December 1, 2022

RSV 101: Why testing is not needed in most cases

Madison, Wis. – Testing for respiratory syncytial virus, or RSV, is not needed in most cases because disease and symptom management does not change with a diagnosis, and most children recover well at home with standard remedies, according to a UW Health Kids infectious disease expert.

The main symptoms of RSV include runny nose, coughing, sneezing, congestion and fever, according to Dr. Gregory DeMuri, pediatric infectious disease physician, UW Health Kids, and professor of pediatrics, University of Wisconsin School of Medicine and Public Health.

“Given the testing, unique treatments and isolation requirements that arose during the pandemic, it makes sense that people are looking for a similar process with RSV,” he said. “However, while protocols for things like isolation and medication are initiated by a positive COVID-19 test, the same is not true for RSV.”

COVID-19 and the flu are considered stronger viruses, and when there is a positive test for COVID-19 or the flu there are specific actions that need to be taken, he said.

“There are no antiviral medications for RSV like we have with the flu or COVID-19,” DeMuri said.

Almost all children get RSV at least once before they are two years old. For most kids, it is like a cold and they get better without being seen by a doctor, he said.

“However, kids 18 months and younger can have more extreme symptoms and develop bronchiolitis or pneumonia, which is inflammation in the lungs that makes it harder for them to breathe,” DeMuri said. “In fact, RSV is one of the most common causes of pneumonia worldwide in young children.”

The elderly are also at risk for more severe outcome with RSV, but school-age children are not generally at risk for severe RSV, he said.

“For school-age children with a typical case of RSV, meaning a fever and cold symptoms, you keep them home like you would any illness with those symptoms,” DeMuri said. “When a child feels better and the fever goes down, they can return to school or daycare.”

While there are no medications specifically designed to treat RSV, DeMuri offers the following tips to treat it at home:

  • Use proper nasal suction to make sure airways are clear for children younger than 2.

  • Stay hydrated. Electrolyte-containing drinks are good alternatives for young children if milk or formula are not appealing to them while they are sick.

  • Use acetaminophen or ibuprofen for fever reduction.

  • Do not give children over-the-counter cough and cold medications to treat respiratory illnesses because they can cause more complications.

  • Seek medical care immediately if your child is struggling to get air. Warning signs include children using their neck or shoulders to breathe, young babies flaring their nostrils to breathe or blue color changes in a child’s face.

“If you have questions, call your primary care doctor. This not only helps you get the timely advice you need, but it can also help reduce crowding at urgent care clinics and emergency departments,” DeMuri said.

There is a preventative medication for RSV, but it is only for high-risk children.

“If a child is born prematurely, has heart disease or an underlying respiratory condition, there is an injection of a monoclonal antibody we can give to them throughout the RSV season,” DeMuri said.

Frequent hand washing, proper sleep habits and hydration are all good ways to prevent illness, he said.