Respiratory syncytial virus (RSV) in babies and children
9-minute read
Key facts
- RSV is a virus that causes infection in the lungs and airways. It is one of the most common causes of respiratory (breathing) infections in children.
- Symptom may include runny nose, cough, sneezing, wheezing and fever.
- Your doctor can confirm that your child's illness is caused by RSV by doing a PCR test (a swab of your child's nose or throat).
- Most cases of RSV are mild and can be treated at home.
- Babies and children with RSV can have complications of viral infections, including bronchiolitis, pneumonia and ear infections.
What is respiratory syncytial virus (RSV)?
Respiratory syncytial virus (RSV) is a virus that causes infection in the lungs and airways. It is one of the most common causes of respiratory (breathing) infections in children, including the common cold. Infections with RSV usually occur towards the end of autumn and during the winter months.
RSV can affect people of all ages, and most people have had RSV by the time they are 2 years old. You can get RSV again and again. Recovery from RSV gives some immunity (protection) against getting it again, but this immunity is not long-lasting.
What are the symptoms of RSV?
In most people, RSV causes a mild respiratory illness. You usually first notice symptoms around 5 days after being exposed to the virus. You may feel increasingly unwell over the first 3 to 4 days of the illness and then start to improve.
Symptoms may include:
RSV symptoms in young babies
If your baby is younger than one year, they are more likely to develop breathing problems caused by bronchiolitis or pneumonia.
Young children may develop wheezing and difficulty breathing, especially if they have asthma.
Your baby may have difficulty feeding and may be unsettled. They may need to go to hospital if they have breathing or feeding difficulties.
What causes RSV?
RSV is a virus that causes lung and airway infections. Babies and children usually catch RSV from people around them who also have the virus.
You are usually infectious (can pass on the virus) for up to 8 days from when your symptoms begin. RSV is very contagious. It can live on surfaces for several hours or your unwashed hands for 30 to 60 minutes.
If you have RSV, you can spread it by coughing, sneezing or sharing cups. It can be difficult to stop the spread of RSV, but practising handwashing and good hygiene can help to avoid passing the virus onto others.
How is RSV diagnosed?
Your doctor can diagnose the common cold, pneumonia and bronchiolitis (often caused by RSV) by talking to you and examining your child. Your doctor can confirm that your child's illness is caused by RSV by doing a PCR test (a swab of your child's nose or throat).
How is RSV treated in babies?
You can usually manage mild cases of RSV at home. Often, you won't need to give your baby medicine, and all they will need is rest.
There are some things you can do at home to make sure your baby stays hydrated and comfortable. It may be easier for your baby to drink small amounts often, so offer your baby the bottle or the breast at frequent intervals.
If your baby has a fever, treat your baby with paracetamol or ibuprofen (in doses recommended on the bottle). Young babies, premature babies, babies with pre-existing heart and lung conditions and babies with severe bronchiolitis may need to go to hospital for help with breathing or feeding.
If your baby is younger than 3 months old and has a fever above 38°C, take them to the nearest hospital emergency department immediately, or call triple zero (000) and ask for an ambulance.
How is RSV treated in young children?
Treating young children with RSV is similar to treating babies with RSV. It is important to offer your child small amounts of fluid often.
You can bring down your child's fever with paracetamol or ibuprofen. If your child attends day care, it is important not to send them back until they are feeling well. If your child has breathing or feeding difficulties, they may need to go to hospital.
When should I see my doctor?
You should take your child to see a doctor if:
- they have a high fever
- they are having difficulty feeding or are refusing to feed
- your child's cough becomes worse
- you are concerned about your child's breathing
If your child is having difficulty breathing, is turning blue, is grunting or is lethargic, call triple zero (000) and ask for an ambulance.
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Can RSV be prevented?
Australia’s Therapeutic Goods Administration has approved the RSV vaccine Beyfortus (nirsevimab) for babies and young children:
- Newborns and infants born just before or during their first RSV season.
- Children up to 24 months who are at risk of severe RSV disease through their second RSV season.
Conditions that increase the risk of severe disease in children include:
- born premature
- cardiac disease
- chronic respiratory conditions
- neuromuscular disorders (including cerebral palsy and spinal muscular atrophy)
- immunocompromising conditions
- Down syndrome
At this stage, New South Wales, Queensland and Western Australia have announced a free vaccination program for eligible children. To find out more information about this vaccine and if your child is eligible, speak to your doctor or vaccination provider.
There is also a medicine called palivizumab that provides passive immunity to RSV. Palivizumab works by transferring readymade antibodies (that fight infection) to the baby, providing some level of protection and immunity against RSV. The medicine is available in Australia to babies who are at particularly high risk of becoming very unwell with RSV.
High-risk babies include those with pre-existing heart or lung problems, premature babies or those who are immunocompromised (with immune systems that don't function properly). This medicine can reduce you baby's risk of needing hospitalisation and intensive care. The medicine is usually given every 4 weeks from May to September. It is given as an injection.
Pregnant women can now be vaccinated with Abrysvo between 24 and 36 weeks of pregnancy. Anti-RSV antibodies will pass from mother to baby and will help protect your baby from birth to 6 months. Abrysvo is not part of the National Immunisation Program or PBS, so there will be a cost involved. Speak to your doctor about getting vaccinated for RSV during pregnancy.
In 2025, pregnant women in Australia will be able to receive free access to the maternal respiratory syncytial virus (RSV) vaccine, Abrysvo, as part of the National Immunisation Program (NIP).
To be eligible for a free NIP vaccine, you must hold or be eligible for a Medicare card.
For more information, speak to your doctor, midwife or vaccine provider.
Other ways to prevent RSV include maintaining good hygiene and teaching older children about personal hygiene. Good hygiene measures include:
- hand washing
- covering your nose and mouth when sneezing and coughing
- regularly cleaning surfaces that may be contaminated
- avoiding sharing cups and eating utensils
- staying at home if you feel unwell
Complications of RSV in babies and children
Babies and children with RSV can have various complications including bronchiolitis, pneumonia and ear infections. If your child develops these complications, your doctor may recommend you manage their health at home with close follow-up. Your doctor may suggest that they go to hospital if they need help with breathing and feeding.
Resources and support
For more information about RSV and its symptoms, diagnosis and treatment, see the following websites:
Speak to a maternal child health nurse
Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.
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Last reviewed: July 2023
