What To Expect This RSV Season

With back to school comes the dreaded return of never-ending respiratory viruses, including greatest hits like "Where Did That Cough Come From?" and "Will This One Take Down the Entire Household?" or earworms like "Why Are We ALWAYS Out of Tissue Boxes?"

If only cold and flu season really was limited to the two main players! Instead, they're joined by heavy hitters like COVID-19, respiratory syncytial virus (RSV), and whatever other nasties are circulating at any given time.

RSV, in particular, is understandably worrisome to parents, especially those with young children or who are frequently around seniors, as both groups are susceptible to more serious illness from the virus. So, what exactly can parents expect ahead of this RSV season?

What is RSV?

First, a quick RSV refresher: It's a virus that causes infections to the lungs and respiratory tract, with symptoms mimicking those of the common cold in adults and older children. Per the Mayo Clinic, RSV symptoms include:

• Congested or runny nose
• Dry cough
• Low-grade fever
• Sore throat
• Sneezing
• Headache

It's very common — in fact, it's so common that "most kids and adults will be exposed to RSV multiple times each respiratory season," as Dr. Zachary Hoy, M.D., board-certified pediatric infectious disease specialist at Pediatrix Medical Group, tells us. Infections generally clear on their own within a week or two, but the virus can be particularly dangerous to young children, who might not have robust immune development just yet.

Why are infants most at risk?

In babies, "RSV can start out looking like your typical cold — what we call a mild upper respiratory tract infection," as Dr. Joanna Parga-Belinkie, M.D., an attending neonatologist in the Division of Neonatology at Children's Hospital of Philadelphia, previously told Romper. "What we worry about with RSV is that it can progress to a more severe lower respiratory tract disease, which can lead to things like bronchiolitis, inflammation of the smaller airways in the lungs, and pneumonia," an infection of the lungs.

"When these are irritated or inflamed, it can lead to poor oxygen exchange — and a drop in the oxygen levels of the blood — wheezing, and difficulty breathing, along with fatigue and dehydration," as Dr. Krupa Playforth, M.D., a board-certified pediatrician in northern Virginia, explained to Romper last RSV season.

RSV poses the greatest risk to young children with weakened immune systems, babies born prematurely, and those with health conditions such as asthma, chronic lung disease, congenital heart disease, and neuromuscular disorders.

For U.S. babies under a year, RSV is actually the most common cause of both bronchiolitis and pneumonia, with as many as 80,000 children under 5 hospitalized each year. "The two factors to watch, especially in younger children, are if there is trouble breathing or dehydration," Hoy explains. "When younger infants have trouble breathing, they don't feed as well," so decreased appetite is something to look out for, as well as rapid breathing or fever.

Of course, you should call your child's pediatrician with any questions or concerns, but it's particularly critical for any fever in a child under 12 weeks or 104 degrees in a child of any age. Generally speaking, "RSV typically has peak symptoms around day three of illness, but sometimes symptoms can last 10-14 days total," adds Hoy.

What will this RSV season look like?

Before panic sets in, let's point to the predictions for this particular season, as outlined by the Centers for Disease Control and Prevention (CDC) 's recent 2024-2025 Respiratory Disease Season Outlook. "The CDC predicts the RSV 2024 season will likely have similar or lower rates of hospitalization for RSV," adding, "Likely there will still be similar amounts of RSV cases and circulation, but adults over 60 getting the RSV vaccine likely will decrease the hospitalization rates."

Previously, RSV season would begin in late fall (around November), peak in the winter, and taper off in the spring, but the COVID pandemic has made things even more difficult for experts to predict. After all, we just experienced yet another major COVID summer surge, which means these illnesses aren't necessarily following the traditional seasonal pattern they once reliably did.

"Unlike seasonal influenza, it is much harder to predict the severity of each RSV season. Additionally, since the onset of the COVID-19 pandemic, we have seen many shifts in typical epidemiological patterns for RSV overall," Dr. Priya Soni, M.D., a pediatric infectious disease specialist at Cedars-Sinai Guerin Children's, told Romper in December 2023.

"In kids, it is common to see multiple viruses detected in children at the same time, for example, RSV and COVID or flu and COVID," says Hoy. (How nice, right?) "This will likely have similar numbers to past years."

Still, Hoy issues a reassuring reminder: "Just because your child tests positive for RSV does not mean they will develop illness requiring doctor or ER visits."

How can you prevent RSV?

"There are two big factors that can help with preventing RSV in parents and kids," explains Hoy. "The first is good and consistent hand hygiene. RSV is spread via contact with virus particles that can be on hands and surfaces. This can be disrupted by consistent hand washing or hand sanitizer use. It is difficult in younger kids such as toddlers because they put more objects in their mouths — especially when playing — and are usually around more kids in daycare or at school."

He continues, "The second factor is avoiding people who are sick. If a kid is sick, they should stay home from daycare or the babysitter's house and vice versa. If the babysitter or family member providing childcare is sick, they should avoid being around kids until they start to feel better."

As with any health concerns, checking in with your family doctor is never a bad idea, especially as colder weather sets in and more activities move indoors, upping the chances of catching respiratory illness. Here's hoping this year's seasonal wave will be even less severe than experts predict, and that parents and littles alike will escape unscathed, happy, and healthy as possible.