What Causes RSV, and Who Catches It Most?

Respiratory syncytial virus (RSV) is a common respiratory virus that infects the lungs and breathing passages. Understanding what causes RSV and who is most at risk helps you take steps to protect yourself and loved ones, without unnecessary worry.

What Causes RSV?

RSV is caused by a virus in the Pneumoviridae family. Here’s how it works:

• Viral Infection

  • The culprit is the RSV virus, which enters the body through the nose or eyes.
  • Once inside, it attaches to cells lining the airways, multiplies rapidly, and triggers inflammation.

• Seasonal Patterns

  • In temperate climates, RSV peaks in late fall, winter, and early spring.
  • In tropical regions, RSV may circulate year-round or during rainy seasons.

• Modes of Transmission

  • Direct contact: Touching an infected person’s hands after they’ve coughed or sneezed.
  • Droplet spread: Breathing in virus-laden droplets expelled when someone coughs or sneezes.
  • Surface contamination: Touching a contaminated surface (doorknob, toy) then touching your face.

• Viral Survival

  • RSV can survive up to 6 hours on hard surfaces and around 30 minutes on skin.
  • Good hand hygiene and cleaning of frequently touched items reduce spread.

Who Catches RSV Most?

While virtually everyone is exposed to RSV by age two, certain groups face higher risks for severe illness:

1. Infants and Young Children

• Age under 1 year: Especially 2–6 months old
• Premature infants: Lungs and immune systems aren’t fully developed
• Chronic lung disease of prematurity (bronchopulmonary dysplasia)
• Congenital heart disease

2. Older Adults

• Age 65 and up: Natural decline in immune response
• Chronic heart or lung diseases (COPD, heart failure)
• Weakened immune systems due to cancer treatments or other conditions

3. Immunocompromised Individuals

• People with HIV/AIDS
• Organ or stem cell transplant recipients
• Those on immunosuppressive medications

4. Other Risk Factors

• Daycare attendance: Increases exposure to many children with RSV.
• Household crowding: More close contacts = higher chance of picking up the virus.
• Exposure to tobacco smoke: Irritates the airways, making infection more severe.

Signs and Symptoms

RSV often looks like a common cold, but can progress to more serious breathing problems:

• Mild to Moderate Illness

  • Runny nose
  • Coughing and sneezing
  • Low-grade fever
  • Decreased appetite
  • Irritability (in infants)

• Severe Illness (more common in high-risk groups)

  • Difficulty breathing or rapid breathing
  • Wheezing (a whistling sound when exhaling)
  • Chest retractions (skin pulling in around the ribs)
  • Dehydration (fewer wet diapers, dry mouth, no tears)

If you or your child develop any signs of difficulty breathing, dehydration, or high fever, speak to a doctor right away.

Diagnosis

Diagnosing RSV usually involves:

• Medical history and exam: Listening to the lungs, checking oxygen levels.
• Lab tests (in hospital or clinic settings):
  • Nasal or throat swab tested for RSV.
  • Blood tests to rule out other infections.

Outpatient cases often don’t require lab confirmation if symptoms are mild.

Treatment and Management

There’s no specific cure for RSV, but most people recover with supportive care:

Home Care for Mild Cases

• Fluids: Prevent dehydration with breast milk, formula, or water (as age-appropriate).
• Rest: Plenty of sleep helps the body fight infection.
• Fever and pain control: Acetaminophen or ibuprofen, following dosing guidelines.
• Nasal suction and saline drops: Ease congestion in babies and young children.

Medical Care for Severe Cases

• Hospitalization: For oxygen support or intravenous (IV) fluids.
• Supplemental oxygen or mechanical ventilation: If breathing is severely compromised.
• Ribavirin: An antiviral occasionally used in high-risk infants (rarely prescribed).
• Palivizumab (Synagis®): A monthly preventive antibody injection for certain high-risk infants during RSV season.

Prevention Strategies

Reducing your risk of RSV involves simple yet effective habits:

• Handwashing: Use soap and water for at least 20 seconds, especially after contact with sick people.
• Avoid touching your face: Keeps virus from entering through eyes, nose, mouth.
• Disinfect surfaces and toys: Regularly clean commonly touched items at home or daycare.
• Limit exposure: Keep infants under six months away from crowds and anyone with cold-like symptoms.
• Breastfeeding: Provides antibodies that help protect infants.
• Smoking cessation: Eliminates harmful airway irritants.

When to Seek Medical Advice

RSV typically resolves in a week to 10 days, but always check with a healthcare professional if you notice:

• Signs of severe breathing trouble (rapid breaths, chest retractions)
• Persistent high fever (especially in babies)
• Signs of dehydration (dry mouth, sunken eyes, very few wet diapers)
• Unusual lethargy or inconsolable crying in infants

You might also consider a free, online symptom check, using the doctor approved Ubie Symptom Checker to help determine the next steps from the comfort of your home.

Always speak to a doctor about anything that could be life threatening or serious.

Key Takeaways

• What causes RSV? A contagious virus that infects the respiratory tract, spreading via droplets and surface contact.
• Who catches it most? Infants (especially under 6 months), older adults, and people with weakened immune systems.
• Symptoms range from mild cold-like signs to severe breathing difficulties.
• No specific cure exists, but supportive care and preventive measures can reduce severity and spread.
• Prevention hinges on good hygiene, limiting exposure, and in select high-risk infants, preventive antibody injections.

By understanding what causes RSV and recognizing who’s most vulnerable, you can take informed steps to protect yourself and those around you. If you’re ever in doubt about symptoms or severity, don’t hesitate to seek medical advice.