Respiratory syncytial virus (RSV) is a virus that causes infections of the lungs and respiratory tract. It's so common that most children have been infected with the virus by age 2. The virus can also infect adults.

In adults and older, healthy children, the signs and symptoms of the infection typically mimic the common cold. However, RSV is the leading cause of serious respiratory infection in infants and children. It may be severe and may require hospitalization, especially in infants under 6 months of age, children with underlying conditions - such as congenital heart or lung disease - and children who were born prematurely.

Common-sense precautions can help prevent the spread of the infection.

Signs and symptoms

Signs and symptoms of RSV typically appear about four to six days after exposure to the infection. In adults and children older than 3, RSV usually causes mild cold-like signs and symptoms similar to those present during an upper respiratory infection. These include:

• Congested or runny nose

• Cough

• Low-grade fever

• Sore throat

• Mild headache

• A general feeling of unease and discomfort (malaise)

• Bronchiolitis

• Headache

• Pneumonia

In children younger than 3 years old, RSV can lead to a lower respiratory tract illness such as pneumonia or bronchiolitis — an inflammation of the air passages in the lungs. Signs and symptoms may include:

• High fever

• Severe cough

• Wheezing — a higher-pitched noise that's usually heard on breathing out (exhaling)

• Rapid breathing or difficulty breathing, which may make the child prefer to sit up rather than lie down

• Bluish color of the skin due to lack of oxygen

Infants are most severely affected by RSV. They may markedly draw in their chest muscles and the skin between their ribs, indicating that they are having trouble breathing, and their breathing may be short, shallow and rapid. Or they may not show any signs of a respiratory tract infection, but will eat poorly and be unusually lethargic and irritable.

Most children and adults recover from the illness in eight to 15 days. But in young babies, infants born prematurely, or those who have chronic heart or lung problems, the virus may cause a more severe — occasionally life-threatening — infection that requires hospitalization.

Causes

RSV enters the body though your eyes, nose or mouth. It spreads easily when infectious respiratory secretions — such as those from coughing or sneezing — are inhaled or passed to others through direct contact, such as shaking hands. The virus can also live for hours on objects such as countertops or silverware. Touch your mouth, nose or eyes after touching a contaminated object, and you're likely to acquire the virus. An infected person is most contagious in the first few days after infection, but RSV may spread for up to a few weeks after the start of infection.

Risk factors

By age 2, most children will have been infected with RSV. Children who attend child-care centers or who have siblings who attend school are at a higher risk of infection. So are infants who are exposed to high levels of air pollution or cigarette smoke. Susceptibility also is greater during the peak RSV season, which typically begins in the fall and ends in the spring.

People at increased risk of severe — sometimes life-threatening — infections include:

• Infants younger than 6 months of age

• Children with underlying conditions such as congenital heart or lung disease

• Children with weakened immune systems, such as those undergoing chemotherapy or transplantation

• Children who were born prematurely

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