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Learn about RSV

(Respiratory syncytial virus)

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What is RSV?

Respiratory syncytial virus (RSV) is a common, seasonal respiratory virus that affects approximately 90% of children by the age of two.1,2,3

  • In Canada, the period of highest RSV activity is between fall and early spring every year. 4
  • RSV usually causes mild, cold-like symptoms, but it can cause serious illness, especially among infants and older adults.1
  • RSV is the most common cause of lower respiratory tract infections in children. 5
  • In North America and Europe, approximately 2% of all children require hospitalization for RSV by their first birthday. 6,7
  • RSV is associated with 8-14x more hospitalizations in children under the age of 2 than influenza. 8,9

Respiratory
hospitalization rates

<2 years

RSV
Influenza
8-14x
more hospitalizations in children under the age of 2 than the flu

What are the signs and symptoms of RSV?

The symptoms of RSV are usually similar to a cold and include 10,11

Runny Nose
Low-grade Fever
Sneezing
Coughing
Decrease in appetite

Who is at risk of severe outcomes related to RSV?

  • Even though most cases of RSV are relatively mild, RSV is unpredictable and severe symptoms can develop regardless of health status.
  • Babies, older adults, and people with compromised immune systems are at highest risk from RSV, but even otherwise healthy people can develop a severe infection.

Babies

Older Adults

People with compromised immune systems

Symptoms of a more severe RSV infection in babies include: 10

Poor Feeding
Irritability
Difficulty Breathing
Unusual tiredness
Cough
Short, shallow, and 

rapid breathing

Severe RSV infection can be especially difficult to identify in infants, who may only display irritability or fatigue.10

It is important to recognize that even mild RSV symptoms can become severe.

Talk to your healthcare provider if any signs of a severe infection appear. Seek medical care immediately if the sick person is having difficulty breathing.11

Did you know?
80% of infants who are hospitalized with RSV were born at term and are otherwise healthy.14,15,16,17

Symptoms of a more severe RSV infection in adults include:

Did you know?
Infection with RSV does not produce long-term immunity to the virus, so most people are infected with RSV multiple times throughout their life.12 Therefore, it is important to take precautions to prevent the spread of RSV even if you have had it before.

Bluish colour
to the skin
Wheezing
Severe Cough
Fever
Rapid breathing or
difficulty breathing

What are the long-term impacts of severe cases of RSV?

In severe cases, RSV may be associated with long-term health impacts such as 13:

Recurrent wheezing

Asthma

Decreased lung function

How is RSV spread?

  • RSV is highly contagious and spreads through exposure to infected droplets.
  • It can be transmitted through direct contact with an infected person or surface, and through coughing and sneezing. 18
  • RSV is most contagious during the first week after contracting it, and the infected person may be contagious a few days before they start showing symptoms.
  • Although most people stop being contagious between 3 and 8 days after infection, infants and people with weakened immune systems can continue to spread the virus long after they stop showing symptoms (up to four weeks).19 
  • RSV cases often go undetected or undiagnosed because its symptoms are similar to other respiratory viruses. It is important to recognize the signs and symptoms of RSV so you can protect yourself and others. 

Infected Droplets

Direct Contact

Coughing, Sneezing

Did you know?

The period of highest risk is during the first RSV season (fall to early spring) after birth.19

How can RSV Be prevented in babies and young children?

Preformed Antibodies Can Prevent Severe RSV Infection

  • Preformed antibodies can be used to reduce the risk of severe RSV infection by administering ready-made antibodies to an infant before their first RSV season.
  • While preformed antibodies do not prevent all cases of RSV, evidence suggests that administration of preformed antibodies to all infants prior to their first RSV season can reduce their risk of severe RSV infection and prevent hospitalization and other serious outcomes.20,21,22
  • Novel developments in this method of RSV prevention will be available in future RSV seasons. Start the conversation with your healthcare provider now about recognizing the signs of RSV, when to seek medical care, and how to protect yourself and your loved ones from RSV.

How Else Can RSV Be Prevented?

The risk of getting RSV can be lowered by practicing good hand hygiene, avoiding close contact with sick individuals, wearing a mask when you are sick or when you are around someone who is sick, and regularly disinfecting household surfaces.23

An RSV vaccine has been authorized in Canada to help protect older adults.

  • Although no vaccine is currently available in Canada for children or pregnant people, vaccines for these groups are being developed.
  • Preformed antibodies can provide a temporary boost to the immune system and can help reduce the risk of severe RSV infection in babies.

Did you know?
Over 60 years of research have gone into developing a vaccine that can prevent severe infection with RSV.22

Test your knowledge

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In Canada, the period of highest RSV activity is fall to early spring.

True
False

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You can only be infected with RSV once.

True
False

The correct answer is: 

Like other respiratory viruses, most people contract RSV multiple times during their lives.

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Even people who are otherwise healthy can develop a severe RSV infection.

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False

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Hand washing, masking, and disinfecting household surfaces can help to prevent the spread of RSV.

True
False

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It is easy to tell if you are infected with RSV.

True
False

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The symptoms of RSV often resemble other respiratory viruses, like a cold or influenza. It is important to recognize the signs of RSV and take precautions to prevent spreading the virus to others.

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References

  1. Mayo Clinic. Respiratory. (2023). Respiratory syncytial virus (RSV). https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098
  2. Baraldi E, et al. (2022). RSV disease in infants and young children: Can we see a brighter future? Hum Vaccin Immunother. 2022 Nov 30;18(4):2079322
  3. Jain H, Schweitzer JW, Justice NA. Respiratory Syncytial Virus Infection. [Updated 2023 Jun 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459215/
  4. Government of Canada. (2023). Respiratory syncytial virus (RSV): Symptoms and treatment. https://www.canada.ca/en/public-health/services/diseases/respiratory-syncytial-virus-rsv.html 
  5. Shi T, et al. (2017). Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. The Lancet. 390:946-958.
  6. Bourdeau M, Vadlamudi NK, Bastien N, et al. Pediatric RSV-Associated Hospitalizations Before and During the COVID-19 Pandemic. JAMA Netw Open. 2023;6(10):e2336863.
  7. Wildenbeest JG, et al. The burden of respiratory syncytial virus in healthy term-born infants in Europe: a prospective birth cohort study. Lancet Respir Med. 2023 Apr;11(4):341-353.
  8. Tang KM et al. (2023). RSV causes more severe respiratory illness than influenza in admitted children under 2-years-old. Pediatr Pulmonol. 58(6):1738-1745
  9. Schanzer DL, et al. Burden of influenza, respiratory syncytial virus, and other respiratory viruses and the completeness of respiratory viral identification among respiratory inpatients, Canada, 2003‐2014. Influenza and other respiratory viruses. 2018 Jan;12(1):113-21.​
  10. Mayo Clinic. Respiratory. (2023). Respiratory syncytial virus (RSV). https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098
  11. Centers for Disease Control and Prevention. (2023). Respiratory syncytial virus (RSV): Symptoms and Care. https://www.cdc.gov/rsv/about/symptoms.html
  12. Heywood, AL. Is It Possible to Get RSV More Than Once? Medline. Accessed on 1 November 2023. https://www.healthline.com/health/can-you-get-rsv-twice#why-you-can-get-rsv-twice
  13. Fauroux B, Simões EAF, Checchia PA, Paes B, Figueras-Aloy J, Manzoni P, Bont L, Carbonell-Estrany X. The Burden and Long-term Respiratory Morbidity Associated with Respiratory Syncytial Virus Infection in Early Childhood. Infect Dis Ther. 2017 Jun;6(2):173-197
  14. Munro APS, et al. (2023). The disease burden of respiratory syncytial virus in Infants. Curr Opin Infect Dis. 36(5):379-384
  15. Bowser DM, et al. (2022). Cost of Respiratory Syncytial Virus Infections in US Infants: Systematic Literature Review and Analysis. J Infect Dis. 2022 Aug 15;226(Suppl 2):S225-S235.
  16. Hall CB, et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics. 2013 Aug;132(2):e341-8.
  17. Pisesky A, et al. (2016). Incidence of Hospitalization for Respiratory Syncytial Virus Infection amongst Children in Ontario, Canada: A Population-Based Study Using Validated Health Administrative Data. PLoS One. 11(3):e0150416.
  18. Centers for Disease Control and Prevention. (2023). Respiratory syncytial virus (RSV): RSV Transmission. https://www.cdc.gov/rsv/about/transmission.html
  19. Openshaw PJM, et al. (2017). Protective and Harmful Immunity to RSV Infection. Annu Rev Immunol. 35:501−532.
  20. Rogers, L. (2023). The Latest in RSV Protection for Kids. Johns Hopkins Bloomberg School of Public Health. https://publichealth.jhu.edu/2023/beyfortus-provides-rsv-protection-for-kids
  21. Jones et al. (2023). Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease Among Infants and Young Children: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023. https://www.cdc.gov/mmwr/volumes/72/wr/mm7234a4.htm
  22. Rodriguez-Fernandez R, Mejias A, Ramilo O. Monoclonal Antibodies for Prevention of Respiratory Syncytial Virus Infection. Pediatr Infect Dis J. 2021 May 1;40(5S):S35-S39.
  23. Centers for Disease Control and Prevention. (2023). Respiratory syncytial virus (RSV): RSV Prevention. https://www.cdc.gov/rsv/about/prevention.html
  24. Public Health Agency of Canada. (2023). Respiratory syncytial virus (RSV): Canadian Immunization Guide. https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/respiratory-syncytial-virus.html.
  25. Killikelly, A et al. (2020). Overview of the respiratory syncytial virus vaccine candidate pipeline in Canada. Canada Communicable Disease Report, 46 (4). Accessed 1 November 2023, from https://publications.gc.ca/collections/collection_2020/aspc-phac/HP3-1-46-4-eng.pdf
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