What is RSV? Symptoms, complications and the new vaccine

A vaccine is being rolled out for RSV – short for respiratory syncytial virus – for the first time among pregnant women and older people.

The common illness which infects 90% of children under the age of two circulates in the UK every winter, typically starting in October and peaking in December or January.

The virus, which can be caught at all ages, is normally mild. But it can lead to severe lung infections, including pneumonia and infant bronchiolitis, and is a leading cause of infant mortality globally.

Officials suggest the vaccine programme could ease the pressure on the NHS.

Here is what you need to know about RSV, its symptoms, the complications it can cause and the vaccine rollout.

What is RSV?

RSV is short for respiratory syncytial virus.

It is a very common virus and most children will have had it by the time they are two.

However, it can reinfect older children and adults may also catch it. Older adults are particularly at risk of complications.

Illness from the virus is the main cause of winter pressures in children’s hospitals each year, leading to increased demands on paediatric intensive care units and cancelled operations.

It accounts for approximately 20,000 hospital admissions in children under one year and is responsible for 20 to 30 infant deaths in the UK each year, according to the Department of Health and Social Care.

What are the symptoms of RSV?

Most children infected with RSV will only experience mild symptoms, including:

• runny nose
• decrease in appetite
• coughing
• sneezing
• fever
• wheezing

These symptoms usually come in stages, rather than all at once. In very young children, the only symptoms may be irritability, decreased activity, and breathing difficulties.

What are the possible complications?

RSV can cause a chest infection called bronchiolitis, which mainly affects children under two.

It is usually mild and can be treated at home, according to the NHS, but it can be serious.

Bronchiolitis is not the same as bronchitis, which causes a cough with lots of mucus and can affect people of all ages.

The symptoms of bronchiolitis include:

• breathing more quickly
• finding it difficult to feed or eat
• noisy breathing (wheezing)
• becoming irritable

Symptoms are usually worst between days three and five, and the cough usually gets better in three weeks, the NHS says.

Some children have a higher risk of getting seriously ill with bronchiolitis, including children born very prematurely, those with a heart or lung condition or a weakened immune system.

About three in 100 babies with bronchiolitis will need hospital treatment, according to Asthma + Lung UK.

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When should you seek treatment?

The NHS advises parents to call 999 or go to A&E if any of the following happens:

• your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
• there are pauses when your child breathes
• your child’s skin, tongue or lips are blue
• your child is floppy and will not wake up or stay awake.

Parents should ask for an urgent GP appointment or call 111 if any of the following happens:

• your child has had a cold and it’s getting worse
• your child is feeding or eating much less than normal
• your child has had a dry nappy for 12 hours or more, or shows other signs of dehydration
• your baby is under 3 months and has a temperature of 38C or more, or is older than 3 months and has a temperature of 39C or higher
• your baby feels hotter than usual when you touch their back or chest, or feels sweaty
• your child is very tired or irritable.

How does the vaccine rollout work?

It started on 1 September, with women being offered it from 28 weeks into pregnancy and a one-off catch up programme to target those aged between 75 and 79 to ensure older people are protected going into this winter.

The vaccine, which is given via injection into your upper arm, will be offered to eligible people through the NHS.

Women should be offered the vaccine at around the time of their 28-week antenatal appointment, as getting vaccinated as close to 28 weeks as possible provides the best protection for babies, the NHS says.

They advise speaking to your maternity service or GP surgery if you’re 28 weeks pregnant or more and have not been offered the vaccine.

People aged 75 to 79 should also be offered the vaccine by their GP surgery.

What treatment is available if someone gets RSV?

There is no specific treatment for RSV and instead treatment is aimed at relieving symptoms.

The anti-viral drug ribavirin has been licensed for treating RSV and is sometimes used in severe cases, but its effectiveness has not been established.

At home, symptoms of RSV and bronchiolitis can be treated with child paracetamol or ibuprofen. Saline nasal drops may make it easier for them to breathe, and feeding babies upright can also help.

In hospital, a child with bronchiolitis may be given extra oxygen. If they are struggling to feed, they may be given food or fluids through a feeding tube. They may also be treated with nasal suction to get rid of excess mucus in the nostrils.

‘Vaccine can prevent trauma’

Health minister Andrew Gwynne has shared his family’s experience with RSV.

His grandson was just weeks old when he contracted the virus, which developed into bronchiolitis.

He was put in an induced coma by medics and spent two weeks in intensive care.

“It was just heart-breaking watching this tiny, weeks old baby just helpless on the machine,” Mr Gwynne said.

“Around 20,000 babies a year are hospitalised with RSV, and very tragically between 20 and 30 a year will die from it.

“And yet it’s entirely preventable. So that’s why this vaccine is so important.

“I don’t want any parent or grandparent to have to go through the trauma that we went through with our grandson with something that is entirely preventable, which RSV is.”

Mr Gwynne added that the vaccine “will ease enormous pressure on the NHS”.

Christine Burlison, whose baby became seriously ill from the virus, is urging pregnant women to take up the new vaccine.

Her daughter, Aria, was 11 days old when she began struggling to breathe and was taken to hospital.

Doctors said she had developed bronchiolitis, a blocking of the airways in the lungs, as a result of RSV.

“Now having the option of a vaccine that could prevent other families having to go through the same experiences as ours did is simply amazing,” Ms Burlison said.

“The most terrible thing that you can face as a parent is seeing your child struggling to breathe.

“Having that protection for a newborn is all you could wish for.”