Respiratory syncytial virus (RSV): symptoms, who is at risk and vaccination in the UK

Respiratory syncytial virus is a virus that infects the nose, throat and lungs. NHS inform describes it as a virus that can affect the lungs and airways, which in most people causes mild cold-like symptoms and occasionally severe lung infections such as bronchiolitis, an infection of the small airways in the lungs, or pneumonia.

The NHS says most people get RSV several times during their life. It peaks during late autumn and winter, according to NHS inform, but can happen all year round. In babies, the NHS says, it is a common cause of bronchiolitis, which can cause breathing problems and may need to be treated in hospital.

The attention RSV receives is because of the minority who become seriously ill, and because the NHS now offers a vaccine and, for very high-risk young children, a preventive antibody injection.

The NHS says some babies and adults have a higher risk of getting seriously ill from RSV, particularly babies under 6 months old, young children who were born prematurely, adults over 75, babies, children and adults with a weakened immune system or long-term lung or heart conditions, and people who smoke tobacco and babies exposed to tobacco smoke. NHS inform lists children under 2 years, people with chronic lung disease or congenital heart disease and adults over 65.

The NHS also notes that RSV can cause a serious lung infection (pneumonia) in babies and older adults, and the NHS vaccine page says that an RSV infection can make symptoms worse if you have a lung condition such as COPD.

The NHS says symptoms usually start within a few days of getting infected and that most people only get cold-like symptoms: a runny or blocked nose, a cough, sneezing, tiredness and a high temperature. Babies with RSV may also be irritable and feed less than usual.

If RSV leads to a more serious infection such as pneumonia or bronchiolitis, the NHS lists a cough that gets worse, shortness of breath, faster breathing or long gaps between breaths, difficulty feeding in babies or loss of appetite, noisy breathing (wheezing) and, in older adults, confusion.

• Runny or blocked nose, cough and sneezing.

• Tiredness and a high temperature.

• In babies, irritability and feeding less.

• Worsening cough, faster breathing or wheezing.

• Confusion in older adults.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if your child is unwell and getting worse, is feeding or eating much less than normal, has had a dry nappy for 12 hours or more or shows other signs of dehydration, feels hotter than usual to touch or is shivering, is under 3 months with a temperature of 38C or 3 months or older with a temperature of 39C or higher, or is very tired or irritable. Adults should seek help if they have cold symptoms and a long-term medical condition or a weakened immune system, or if they have difficulty breathing.

It says to call 999 if a child is having difficulty breathing, with grunting noises, long pauses in breathing or the tummy sucking under the ribs; if you have severe difficulty breathing, gasping or choking; if you or your child is floppy and will not wake up or stay awake; if lips or skin turn very pale, blue or grey; or if a child under 5 has a temperature below 36C. It adds that as a parent you may know if your child seems seriously unwell and should trust your judgement.

The NHS says there is no specific treatment for an RSV infection and it often gets better on its own in 1 or 2 weeks. It suggests taking paracetamol or ibuprofen if you have a high temperature and are uncomfortable, giving children's paracetamol or ibuprofen if suitable, using saline nose drops if the nose is blocked, and drinking lots of fluids, with smaller feeds more often for babies.

It advises not giving aspirin to children under 16, not smoking around your child, and not trying to lower a child's temperature by sponging with cool water or taking off all their clothes. If serious infection develops, hospital treatment may include fluids to avoid dehydration or oxygen to help breathing.

NHS inform says RSV is spread by droplets from coughs and sneezes and can live on surfaces or objects for several hours. Someone with RSV is normally contagious for 1 to 2 days before symptoms start, most people are contagious for 3 to 8 days, and some infants and people with weakened immune systems may be contagious for up to 4 weeks.

The NHS suggests washing or wiping down toys and cleaning surfaces regularly, not touching your eyes, nose or mouth if your hands are not clean, using disposable tissues and throwing them away straight away, and trying to keep newborn babies away from anyone with a cold or flu, especially if they were born prematurely or have serious health conditions. NHS inform adds not sharing towels with someone who has cold-like symptoms and not letting children share toys.

The NHS says you can get a free RSV vaccination if you are 28 weeks pregnant or more, which helps protect your baby for the first few months after birth and is recommended during every pregnancy; if you are aged 75 or over; if you are aged 65 to 74 with a weakened immune system or a long-term lung condition (not including well-controlled asthma); or if you live in a care home for older adults. The vaccine helps reduce the risk of serious problems such as pneumonia and bronchiolitis.

For pregnant women the NHS says the vaccine should be offered around the 28-week antenatal appointment, can be given later if needed up until labour, and women who have not been offered it should speak to their maternity service or GP surgery. Young children with a very high risk of serious illness may be given an injection of infection-fighting antibodies each winter, usually in a children's clinic in hospital.

RSV care and vaccination are delivered through NHS primary care, maternity services, pharmacies in some areas, and hospitals for serious illness. NHS 111 is the route for urgent advice.

The NHS vaccine is free for the groups listed above. If you are unsure whether you qualify, the NHS advises speaking to your maternity service or GP surgery, and says the vaccine can also be had at a pharmacy in some areas.