Respiratory Syncytial Virus (RSV) is on the rise in Ohio, in line with national trends in RSV cases. The Centers for Disease Control and Prevention (CDC) issued a health advisory on Friday, Nov. 4, about early, elevated respiratory illnesses, especially among children. Co-circulation of RSV, the flu and COVID-19 could place stress on healthcare systems this fall and winter, according to CDC.

In addition to COVID-19, CDC is tracking levels of RSV, influenza, and rhinovirus/enterovirus (RV/EV) that are higher than usual for this time of year, especially among children, though RV/EV levels may have plateaued in recent weeks.

The CDC recommends vaccination against flu and COVID-19 for people ages 6 months and older who are not up to date on vaccinations. This includes the updated COVID-19 booster that increases protection against the Omicron variant for people ages 5 years and older who received their primary vaccine series or an original booster at least two months ago.


The timing of RSV in a community may vary from year to year, although we typically see increases in RSV during the fall and winter months. This year, cases seem to be rising earlier than is typical. Annually, in the United States, RSV leads to about 58,000 hospitalizations, with 100-500 deaths among children younger than 5 years old and 177,000 hospitalizations with 14,000 deaths among adults aged 65 years or older. (Source: CDC Health Alert Network (HAN) 00443)

 RSV is a common respiratory virus that usually causes cold-like symptoms. It is the most common cause of bronchiolitis and viral pneumonia in infants under 1 year old and can cause severe illness in older adults. RSV is spread through respiratory droplets when someone coughs or sneezes. These droplets can settle in the eyes, nose, or mouth of another person and may settle on common household items such as tables, doorknobs, and cell phones and tablets. You can get sick by touching these surfaces, then touching your eyes, nose, or mouth before washing your hands. If you are sick with RSV, you can easily pass it to babies by snuggling them.  

Babies, young children, and older adults with chronic medical conditions such as cystic fibrosis, congenital heart disease, chronic lung disease, transplant recipients, those receiving chemotherapy, or with weakened or compromised immune systems are at risk of severe disease from RSV infection. In some cases, RSV infection can lead to worsening of chronic conditions like asthma, chronic obstructive pulmonary disease, and congestive heart failure.

Symptoms can change depending on age. Babies younger than 6 months old may show:

  •  Irritability.
  •  Decreased feeding.
  •  Decreased activity level.
  •  Temporary pauses in breathing (apnea).
  •  Fever.
  •  Wheezing.

Older babies and children may show:

  • Runny nose.
  • Nasal congestion.
  • Decreased appetite a few days before the cough.
  • Sneezing.
  • Fever.
  • Wheezing.

 In adults, the symptoms may mimic the common cold and include:

  • Runny nose.
  • Sore throat.
  • Cough.
  • Headache.
  • Fatigue.
  • Fever.

It’s important to stay home if you feel sick, even if it’s just the common cold. You may be unknowingly spreading RSV to others. It can be difficult to know the signs of breathing trouble in babies. The American Academy of Pediatrics offers advice to parents on signs/symptoms to watch for.

It’s possible for babies and young children to have more than one respiratory virus at one time. It’s important to see a healthcare provider if you think you or someone you’re caring for have respiratory illness. Most individuals with RSV can be diagnosed and cared for by a healthcare provider with an outpatient appointment and generally improve in 1-2 weeks. Your healthcare provider will be able to determine if a test for RSV is needed and the best course of treatment for the symptoms. Contact a healthcare provider immediately if you or someone you’re caring for have more severe symptoms such as dehydration, difficulty breathing, or decreased oxygen levels.

RSV is easily spread, but there are measures you can take to help prevent it from hitting your family.

  • For some babies who meet specific criteria for being at high risk of getting RSV, there is a preventive monoclonal antibody called Palivizumab available. Your child’s healthcare provider will discuss this option with you if your baby or child is eligible. Monoclonal antibodies will not treat or cure an existing infection and are only used to prevent RSV in eligible individuals.
  • Encourage good handwashing of adults and older children in the household for at least 20 seconds.
  • Remember to cover coughs and sneezes.
  • Avoid close contact with anyone who is sick (avoid kissing, handshakes, sharing eating or drinking utensils).
  • Clean high-touch surfaces like doorknobs, tables, cell phones, and other electronics. 
  • Older children, caregivers, and adults in the home who are sick with viruses should avoid interactions with individuals considered to be at high risk of severe RSV.
  • Limit time in potentially contagious settings such as childcare centers.
  • Decrease or eliminate exposure to environmental secondhand smoke and
  • Breastfeeding, if you can, to help reduce respiratory infections.
  • Keep an eye on RSV trends in your area and take extra precautions when needed.

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