Respiratory syncytial virus (RSV)

Find out more about Respiratory Syncytial Virus (RSV), prevention, symptoms, and treatment.

You know your baby best. If you are worried, reach out this winter.

What is Respiratory Syncytial Virus (RSV)?

RSV is a common virus that causes cold-like symptoms. It is very contagious and passes easily between people through hand contact or in droplets produced by coughing and sneezing.

It’s known to infect almost all children by the age of two, and often parents will not know that the colds and sniffles their baby is experiencing are caused by RSV.

RSV can cause critical illness in babies born premature or sick, and those with underlying medical conditions such as chronic lung disease (also known as bronchopulmonary dysplasia, or BPD) congenital heart disease, and other conditions affecting the immune system.

If the lungs become affected it can lead to breathing difficulties and may require hospital treatment. Risk of severe infection and hospitalisation decreases as your baby gets older.

What are the signs and symptoms of RSV?

In the early stages, RSV symptoms are similar to a common cold (runny or blocked nose, cough, sneezing and high temperature).

Symptoms usually last between one and three weeks. If the lungs are affected, one or more of the following symptoms will develop or get worse:

  • A cough that gets worse
  • Wheezing – a whistling sound when breathing out
  • Difficulty or distress when breathing
  • Reduction in feeding and drinking because of breathing difficulties.

RSV can lead to bronchiolitis and viral pneumonia, which can be serious conditions.

When is RSV likely to be a problem for my baby?

If your baby was born prematurely, is prone to lung infections or was born with a congenital heart problem, they could be at greater risk of becoming seriously ill if infected with RSV.

Like other seasonal coughs, colds and flu, RSV is usually most prevalent in the UK between October and March each year.

Through the coronavirus (COVID-19) pandemic, restrictions in social contact meant that cases of RSV were reduced.

Since people began mixing again, there has been an increase in cases ahead of the usual seasonal trend, from June, mainly in children aged under five.

How can RSV infections be prevented in premature and sick babies?

A monthly antibody injection (palivizumab) has proved effective at protecting against severe infection and reducing hospitalisation.

It is recommended by the Joint Committee on Vaccination and Immunisation (JCVI) for children under two years who are considered to be high-risk.

This includes some babies born premature or sick with chronic lung disease or congenital heart problems, and those known to have a weakened immune system.

This injection must be given once a month over the RSV season, and healthcare professionals will give up to seven doses.

Because of the coronavirus (COVID-19) pandemic, more babies are eligible to receive the jab. This includes most babies who have been discharged from hospital on oxygen in the last nine months.

Since RSV infections are on the rise out of the usual seasonal cycle, you can speak with your GP or neonatal staff to understand whether preventative antibody treatment might be available for your child.

If your baby is in the neonatal unit, staff may arrange for RSV immunisations to take place before they are discharged from hospital. 

Even with palivizumab treatment, your baby could become infected with RSV, but they are less likely to to need to be treated in hospital.

Is there a vaccine for RSV?

Currently injections of preventative antibodies in the form of palivizumab are the best protection against severe infection.

Several vaccines that create longer-lasting immunity are in the late stages of clinical trials.

The World Health Organization (WHO) expects one to be available within a few years.

Can I reduce the risk of my baby getting RSV? 

RSV is very contagious and passes easily between people via droplets from the nose or mouth. It can survive on surfaces for up to 24 hours.

Practice good hygiene by washing hands regularly, discourage adults and children with cold-like symptoms from handling, kissing and cuddling your baby, and try to reduce your baby’s exposure to crowds and public transport.

Previous infection does not provide immunity, meaning that your child can get RSV again even if they’ve had it before.

RSV is more likely to spread where there are groups of young children, for example in nurseries, playgroups and schools, and in babies with preschool-age siblings.

Exclusive breastfeeding reduces the risk of severe infection and hospitalisation with RSV. If you would like to breastfeed and need support, speak with healthcare professionals who will be able to help.

If your baby is in the neonatal unit and you are not able to breastfeed them, you may want to express your milk.

This can be fed to your baby through a tube into their tummy, giving them the benefits of breast milk. Visit our pages on feeding for more information.

Smoking or allowing others to smoke near your baby increases their risk of hospitalisation with RSV.

The NHS runs free stop smoking services that can support you or members of your household to quit smoking. 

My child is older than two. Are they still at risk of RSV?

The risk of hospitalisation due to an RSV infection is greatest in the first few months of life. Being infected again is common and can occur at any age, but symptoms are usually less severe. 

If you are concerned, speak with a GP, neonatal staff or another healthcare professional, such as a health visitor or community nurse.

They will be able to tell you if your child is in the at-risk category and therefore qualifies for preventative treatment.

When to seek help from a hospital

Babies who show any of the following symptoms should be taken to hospital immediately:

  • Apnoea (pauses in breathing, particularly during sleep)
  • Infant appears to be seriously unwell
  • Severe respiratory problems (such as grunting), a marked chest recession (where the chest seems to sink inwards), or a respiratory rate of over 60 breaths per minute
  • Central cyanosis (blue or purple discolouration of the skin due to lack of oxygen).

What are the possible hospital treatments for RSV?

If your baby needs to stay in hospital due to an RSV infection, they will be monitored closely. They may be given oxygen support, fluids directly into their veins (IV fluids) and assistance with breathing.

What are the long-term effects of RSV?

Wheezing that keeps returning, asthma, and other problems with breathing have been seen in children who had hospital treatment for RSV.

Some studies have also shown that children who had a severe RSV infection may be more likely to develop sensitivities to allergens such as pollen or dust mites. 

Where can I get more help and support for RSV?

In the first instance, always speak with a healthcare professional such as your GP, health visitor, community nurse, or neonatal team.

You can also call these out-of-hours services:

NHS 111 England

NHS Direct Wales 0845 4647

NHS 24 (Scotland) 0845 424 2424

Dial 999 immediately if you think your baby might be seriously unwell.

Information due to be reviewed by September 2024

Please email information@bliss.org.uk if you have comments or feedback, or would like to see full references for this content.