Respiratory Syncytial Virus (RSV) Infection

 
About Respiratory Syncytial Virus (RSV) in New York State

Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild illness but which can be very harmful to very young children, older adults, people with medical conditions, or those born premature or with underlying lung conditions. Like influenza and COVID-19, RSV infection typically spreads during the fall and winter months. It is important for New Yorkers to learn about the new RSV vaccines, preventing RSV spread, managing symptoms, and how to protect loved ones at the greatest risk of getting very ill.

While RSV is not yet a disease that is reported to the New York State Department of Health (NYSDOH), NYSDOH works to ensure that outbreaks are controlled. RSV outbreaks are investigated by local health departments.

 
What is RSV?

Respiratory syncytial virus (RSV) infection is a common respiratory illness caused by a virus. Anyone can be infected, but RSV most often causes serious illness in infants and very young children, older adults, or those with a weakened immune system or illnesses like heart disease, chronic lung disease, and diabetes. Much like other respiratory viruses, RSV infections typically occur during the fall and winter.

 
How does RSV spread?

RSV is spread through 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. Direct contact with the virus, such as kissing, can also spread the virus. RSV can remain infectious on hard surfaces for several hours and on skin for shorter amounts of time.

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What are RSV symptoms?

Typical symptoms resemble the common cold: runny nose, coughing, sneezing, fever, wheezing, and decreased appetite. Mild or unnoticeable illness may occur. However, RSV infection can also result in pneumonia, especially in the very young, the very old, or those with weakened immune systems. Individuals can also be infected with multiple respiratory viruses at the same time, which can cause more serious complications.

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

 
How is RSV diagnosed?

RSV is diagnosed by a pediatrician/health care provider. It is usually identified from the appearance of typical symptoms. The use of specific laboratory tests is often limited to cases of severe illness and to special outbreak investigations. The most common laboratory tests use a swab or respiratory fluid to look for the virus.

 
If my child or I have symptoms consistent with RSV, what should I do?

If you or your child have symptoms consistent with RSV, or any respiratory illness, and you are concerned about severe illness, contact a health care provider right away who can help you with diagnosis, treatment, and care. While sick, stay home from school or work to prevent spreading the illness. Cover your cough/sneezes, wash your hands and avoid close contacts and clean frequently touched surfaces.

 
If my child or I do catch RSV, what care is available?

If you or your child have symptoms consistent with RSV, and you are concerned about severe illness, reach out to a health care provider right away. A health care provider will advise on testing and care, but there are steps you can take to relieve symptoms. According to CDC:

• Manage fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. (Do not 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 nonprescription cold medicines. Some medicines contain ingredients that are not good for children.

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How can I prevent RSV?

To prevent RSV and other respiratory viruses that circulate during the fall and winter, including COVID-19 and influenza, adults, parents, and guardians should make sure they and their children:

• If eligible, get vaccinated or receive the monoclonal antibody to protect yourself and your family
• Stay up to date with COVID-19 shots and receive an updated booster as soon as eligible.
• Get an annual flu shot.
• Teach children to cough and sneeze into a tissue or into their elbows rather than their hands.
• Practice good hand hygiene, and keep frequently touched surfaces (tables, utensils, doorknobs) clean.
• Stay home from work or school when sick, until symptoms subside.
• If you have very young children or elderly adults at home, including a child who was born premature or a child or adult with congenital lung disease, try to keep them isolated from family members who develop respiratory viruses or symptoms.
• Keep social distancing in mind, which can aid in reducing spread.
• Ventilate indoors or keep windows open for air circulation if possible.
• Consider wearing a mask when indoors or in crowded settings. This may be important for parents, guardians, siblings, and other friends or family members who may live with newborns, very young children, or elderly who are at the highest risk, and are looking to take precautionary measures.

 
Is there a vaccine available to prevent and protect against RSV?

Yes! There are two RSV vaccines available for adults aged 60 years and older. The vaccines were approved for use in June 2023 and are called Arexvy (RSVPreF3 +AS01E) and Abrysvo (RSVpreF). If you are interested in the vaccine, please talk to your healthcare provider. For best protection against the upcoming RSV season, getting the vaccine as soon as possible is recommended.

If your child was born premature and is at high risk of developing severe infection due to underlying lung conditions, talk to their health care provider about palivizumab (Synagis). This medication is a monoclonal antibody recommended by the American Academy of Pediatrics (AAP) to be administered to high-risk infants and young children likely to benefit based on gestational age and certain underlying medical conditions. It is given in monthly intramuscular injections during the RSV season, which generally occurs during fall, winter, and spring in most locations in the United States.

In the near future, a new type of RSV vaccine (RSVpreF) is expected to be available, which would be the first vaccine for administration to pregnant people to help protect against the complications of RSV disease in infants from birth to six months. In addition, a new product called nirsevimab (Beyfortus) should also be available soon. It is a ready-made antibody that can prevent RSV infection. It is given as a single injection to infants and children up to 24 months for protection from RSV.

 
Are cases of RSV reported to NYSDOH?

Individual cases of RSV are not currently reported to NYSDOH. Outbreaks of RSV should be reported by providers, would be investigated by local health departments, and reported to the NYSDOH.

 
Where can I find information about RSV cases in New York?

Some laboratories in New York report the total number of RSV tests performed and the number of positive tests to CDC each week. The Centers for Disease Control and Prevention (CDC) tracks some cases of RSV at the State level, which New Yorkers can view here. Because reporting delays may be expected for some laboratories, data shown for the most recent weeks may be less complete than others.

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