be more severe. NHS 111 or your GP can offer advice if any parent has concerns.

It is perfectly okay for parents to ask people with colds to keep away from new-born babies, particularly in the first two months, and for babies born prematurely.

RSV is highly infectious, which is why it is important to stick to basic hand and respiratory hygiene practices to help prevent it spreading. RSV usually spreads widely in the autumn and winter months.

Symptoms generally begin 4-6 days after exposure. An ill person can spread the virus for up to 8 days and sometimes longer. It can take 1-2 weeks to feel better.

Many other viruses can cause RSV-like illness: acute viral respiratory infections include Influenza, COVID-19, Parainfluenza, Rhinovirus and Human metapneumovirus. When viruses invade cells of the respiratory tract, they trigger inflammation and production of mucus. This situation leads to nasal congestion, a runny nose, scratchy throat, high temperature and cough- these are usually the common symptoms among the respiratory viruses. Persistent cough and loss of taste and/smell usually develop with COVID-19.

Other typical symptoms in children with respiratory infections caused by viruses include decreased appetite, lethargy, and a general feeling of illness. Headaches and body aches develop, particularly with influenza.

Guidance for when to seek help is similar for most of the Respiratory viruses as they present with like symptoms: Please refer to the RSV traffic light guide (pdf, 164KB) for further guidance on when to seek help.    

• NHS bronchiolitis advice
• More information about bronchiolitis
• RSV advice for parents
• Gov UK advice on RSV
• Government data and analysis of RSV
• NHS clinical pathway for bronchiolitis (pdf, 314KB)