6 Pediatric Specialists Tell Us How to Prevent RSV

Respiratory syncytial virus (RSV) is a common—and extremely contagious—virus that infects a person’s respiratory tract and lungs. Most kids will get RSV before they are 2 years old, and approximately 20% to 30% of those impacted will develop a lower respiratory tract infection like pneumonia or bronchiolitis.

Most of the time, RSV symptoms are mild and cold-like and include coughing, sneezing, and congestion and will resolve in about a week without treatment. But for premature babies, infants younger than 6 months, and those with heart or lung issues, RSV can cause severe illnesses, including breathing difficulties, that require hospitalization. For this reason, it’s important to know how to prevent this potentially dangerous virus.

How to Prevent RSV in Babies and Children

RSV spreads when someone with the virus coughs or sneezes. Tiny virus droplets are released into the air, and you can catch it by breathing them in or touching contaminated surfaces, says Haytham Hamwi, M.D., Nemours Children’s Health pediatric hospitalist chief at Inspira Health.

“It can also spread by touching surfaces like toys, doorknobs, or tables where the virus can live for hours,” he says. “If you touch these surfaces and then touch your face, you may get sick. Another way it spreads is through direct contact, such as kissing or holding someone who is sick or touching their used tissues.”

Because of how serious RSV can become, especially for babies and young kids, it’s important to contain its spread. Here are some ways pediatricians and other healthcare providers recommend preventing RSV.

Practice Good Hygiene

The primary way to prevent the spread of RSV is to practice good handwashing and control secretions, says Amy Edwards, M.D., an assistant professor of pediatrics at the School of Medicine at Case Western Reserve University. “So if someone coughs or sneezes, they need to do it into their elbow or into a tissue that can be disposed of, then they need to wash their hands or use hand sanitizer.”

She also suggests having older kids wash their hands when getting home from school or daycare to try to prevent bringing RSV into the home. Because good hygiene and handwashing is critical for respiratory infection prevention—and not something that comes naturally for young kids—Jericho Bell, M.D., internal medicine and pediatrics at St. Dominic’s Family Medicine in Madison, Mississippi, suggests making it fun.

“Handwashing becomes a game with a song or silly faces in the mirror while the soap and water do their work,” he says. “Teach your child to ‘catch’ their cough in their elbow by showing them how you do it. Say things like: ‘I got it!’ ‘That was a big one!’ and ‘Good catch!’ ”

Ideally, you and your kids should wash their hands often with soap and water for at least 20 seconds. Also, remind them to keep their hands away from their face to avoid spreading germs, and use their elbow or a tissue to cover their mouth when coughing and sneezing—and wash their hands afterward.

Disinfect Surfaces

You should consider frequently cleaning doorknobs, light switches, cell phones, toys, and other high-touch surfaces in the home—and beyond. This is because, according to Hannah Fotus Smitherman, M.D., the pediatric clerkship director at Texas Christian University, you can contract RSV through indirect contact, i.e., by touching handrails, grocery carts, and countertops. Consider using hand sanitizer after touching these communal items or try to clean the surface before touching it.

“RSV is one of the more contagious infections, and typically everyone in a household gets it if one of the family members has it,” says Zachary Hoy, M.D., board-certified pediatric infectious disease specialist at Pediatrix Medical Group in Nashville, Tennessee.

Avoid Secondhand Smoke

Avoiding secondhand smoke exposure is the one major risk factor that actually is alterable, says Smitherman. She suggests keeping kids out of secondhand smoke zones, especially because it has the added benefit of helping to reduce the number of middle ear infections as well. 

“Secondhand smoke wreaks havoc on the little ones,” says Smitherman. 

Consider Preventive Shots for Newborns

Nirsevimab (Beyfortus) is the new preventive shot recommended for babies in their first winter, says Bell. And bonus: It lasts all RSV season.

“This is a really cool shot that contains antibodies that last for about five months to protect babies through the worst part of their first RSV season,” Bell says. “I cannot tell you how thrilled I was to offer this to my first little patient. Nirsevimab passes immunity to babies through ‘passive immunization.’ ” 

What this means is that your baby doesn’t have to produce antibodies, he says: “The shot gives them antibodies that have already been made.” 

“With nirsevimab, babies are protected right away,” Bell adds.

For this reason, nirsevimab is recommended to all babies as soon as possible during their first respiratory virus season (typically fall through spring). It can even be given to newborns while they are still in the hospital, he says.

“This is such a gift to our little ones,” says Bell. “Nirsevimab has been available for just over a year, and the data for the first year is just thrilling for me as a pediatrician. We saw 90% effectiveness in preventing infants from being hospitalized with RSV. This is a game changer.”

Limit Contact With People Who Are Sick

Children can be protected against the virus by limiting transmission, says Wassim Ballan, M.D., division chief of infectious disease at Phoenix Children’s. “This is done by avoiding exposure to people with cold symptoms, wearing a mask when sick, washing hands frequently, and disinfecting contaminated surfaces.”

RSV is spread primarily through contact with respiratory secretions from someone who is sick with RSV. Typically, this is little kids sticking their hands in their mouths and noses and then touching each other or their caregivers or touching surfaces that other people then touch, says Edwards. 

“This virus is very stable on hands and on surfaces,” she says. “In fact, the live virus can still be detected up to four hours after an ill individual has touched a surface. It also can be spread via coughing or sneezing, but the virus is not super stable in the air and so this mode of transmission is less efficient.”

Stay Home When You or Your Child Is Sick

RSV is one of the more contagious infections, and typically everyone in a household gets it if one of the family members has it, says Hoy. So, it’s important to limit your exposure to others when someone in your household is sick.

“Sick kids with copious runny noses, coughs, and certainly those with fever in the last 24 hours should be excluded from school and daycare,” says Smitherman. “Everyone will benefit if we attempt to contain secretions like runny noses, coughs, and sneezes.”