Is your child at risk for RSV? What you need to know

Winter is coming – and so is the common respiratory syncytial virus. Here is why RSV often hits young kids harder, and what you can do about it.

At this time of year, temperatures in many parts of Australia start to drop and the cooler weather brings a bout of winter viruses, including respiratory syncytial virus (RSV).

The National Notifiable Disease Surveillance System dashboard shows Australia has received more than 20,000 RSV notifications so far this year.

New South Wales has received the highest total of cases, with over 12,000 notifications, followed by Queensland (over 5000) and Victoria (over 2000).

While anyone can get RSV, it’s common in young children, and babies are at higher risk of severe illness.

What is RSV?

The Royal Children’s Hospital (RCH) in Melbourne says RSV is a common cause of respiratory infection in young kids.

It typically causes cold-like symptoms such as a runny nose, cough, wheezing and low-grade fever.

“In some younger infants, particularly those aged less than six months, it can infect the smaller airways of the lung, causing bronchiolitis that can be associated with wheezing, shortness of breath and difficulties in feeding,” RCH chief of medicine Associate Professor Tom Connell says.

Is RSV contagious?

The Royal Australian College of General Practitioners WA chair Dr Ramya Raman says RSV is highly contagious, affecting approximately 65 per cent of babies during their first year.

“Children are able to pass the virus on to others for around eight days,” Dr Raman says.

“It can spread by coughing and sneezing and direct contact, and can live on surfaces for several hours.”

RSV can also spread if children share cups, cutlery and toys.

Regular handwashing, wiping down surfaces, and sneezing into tissues or an elbow help minimise contamination.

Who is most at risk for RSV infection?

Assoc Prof Connell says RSV is most common in children under two years old.

“Most children under the age of two will have already come across RSV and may not have become unwell, or only had mild symptoms,” he says.

“Infants under six months are most vulnerable as RSV may make breathing a little harder and cause some issues with feeding.”

Dr Raman adds that RSV can also be a risk for older patients.

Fortunately, she says, a highly effective vaccine was approved for over-60s in Australia earlier this year.

While it’s not yet available under the National Immunisation Program, older adults are encouraged to discuss RSV vaccination with their GP.

How serious is RSV?

“It’s the leading cause of hospitalisation of children under five years old in Australia,” Dr Raman says.

“A quarter of the children who are hospitalised need intensive care.”

Assoc Prof Connell adds that for most people, RSV goes away on its own without them needing medical treatment.

But parents should see a GP if their child has a high temperature and breathing difficulties, or if they’re concerned about feeding.

“Hospitals are very experienced in dealing with RSV,” Assoc Prof Connell says.

“A very small minority of babies may require supplementary oxygen but, usually, they just need support with feeding.”

How long does RSV infection last for?

According to RCH, RSV in children can generally last between eight and 15 days.

While infected, children should rest at home and drink plenty of fluids if they feel unwell.

Can RSV cause a rash?

Dr Raman says while RSV can cause a rash, parents should look out for symptoms similar to a cold.

“When it spreads to the lower respiratory tract, it can become more severe and cause pneumonia or bronchiolitis,” she says.

“Infants are most severely affected by RSV, so they may also show reduced feeding, unusual tiredness and irritability.”

As for gastrointestinal symptoms such as diarrhoea or nausea, Dr Raman says these are usually quite uncommon.

Is there an RSV vaccine for kids in Australia?

Since the announcement of an RSV infant immunisation program to be available in Western Australia from April 1, other states have quickly followed suit.

“The WA program is the first supply agreement anywhere in the southern hemisphere and a real boost in our efforts to combat RSV in the community,” Dr Raman says.

“The release of infant immunisation Nirsevimab ahead of the winter months will make a difference, and I encourage families with infants who are eligible to step forward and take full advantage.”

Recently, New South Wales and Queensland have joined Western Australia in their efforts for a free RSV vaccine rollout to reduce the risk of infection for newborn babies and young infants.

“Now that we have three states introducing this new preventative treatment for babies, for the commonest cause of hospitalisation in young children, we can look forward to a combined national approach soon,” Professor Robert Booy, Chair of the Immunisation Coalition Scientific Advisory Committee, says. 

Parents should speak with their GP to check if their kids are eligible for the vaccination.

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 Originally written by Sarah Marinos, 9 June, 2022. Updated by Melissa Hong, March 2024.