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Respiratory syncytial virus (RSV)

Respiratory Syncytial Virus (RSV) 

With many of us wearing masks and practicing social distancing for COVID-19, cases of respiratory syncytial virus (RSV) were much lower in 2020 compared to other years. Most children get RSV at least once before they are 2 years old; however, as a result of COVID-19 precautions and social isolation due to the pandemic, the virus was not widely circulating as it had before. As a result, it is now infecting babies and young children who have little or no immunity to the virus and there has been a rise in RSV cases. 

What is RSV?

Like flu, respiratory syncytial virus (RSV) is a common respiratory virus that causes a yearly epidemic of respiratory illnesses. RSV infections most commonly occur in the late fall through early spring months. 

Both adults and children can become infected, but RSV most often causes serious illness in infants, young children, and older adults. It is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than one year of age in the United States.

What are the symptoms of RSV?

For most healthy adults and children, the symptoms will be similar to a common cold. They will include: 

  • Runny nose
  • Decrease in appetite
  • Coughing
  • Sneezing
  • Fever
  • Wheezing

Symptoms generally begin four to six days after exposure and develop slowly over several days. The contagious period is usually less than 10 days after symptoms begin but is occasionally longer. Symptoms, particularly a cough, may persist for a few days to several weeks.

While sick, stay home from school and/or work to prevent spreading the illness.

Is there a treatment for RSV?

Most RSV infections go away on their own in a week or two.There is no vaccine for RSV. 

Treatment will primarily entail treating the symptoms. According to the CDC:

  • Manage fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. Never give aspirin to children.
  • Drink enough fluids. It is important for people with RSV infection to drink enough fluids to prevent dehydration (loss of body fluids).
  • Talk to your healthcare provider before giving your child over-the-counter cold medicines as some contain ingredients that are not good for children.

In some cases, especially among older adults and infants younger than six months of age, symptoms can be severe. If you or your child are having trouble breathing or are dehydrated, they may need to be hospitalized. You should reach out to a healthcare provider immediately. 

In the most severe cases, a person may require additional oxygen, IV fluids (if they can’t eat or drink enough), or intubation with mechanical ventilation (a machine to help a person breathe). In most of these cases, hospitalization only lasts a few days.

How is it spread, and how can I prevent RSV in my school?

RSV, like other similar seasonal respiratory viruses, such as COVID-19 and flu, is spread by contact with droplets from the nose and throat of infected people when they cough and sneeze. RSV can also spread through dried respiratory secretions on bedclothes and similar items. RSV can remain on hard surfaces for several hours and on the skin for shorter amounts of time.

Many COVID-19 precautions will also help reduce the spread of RSV and other respiratory viruses in schools.  

  • Cover your coughs and sneezes, wash your hands, and clean frequently-touched surfaces.
  • Stay home when sick and avoid close contact with people at increased risk for severe infection.
  • Get tested for flu, COVID-19 and RSV, as appropriate, if you have symptoms. 
  • Wear a face mask. KN95s and surgical masks should be available for staff and students in their schools. 
  • Get an annual flu shot and stay up-to-date with your COVID-19 vaccinations and boosters.

Who is most at risk for severe symptoms?

Anyone can be infected, but RSV can be serious, especially in infants and older adults.

People at the highest risk of severe symptoms include:

  • Infants, especially those born premature and those six months and younger
  • Children younger than two years old with chronic lung disease or congenital (present from birth) heart disease
  • Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus
  • Adults 65 years and older
  • Adults with chronic heart or lung disease
  • People with weakened immune systems

It is possible to get RSV again after recovering from an RSV infection.

What if there is a confirmed case in my school?

Confirmed RSV cases should be treated as they would other communicable diseases in your school, which is to follow guidance from the patient’s doctor for isolation and return to school and/or work. Your principal may contact their on-site nurse, the DOE Office of School Health, or the NYC DOHMH Bureau of Communicable Diseases for guidance. Refer to the Office of School Health’s Communicable Disease Reporting Guide for more instruction on the protocols for reporting diseases and outbreaks in schools. 

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