How to Prevent RSV in Adults and Children

Respiratory syncytial virus (RSV) is a common, highly contagious illness that affects the nose, throat, and lungs. Although RSV usually causes mild illness with cold-like symptoms, the infection can cause severe respiratory illness in infants, young children, older adults, and people with weakened immune systems or underlying health conditions.

In the United States, RSV season begins in the fall and peaks in the winter. While there is no cure for RSV, there are ways to lower your risk of infection. This article explores practical steps to prevent RSV, including at-home measures, vaccinations, and medications to safeguard yourself and your loved ones against RSV.

How to Prevent RSV From Spreading 

Every year, an estimated 64 million people worldwide experience RSV infections. RSV spreads through contact with respiratory droplets of an infected person when they cough, sneeze, or talk, or by touching objects that have the virus on them (e.g., doorknobs, toys) and then touching your eyes, nose, or mouth.

You can help limit the spread of RSV and lower your risk of infection by practicing simple and effective habits daily, such as:

• Wash your hands regularly with soap and water for at least 20 seconds. Handwashing is one of the most effective ways to prevent the spread of RSV. Make it a habit to wash your hands after coughing, sneezing, eating, and being in crowded or public places.
• Avoid touching your eyes, nose, and mouth after spending time with others or in public places until you’ve washed your hands. 
• Cover coughs and sneezes using your elbow or a tissue to cover your mouth and nose to prevent respiratory droplets carrying the virus from spreading.
• Avoid close contact with people who are sick, especially if they are coughing or sneezing. Keeping a safe distance can reduce the likelihood of coming into contact with infectious respiratory droplets.
• Disinfect frequently touched surfaces, such as countertops, doorknobs, light switches, and countertops. RSV can survive on hard surfaces for several hours, so cleaning these areas can help prevent its spread.
• See a healthcare provider if you have symptoms of a cold (e.g., runny nose, coughing, sneezing), especially if they last longer than a week or worsen. 
• Discuss RSV vaccination with a healthcare provider if you are an older adult (60 and older).

Can I Prevent RSV in My Child?

Most children have had and recovered from at least one RSV infection by age two. RSV usually causes mild symptoms, but some infants and young children are at risk of severe illness that may require hospitalization. Taking simple protective measures can help lower your child’s risk of RSV. 

• Wash your hands thoroughly before interacting with your child, especially if you’ve been in crowded or public places. Encourage family members and visitors to do the same before holding or playing with your child, and teach your children proper handwashing techniques. 
• Minimize your child’s exposure to crowded or enclosed spaces, especially during peak RSV seasons. 
• Regularly clean and disinfect surfaces your child touches, such as toys, play areas, and high chairs. RSV can linger on surfaces for hours, and maintaining cleanliness helps reduce the risk of transmission.
• Educate your child’s caregivers, such as babysitters and family members, on preventing RSV. Share information about proper hygiene and the signs of respiratory illness to look for. 
• Avoid exposure to secondhand smoke, which increases the risk of severe RSV infection in children. 
• Breastfeeding your baby can provide antibodies to help boost their immune system and provide some protection against respiratory infections like RSV.

Who’s More Likely to Develop Severe RSV?

People of all ages can become infected with RSV. While the virus usually causes mild symptoms that resolve within a week or two, some groups are at higher risk of developing severe RSV infections, including:

• Infants, especially those 6 months or younger or born prematurely
• Children with congenital heart disease, chronic lung disease, or neuromuscular disorders
• Children and adults with weakened immune systems 
• Adults with heart or lung disease 
• Older adults (60 and older) 

Infants have underdeveloped immune systems and smaller airways more prone to swelling and congestion. This makes babies more susceptible to severe RSV complications, such as bronchiolitis (inflammation of the airways) and pneumonia (lung infection).

For older adults, age-related lung and respiratory function changes coupled with a slower immune response increase the risk of severe respiratory infections. RSV infections may worsen symptoms of underlying health conditions in older adults, such as asthma, heart failure, or chronic obstructive pulmonary disease (COPD).

Is There an RSV Vaccine?

Research breakthroughs have led to the development of RSV vaccines specifically targeted to protect high-risk groups from the impact of RSV. In May 2023, the Food and Drug Administration (FDA) approved two RSV vaccines for older adults (ages 60 and up): GSK’s Arexvy and Pfizer’s Abrysvo.

The vaccines, given in a single dose, stimulate the immune system to produce antibodies to protect against severe RSV infections and complications (e.g., pneumonia). In clinical trials, both vaccines were shown to be highly effective:

• Arexvy reduced the risk of RSV-associated lower respiratory infections by 82.6% and lowered the risk of severe complications by 94.1%.
• Abrysvo shows 66.7% effectiveness at preventing RSV-associated lower respiratory tract infections and 85.7% at protecting against severe RSV-associated illness. 

The Centers for Disease Control and Prevention (CDC) strongly recommends that people ages 60 and older discuss RSV vaccination with a healthcare provider. 

In August 2023, the FDA approved an RSV vaccination for pregnant people between weeks 32 and 36 gestation, to prevent occurrence of the illness in infants. Research suggests the vaccine may pass maternal RSV antibodies onto the fetus to protect newborns from the virus for the first six months of life. Clinical trial results showed Abrysvo was 81.8% effective in preventing severe RSV in infants for the first six months of life.

How to Prevent RSV in Babies, Including Infants

The FDA approved a promising new preventive option for protecting babies against severe RSV in July 2023. Beyfortus (nirsevimab) is a monoclonal antibody antiviral drug administered as a single intramuscular injection for infants and young children up to 24 months old. It provides antibodies that help bolster an infant’s immune system to prevent severe lung disease (e.g., pneumonia) caused by RSV.

Research shows Beyfortus may reduce the risk of RSV-related hospitalizations and healthcare visits in infants by up to 80%. The CDC recommends one dose for infants eight months and younger born in or during their first RSV season and one dose for those between 8 and 19 months with an increased risk of severe RSV infection. While generally safe, the drug may cause mild side effects such as rash or irritation at the injection site.

While Beyfortus is a powerful tool in preventing RSV in infants, parents and caregivers should continue implementing other preventative measures, including frequent handwashing, avoiding close contact with sick people, and maintaining a clean environment. 

Protective Medications for High-Risk Children

For high-risk babies and young children under 24 months of age vulnerable to severe RSV infections, specialized preventive medications offer an extra layer of defense. Synagis (palivizumab) is an antiviral monoclonal antibody designed to protect against severe RSV illness in infants and young children at high risk of complications, including those born prematurely or with heart or lung diseases. 

Palivizumab is administered as a monthly injection during RSV season. It helps boost the immune system to stop or slow the spread of RSV in the body, but it cannot prevent infection and is not used to treat symptoms once a child has RSV. While generally well-tolerated, palivizumab may cause side effects such as fever, rash, pain, and swelling at the injection site. 

How Long Am I Contagious With RSV?

People with RSV are usually contagious for three to eight days and may be contagious for a day or two before symptoms develop. Infants and those with weakened immune systems may be contagious for up to four weeks, long after symptoms resolve.

After exposure to RSV, there is an incubation period of approximately four to six days before symptoms develop. During this time, the virus replicates in the body, though you may have no signs of illness. When symptoms develop, they usually last between one and two weeks, with peak symptoms occurring in the first few days.

While symptoms like sneezing, runny nose, and decreased appetite may improve after the first week, coughing and congestion can persist for weeks. To prevent the spread of RSV when you’re sick, you can: 

• Stay home from work, school, or public places when you’re experiencing symptoms to avoid exposing others to the virus.
• Practice good hand hygiene by washing your hands frequently with soap and water for at least 20 seconds.
• Cover your mouth and nose with a tissue or your elbow when you cough or sneeze.
• Avoid close contact with people more vulnerable to severe RSV infections, including infants, older adults, and people with weakened immune systems.
• Regularly clean and disinfect frequently touched surfaces to reduce the risk of passing the virus to others.

Summary 

Respiratory syncytial virus (RSV) is a highly contagious respiratory illness that usually causes mild, cold-like symptoms. Infants, older adults, and people with weakened immune systems are vulnerable to more severe RSV infections that may require hospitalization. You can use at-home measures to prevent RSV. Recent research advancements have introduced RSV vaccines and monoclonal antibodies that protect specific populations from serious illnesses.

Talk to a healthcare provider to determine if RSV vaccination is right for you or if your baby or young child should receive monoclonal antibodies to help prevent RSV.