Is it a cold or RSV? Know when to call your child’s doctor

This piece is sponsored by Sanford Health.

RSV, or respiratory syncytial virus, is a common virus. In fact, we think almost all children have been infected with RSV by the time they reach their second birthdays. It’s also likely a common cause of congestion and cough in adults.

The virus can cause a range of symptoms. People usually start showing symptoms within a week of being exposed. Symptoms often begin with congestion and decreased appetite. They can progress to include cough and fever a few days later.

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There are some special characteristics of this virus that allow it to affect the lower respiratory tract and cause a cough for a long time. Often, the worst is over in 10 to 14 days. However, some kids can have a cough that takes up to a month to resolve.

In some, it can cause bronchiolitis or lead to pneumonia. Some children need to be hospitalized, and the sickest require a breathing tube and time in the intensive care unit. Premature infants, children younger than 1 year old or children with chronic medical problems such as chronic heart or lung conditions are at a higher risk of serious illness.

The virus typically makes its appearance in winter, and the timing can vary from year to year.

How common is RSV?

It is important to note there is a wide range of how RSV can affect a given child.

According to the National Institute of Allergy and Infectious Diseases, symptoms of RSV infection are usually mild and resolve within a week. However, RSV can cause serious illness or death in vulnerable individuals, including premature and very young infants, children with chronic lung disease or congenital heart disease and people who are older than 65.

In the United States, RSV is the most common cause of bronchiolitis — inflammation of the small airways in the lungs — in children younger than 1 year old and causes about 58,000 hospitalizations among children younger than 5 annually. RSV infection is estimated to cause 14,000 annual deaths in U.S. adults older than 65. Globally, RSV affects an estimated 64 million people and causes 160,000 deaths each year.

When to go to the doctor

Children who have RSV typically need medical care for a few specific reasons. Hospitalization from RSV usually occurs when a child has severe changes in breathing, gets dehydrated or develops a secondary infection.

If you think your child has RSV or another respiratory virus, watch their breathing. If your child is breathing fast for their age — in infants this is faster than 60 times a minute — take your child to the doctor.

Also, watch how hard they are working to breathe. If your child is using extra muscles like the muscles between the ribs, go to the doctor.

Monitor how many wet diapers the child is having, and notify your doctor if it is less than one every eight hours. Also, consider having your child seen if they are very young, have a chronic medical issue or the illness isn’t improving the way you think it should.

Is there an RSV vaccine?

Yes, there is an RSV vaccine for certain groups of people.

To prevent severe RSV disease in infants, the Centers for Disease Control and Prevention recommends either maternal RSV vaccination or infant immunization with RSV monoclonal antibodies. Most infants will not need both. The CDC also recommends:

RSV vaccine for pregnant people

• One dose of maternal RSV vaccine during weeks 32 through 36 of pregnancy, given September through January. Pfizer Abrysvo is the only RSV vaccine recommended during pregnancy.

RSV immunization for infants and young children

• One dose of the monoclonal antibody product, nirsevimab, for all infants younger than 8 months born shortly before or are entering their first RSV season.
• One dose of nirsevimab for infants and children 8 to 19 months who are at higher risk for severe RSV disease and entering their second RSV season. Considered higher risk are:
  • American Indian and Alaska Native children
  • Children with chronic lung disease of prematurity who require medical support during the 6 months before the start of their second RSV season
  • Children who are severely immunocompromised
  • Children with severe cystic fibrosis

RSV vaccine for adults age 50+

• An RSV vaccine for everyone 75 and older and adults 50 to 74 at increased risk of severe RSV.
• Adults 50 to 74 who are at increased risk include those who:
  • Have chronic heart or lung disease
  • Have certain other chronic medical conditions
  • Are residents of nursing homes or other long-term care facilities
• RSV vaccine data now shows that the vaccine provides protection for at least two years.
• The best time to get vaccinated is in late summer and early fall — just before RSV usually starts to spread in the community.

If you have any questions about RSV or the products listed, talk to your health care provider.

How else do I prevent RSV?

Wash your hands and your infant’s hands. Wipe down shopping carts and other frequently touched public places. Wash foods that come from the grocery store that others’ hands may have touched — like produce. Avoid people who are ill, and cover your cough.

We think many adults suffering mild winter colds actually may have RSV and be spreading it. When in doubt, and especially if your child is younger than 2 or has the serious symptoms discussed above, consider seeing your doctor.

Learn more

• Small-town care was ready when baby needed it
• Nurse thankful for new RSV treatments after son’s scare
• Infant colds: What’s normal and what’s not