Overview

Respiratory syncytial virus (RSV) is a major cause of lower respiratory illness, particularly among infants, young children, and older adults, affecting the lungs and airways. It may cause cold-like symptoms and is the most common cause of bronchiolitis, a common chest infection that affects infants and toddlers. Most children will have at least one RSV infection by the age of 2. The infection is most severe in young babies and older adults and can cause serious lung infections that may require hospitalization.

Most infants and children infected by RSV typically experience mild symptoms that last a few days. Older children and adults also get RSV but symptoms are typically mild, similar to a common cold.

Through the Respiratory Syncytial Virus (RSV) Prophylaxis for High-Risk Infants Program, infants and children who are less than 2 years of age at high risk of severe illness from RSV may be eligible for an injection used to prevent a serious lower respiratory tract infection caused by the virus.

Older adults and those with underlying health conditions such as asthma, chronic heart or lung disease, and those with weakened immune systems, can be at risk of severe illness with RSV.

Through the high-risk older adult RSV vaccine program, adults aged 60 years and older residing in long-term care homes, Elder Care Lodges, and some retirement homes may be eligible for the vaccine used to prevent a serious lower respiratory tract infection caused by the virus. If adults aged 60 years and older don’t qualify for the free RSV vaccine, they can still purchase the vaccine with a prescription from their family doctor or other primary care provider.

Signs and symptoms of RSV

Symptoms of RSV are similar to those of the cold or flu, including:

  • coughing
  • a runny nose
  • fever
  • wheezing
  • a decrease in appetite and energy
  • irritability in children

Because these are common symptoms, it is easy to mistake RSV for other respiratory illnesses, such as the flu or COVID-19. While most RSV symptoms will go away in a few days, seek medical attention if you or your child have trouble breathing, are not drinking enough fluids or are experiencing worsening symptoms.

Key facts

  • most people who get an RSV infection will have mild illness and will recover within a week or 2 without the need for medical attention or treatment
  • for some individuals, RSV may result in severe infections, particularly among infants, young children and older adults (RSV can also make chronic health problems worse)
  • individuals are most likely to catch RSV from late fall to early spring, when the virus is most active

How RSV is spread

RSV is very contagious and spreads the same way as a common cold by:

  • touching droplets containing the virus after someone coughs or sneezes
  • being close (less than 2 metres apart) to someone with the infection who is coughing or sneezing

After exposure to the virus, it can take 2 to 8 days before becoming sick. People are usually contagious for up to 3 to 8 days. Children are often exposed to and infected with RSV outside the home, such as in school or childcare centers, and can then transmit the virus to other members of the family.

Information for individuals, parents and caregivers

How to treat someone with RSV

In most cases, you can take care of someone with RSV at home as long as they are breathing comfortably, their skin does not look blue and they are drinking and urinating as usual. Most people get better within a week or 2.

Because RSV is a virus, antibiotics will not help someone get better faster.

What you can do to help

Manage fever and pain:

  • use over-the-counter acetaminophen or ibuprofen
  • do not give ibuprofen to babies under 6 months old without first talking to your doctor or other primary care provider
  • never give aspirin to children

Hydrate:

  • it is important to drink enough fluids to prevent dehydration (loss of body fluids)
  • if your baby is having trouble drinking, try to clear nasal congestion gently with a bulb syringe or with saline (salt water) nose drops

Bathing:

  • a lukewarm bath or wet face cloths will not change someone’s body temperature, but may help them feel more comfortable
  • avoid cold baths because they are uncomfortable and can make the person shiver, raising their temperature
  • alcohol baths or rubs are not recommended

Clothing:

  • dress in light clothing, to allow the body to cool down and help increase comfort
  • if the person starts to shiver, add warmer clothing — remove them when the shivering stops

Talk to your health care provider:

  • before combining natural or herbal supplements with medicine, as some of ingredients may interact
  • some medicines, like over-the-counter cough and cold medicines, contain ingredients that are not good for children

When to go to an emergency department

Some people can develop a severe form of RSV, which may result in pneumonia or, in infants and children, bronchiolitis. These illnesses can be serious and may require a visit to a health care provider or to the emergency department.

Go to an emergency department if someone:

  • has trouble breathing (working hard to breathe, breathing faster than normal), pale skin, lips that look white or blue, asthma or wheezing
  • has any of the following symptoms:
    • fever or is very sleepy/difficult to wake
    • repeated vomiting and unable to keep any liquids down for 8 hours or more
    • vomiting or diarrhea containing a large amount of blood
    • signs of dehydration with dry mouth or no urination for 8 hours or more

Severe RSV infections can result in lung infections or pneumonia in some older adults and those with underlying health conditions. RSV can also lead to worsening of:

  • asthma
  • Chronic Obstructive Pulmonary Disease (COPD) — a chronic disease of the lungs that makes it hard to breathe
  • Congestive heart failure — when the heart can’t pump enough blood and oxygen through the body

Adults who experience difficulty breathing should seek immediate medical attention.

How to protect yourself and others from RSV

  • Stay home: Stay home if you or someone you’re caring for are sick and until you/they have no fever and symptoms are improving for at least 24 hours (or 48 hours if there was nausea, vomiting and/or diarrhea). Wear a mask when you are outside your home and in public places for 10 days from when your symptoms started.
  • Clean surfaces: Clean surfaces in your home that are touched often on a regular basis.
  • Wash your hands: Wash your hands often to reduce the spread of germs. Ask others to do the same.
  • Use your arm: Coughing or sneezing into your arm instead of your hands and putting used tissue into the garbage right away.
  • Breastfeed your baby: Breast milk contains antibodies and other immune factors that help prevent and fight off illness.
  • Don’t smoke: Make sure nobody is around cigarette smoke, especially in your car or home.

If your child is under the age of 2 years and at high risk of severe illness from RSV, they may be eligible for an injection used to prevent a serious lower respiratory tract infection caused by the virus. Please see eligibility below and discuss this option with your child’s health care provider.

High-risk older adult RSV vaccine program

Ontario is introducing its first publicly funded high-risk older adult RSV vaccine program.

The vaccine is approved for adults aged 60 years and older.

How you qualify for a free RSV vaccine

Through the high-risk older adult vaccine program, the Ministry of Health covers the full cost of the vaccine for adults aged 60 years and older living in long-term care homes, Elder Care Lodges, and retirement homes licensed to provide dementia care services.

If you wish to purchase an RSV vaccine

If you are aged 60 years and older and don’t qualify for the free RSV vaccine, you can still purchase the vaccine with a prescription from your family doctor or other primary care provider.

Once you get a prescription, you would then buy the vaccine at your pharmacy and take it back to your doctor or other primary care provider to get the shot.

Check with your pharmacy and physicians before you go to understand the clinic policies and related costs.

Some private insurers may cover all or part of the cost of the vaccine. Check with your insurance company for more information on your individual coverage.

When you can get the RSV vaccine

It is recommended that eligible individuals who wish to receive the RSV vaccine get it at least 14 days before or after receiving other vaccines, including COVID-19 and/or flu vaccines.

RSV Prophylaxis for High-Risk Infants Program

Through the RSV Prophylaxis for High-Risk Infants Program, the Ministry of Health covers the full cost of a drug used to prevent a serious lower respiratory tract infection caused by RSV in infants who are younger than 2 years of age at the start of the RSV season and who are at high risk for RSV disease.

The injection is only provided during the active season (approximately November to April) to infants who meet the ministry’s eligibility criteria for funding. 

For information on eligibility, please contact your family doctor or other primary care provider, as they will know which criteria and medical illnesses apply.

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