What is RSV and what are the most common symptoms?

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Across Canada, cases of respiratory syncytial virus (RSV) are rising, particularly in children.

RSV is a very common virus that causes infections in an individual’s respiratory tract, according to the National Collaborating Centre for Infectious Diseases, an organization based in Winnipeg.

Physicians raised the alarm about cases increasing across the United States, and officials north of the border are seeing a spike in cases as well.The Public Health Agency of Canada said in its latest respiratory virus detection report that there has been a steady increase in positive RSV cases since early September.

The report, which provides data for the week ending on Oct. 15, states the number of cases is “above expected levels for this time of year” and that so far there have been 486 case detections and a 3.5 per cent positivity rate.

The steepest rise has been in Quebec, where weekly positivity rates have hovered around 13 per cent and indicate the province is in the middle of a significant RSV season when normally, it wouldn’t have begun yet, according to reporting from The Canadian Press.

Parents have shared their concerns with CTVNews.ca about the virus’ spread, saying they worry about their kids’ vulnerability with lessened health restrictions in schools.

And rising cases of RSV during a time when hospitals across the country are facing significant strain, ER closures and staffing shortages add an extra layer of stress for worried parents.

As well, some hospitals are reporting a significant influx of RSV-related admissions. Staff at the Children’s Hospital of Eastern Ontario (CHEO), an Ottawa-based pediatric hospital, said at a press conference Wednesday that RSV admissions for October are currently 10 times higher than the pre-pandemic historical average, which is just three cases.

“What we’re seeing right now in terms of RSV at CHEO also reflects what’s happening across Ontario and south of the border. We’re seeing a significant increased number of RSV cases and a significant increase in RSV hospitalizations,” said Dr. Chuck Hui, chief of infectious disease, immunology and allergy at CHEO, during the press conference.

So what is RSV and what kind of an impact can it have on the body? Here’s what you need to know.

WHAT IS RSV?

According to the National Collaborating Centre for Infectious Diseases, RSV is a common virus in the respiratory tract and is characterized by a single-stranded RNA.

There are yearly outbreaks of the disease that causes respiratory tract infections, typically in late fall to early spring, according to the PHAC’s information bulletin on the illness. RSV is also the most common cause of lower respiratory tract infections in young children globally, the PHAC states.

“Like with all respiratory viruses, they disproportionately affect children, and especially children that are less than two years of age,” said Hui.

WHAT ARE THE SYMPTOMS OF RSV?

Those who are infected with RSV show symptoms about four to six days after being infected, according to the National Collaborating Centre.

An individual will usually have cold-like symptoms, including a runny nose, coughing, sneezing, fever and wheezing, along with a decrease in appetite, the Centre states on its website.

For particular symptoms in babies, an infant might seem overly irritable and less active, and appear to have breathing difficulties, it adds.

HOW IS RSV TRANSMITTED?

RSV is transmitted through direct contact with “infectious secretions” via objects or large-particle aerosols, according to the National Collaborating Centre.

That means when someone coughs or sneezes, and virus droplets enter the body through the eyes, nose or mouth, RSV can spread. It can also spread through touching a surface that has RSV droplets on it, and then touching the face, as the RSV virus can survive for hours on surfaces, according to the centre.

People are usually most infectious during the first week after an infection, but those with a weaker immune system or babies could remain infectious for weeks, the centre warns.

WHAT HEALTH OUTCOMES CAN OCCUR AFTER CONTRACTING RSV?

While many RSV infections lead to “simple colds” that are mild, the virus can also create severe outcomes including bronchiolitis or pneumonia that could lead to hospitalization, especially in children under age two, according to the PHAC.

Any underlying health conditions like premature birth, chronic lung disease or congenital heart disease could make someone more likely to develop severe outcomes if they are infected with RSV, it said.

The kind of infection RSV can produce ranges from lower respiratory tract infections to upper ones, according to the National Collaborating Centre.

“RSV infections usually begin with upper respiratory tract disease which has the tendency to progress to lower respiratory tract disease in 50 per cent cases,” the centre states on its website.

And most infections will go away on their own within one to two weeks. However, infants and older adults over age 65 are the most at risk for a more serious infection and in some cases an ear infection can also occur, the centre explains.

“RSV can also make chronic health problems like asthma or heart and lung disease worse like a person may experience asthma attacks as a result of RSV infection,” it states.

Most of the time people are fairly resilient against RSV, but may require hospitalization to support their breathing, or may need fluids, said Hui at the CHEO press conference.

IS THERE A VACCINE, AND HOW CAN I TREAT THE VIRUS?

The Public Health Agency of Canada states on its website that there is currently no specific treatment or vaccine for RSV.

However, researchers are working to develop vaccines and antiviral treatments, according to the National Collaborating Centre for Infectious Disease.

“We hope to have a vaccine in the fairly near future,” said Hui. A “whole bundle” of approaches can be done to treat RSV, including getting the flu vaccine, getting the COVID-19 vaccine and staying home when sick, he added.

Public health units are recommending masks are worn in indoor spaces as this can help prevent and reduce all types of virus, including RSV, said Hui.

Hospital attention is required if older adults or infants younger than six months are having trouble breathing or are dehydrated, and if oxygen is required.

Washing hands often, cleaning frequent touch points and surfaces, and covering coughs and sneezes and avoiding close contact will help curb the virus spread, the centre states on its website.

“One can take steps to relieve symptoms associated with RSV infections like managing the fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen,” the centre states on its website. However, do not give aspirin to children, it adds.

Concerns around a current shortage of children’s Tylenol and pain relievers overall during the spike of RSV cases also have parents concerned.

Dr. Donald Vinh, an infectious disease specialist at McGill University in Montreal, told CTVNews.ca on Monday that RSV is very contagious in a way that’s similar to COVID-19 and other respiratory viruses.

"We are seeing a return to what it was before the pandemic with these respiratory viruses, except it's not just those respiratory viruses from prior to the pandemic — added to the mix now is also COVID," he said.