Bug of the Month: RSV Infection or Bronchiolitis

Technical Names: RSV Bronchiolitis

NickNames: RSV, wheezing virus

What it is: viral infection of the small airways of the lung; can cause a true viral pneumoniaas well.

Typical Ages for Illness: All ages; most severe in young and premature infants and children with heart and lung problems including congenital heart disease and asthma. Interesting fact: all kids become infected by RSV by the age of 2 and many of us get it multiple times throughout our lives.

Typical Symptoms:

adults: bad cold symptoms

older infants and children: similar to a bad cold

young infants: lethargy, trouble eating, fast breathing, cough, wheeze.

Etiology: Respiratory Syncytial Virus

Seasonal Issues: occurs predictably between November to March

How’s It Spread? Direct contact with secretions – person to person or on objects.

Incubation Period: 4-6 days but can range from 2 to 8 days

Diagnosis: Usually clinical – based on symptoms and high index of suspicion given out breaks in community. Rapid assay test available in many offices and emergency rooms – most useful if a child needs to be hospitalized to control infection.

Symptom Duration: 7-14 days, as with most viral illnesses with the most intense symptoms early in the illness.


  • cold treatment: saline nose spray and bulb syringe, humidifier
  • +/- breathing treatments such as inhalers or nebulizers
  • fluids
  • tylenol or motrin for fever and discomfort
  • some children do need to be hospitalized due to severe respiratory symptoms such as trouble breathing and needing oxygen, or due to underlying heart and lung problems.

Call Your Pediatrician if your child has:

  • high fever, or fever not gone in 2-3 days
  • vomiting or diarrhea and can’t hydrate well
  • lethargy
  • sick appearance
  • trouble breathing despite treatment
  • blue or gray color to lips or fingernail beds


  • stay home if sick
  • good hand washing
  • having the child cover his or her mouth when coughing, if possible
  • cleaning toys and objects likely contaminated by respiratory droplets
  • a medication called Synagis before RSV season is available for kids under 2 years of age that are high risk – premature babies younger than 35 weeks and congenital heart disease children. This is usually given starting in November as RSV season begins. Your pediatrician will alert you if your child falls into this group.

School and After school Activity Issues

  • may return to daycare when fever free for 24hours and able to eat and drink normally, and breathing normally
  • avoid large groups of kids if cough is not controlled to prevent further spread
  • if on antibiotics, needs to be on them for 24 hours before returning to school
  • activities should be curtailed until the child has the energy to participate without becoming winded or fatigued.

Internet Resources For Parents

General Info on RSV (KidsHealth)

General Info on Bronchiolitis (Kids Health)

How Lungs Work (KidsHealth)