Medicines for Respiratory syncytial virus (RSV)

What it is

Respiratory syncytial virus (RSV) is a common virus that infects the airways and lungs. It is very common — most children have had an RSV infection by the age of two — and infections tend to occur especially in the colder months (autumn and winter). In most people, RSV causes a mild, cold-like illness, with symptoms such as a runny or blocked nose, a cough, sneezing, a sore throat, a mild fever, and tiredness, which usually get better on their own within a week or two with simple self-care. However, RSV is important because in certain groups it can cause more serious illness affecting the lower airways and lungs — particularly bronchiolitis (inflammation of the small airways) and pneumonia — and can cause significant breathing difficulty. The groups most at risk of serious RSV illness are: young babies (especially those under six months, and those born prematurely or with certain heart or lung conditions); older adults; and people with weakened immune systems or certain long-term health conditions. In babies, warning signs of more serious RSV illness (such as bronchiolitis) include breathing difficulties — such as fast, laboured, or noisy breathing, the skin sucking in around the ribs, pauses in breathing, or the baby becoming pale, floppy, or having trouble feeding — which need prompt or urgent medical attention. RSV is spread through droplets from coughs and sneezes and by contact with contaminated surfaces, so good hygiene helps reduce spread. There are also measures to protect those most at risk, including vaccines and other preventive treatments offered to certain groups (such as some older adults, pregnant women to protect their babies, and some vulnerable infants) — the specific programmes vary and are advised by health services. The key messages are that RSV usually causes a mild cold-like illness, that it can cause serious breathing problems in babies and vulnerable people (so warning signs need prompt attention), and that hygiene and preventive measures for at-risk groups help.

How it is treated

RSV is managed according to the severity of illness — usually with simple self-care for the common mild illness, and with medical care for those who become more seriously affected, particularly at-risk groups; prevention is important for those most at risk. For the common, mild cold-like illness caused by RSV, self-care is usually all that is needed: rest, drinking plenty of fluids, simple measures to ease symptoms (such as relieving a blocked nose, and keeping comfortable), and, for children, ensuring they are drinking and feeding and using suitable measures for fever and discomfort; there is no specific medicine needed for the virus, and it usually clears on its own within a week or two. However, it is important to recognise when RSV is causing more serious illness, particularly in babies and vulnerable people, and to seek help: in babies, warning signs of serious illness (such as bronchiolitis) include fast, laboured, or noisy breathing, the skin or ribs being sucked in with breathing, pauses in breathing, difficulty feeding or much reduced feeding, fewer wet nappies, becoming pale or floppy, or a persistent high temperature — these need prompt or urgent medical assessment. Serious RSV illness may need hospital care, which is supportive — for example help with feeding and fluids, help with breathing and oxygen if needed, and monitoring — while the illness runs its course; there is no cure for the virus itself, so care focuses on supporting the person. Prevention is an important part of the picture: good hygiene (washing hands, catching coughs and sneezes, cleaning surfaces, and keeping newborns and vulnerable people away from people with cold symptoms where possible) reduces spread; and there are preventive measures for those most at risk, including vaccines and other treatments offered to certain groups — such as vaccination for some older adults, vaccination in pregnancy to protect the newborn baby, and preventive treatment for some high-risk infants — with the specific programmes advised by health services (these have expanded in recent years). The key messages are that RSV usually causes a mild illness managed with self-care, that it can cause serious breathing problems in babies and vulnerable people (so the warning signs need prompt attention), and that hygiene and preventive measures for at-risk groups help protect those most vulnerable.