Is Respiratory Syncytial Virus (RSV) Contagious?

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Is respiratory syncytial virus (RSV) contagious?

Respiratory syncytial virus (RSV) is contagious. In the United States, it's the most common cause of inflammation of the small airways in the lungs (bronchiolitis) and of pneumonia in children under 1 year of age. It also is significant cause of respiratory illnesses in older adults. Nearly all children in the U.S. will have been infected by RSV by 2 years of age. RSV usually causes a mild respiratory infection, but it can occasionally cause more serious infections that require hospitalization from breathing compromise with bronchiolitis or pneumonia. RSV was discovered in 1956 (isolated from a chimpanzee but later found to be from human origins) and was designated chimpanzee coryza agent by J. Morris and associates. Years later, the viruses were renamed respiratory syncytial virus (RSV). In virology terminology, RSV is an enveloped RNA virus and is a member of the family Paramyxoviridae that infects lung tissue.

What is the incubation period for a respiratory syncytial virus (RSV) infection?

Most infants and children and older adults usually develop symptoms about four to six days after their first exposure to RSV. This is referred to as the incubation period. Symptoms of RSV include a runny nose and decreased appetite followed by coughing, sneezing, no fever or a mild fever at one to three days. Most individuals with RSV who are otherwise healthy do not require hospitalization. However, some very young infants and others may develop more serious symptoms of wheezing, irritability, decreased activity, cyanosis (blue-gray color to skin) and breathing difficulties. Some of these individuals may require short (three to five days) hospital stays. Even more severe infections can require supported breathing. Definitive diagnosis can be done by viral cultures, detecting RSV antigens, PCR assays, and molecular probes (molecules used to detect other molecules or structures).

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Respiratory Syncytial Virus (RSV) Risk Factors

Who is at risk for severe disease?

Several broad categories of patients are most vulnerable to RSV infection. These include:

  • premature infants and all infants less than 1 year of age,
  • children 2 years old with cardiac disease or chronic lung disease (for example, asthma, cystic fibrosis, etc.),
  • those of any age with a compromised immune system, and
  • those 65 years of age or older.

What is the contagious period for RSV?

The symptoms described in the previous section usually last approximately one week during which symptoms gradually disappear. Individuals are usually no longer contagious after the symptoms disappear (five to eight days). However, individuals with weakened immune systems can be contagious for as long as four weeks.

How is respiratory syncytial virus (RSV) transmitted?

RSV is spread person to person. Coughs and/or sneezes distribute droplets filled with the RSV microbes into the air. If uninfected individuals have the droplets contact their mouth, nose, or eyes, or inhale them, they may become infected with RSV. Infections can also occur from direct person-to-person contact such as kissing the face of an infected child. In this way, RSV can be transferred from infants to adults and from infants to pregnant adults. In addition, indirect contact with RSV-infected droplets that have landed on surfaces that can be touched, such as doorknobs, eating utensils, or toys, can also become sources that transfer the infection. RSV can survive for many hours on hard surfaces.

When should I seek medical care for anyone with RSV infection?

Most children and some adults who develop RSV infections do not need to seek medical care. Individuals with premature infants, young children with chronic heart or lung conditions, and children or adults with weakened immune systems should seek medical care immediately if infection with RSV is suspected. While there is no commercially available RSV vaccine, there is a drug called palivizumab (Synagis) that may be used in certain infants and children who are at high risk for developing severe RSV infection. Unfortunately, this drug cannot help or cure children already suffering from serious RSV disease and cannot prevent infection with RSV. The drug's function, according to the American Academy of Pediatrics, is to reduce the severity of RSV in children (mainly under 1 year of age) with underlying problems such as congenital heart disease, chronic lung disease, or other debilitating conditions.

REFERENCES:

American Academy of Pediatrics. "Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection." Pediatrics 134.2 Aug. 1, 2014: 415-420. <http://pediatrics.aappublications.org/content/134/2/415.full>.

Krilov, Leonard R. "Respiratory Syncytial Virus Infection." Medscape.com. June 25, 2015. <http://emedicine.medscape.com/article/971488-overview>.

United States. Centers for Disease Control and Prevention. "Respiratory Syncytial Virus Infection (RSV)." Dec. 4, 2014. <http://www.cdc.gov/rsv/>.

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Reviewed on 8/16/2016
References
REFERENCES:

American Academy of Pediatrics. "Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection." Pediatrics 134.2 Aug. 1, 2014: 415-420. <http://pediatrics.aappublications.org/content/134/2/415.full>.

Krilov, Leonard R. "Respiratory Syncytial Virus Infection." Medscape.com. June 25, 2015. <http://emedicine.medscape.com/article/971488-overview>.

United States. Centers for Disease Control and Prevention. "Respiratory Syncytial Virus Infection (RSV)." Dec. 4, 2014. <http://www.cdc.gov/rsv/>.

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