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What are the symptoms of RSV and how long is it contagious for? Let's unpack this common cold virus

Most cases of RSV are mild, but it can lead to serious illness in infants, the elderly and immunocompromised people. (ABC Riverland: Catherine Heuzenroeder)

We're not in winter just yet, but the cold and flu season has arrived.

While there's been a lot of focus on COVID-19 and influenza in previous years, you might have heard about another virus going around: RSV. 

Let's unpack what it is, how it spreads and how you can keep yourself from catching it. 

What is RSV?

It stands for respiratory syncytial virus, which causes respiratory infections.

RSV is one of about 200 viruses that can cause a cold — which is very common. 

"Most children will be infected with RSV at least once before they turn two," a Queensland Health spokesperson said.

"A single RSV infection does not result in long-lasting protective immunity and repeat infections can occur in children."

Most cases of illness caused by RSV are mild.

But it can lead to serious illness for young children, the elderly and people with immunosuppressive conditions.

Contracting the virus can lead to chest infections like bronchiolitis and pneumonia.

It can also cause ear infections and the coughing associated with the illness can worsen asthma symptoms

What are the symptoms of RSV?

Usually, the first symptoms are:

  • Fever
  • Runny nose
  • Coughing
  • Wheezing or difficulty breathing 
  • Decreased appetite

How long do RSV symptoms last?

Typically, most cases go away after about two weeks.

But NSW Health says coughs associated with the virus can last for up to four weeks.

Symptoms of RSV include a fever, runny nose and coughing — but can run to more serious chest infections.  (ABC News: Kym Agius)

What's the treatment for RSV?

It can't be treated with antibiotics, because antibiotics don't work against viruses. 

So the treatment is about relieving the symptoms.

For most cases of RSV illness, this means bed rest, drinking plenty of fluids and using paracetamol and ibuprofen to relieve pain. 

But for infants, small children, older adults and people with certain underlying health conditions, it can mean time in hospital to be treated with intravenous fluids and extra oxygen.

How is RSV spread?

Through droplets containing the virus.

So it can spread through inhaling droplets from an infected person talking, coughing or sneezing. 

It can also be spread by touching surfaces contaminated with droplets and then touching your nose, mouth or eyes. 

Are there figures for RSV cases?

Yes.

RSV became a reportable virus to the National Notifiable Disease Surveillance System (NNDSS) in July 2021 — which means they're keeping track of the numbers. 

The Communicable Disease Network Australia puts out a report on case numbers fortnightly. 

But not all states and territories were routinely reporting cases until September, so comparing this year's national case numbers to last year's doesn't really tell us much

What are the RSV case numbers?

In the most recent fortnightly data release, 6,356 infections were reported across the country

That's a slight increase from the previous fortnight, when 6,292 cases were reported. 

The database also shows that most cases were in children aged four or younger: that's 19,641 cases for 2023 to May 12, out of 32,259 total cases — almost two-thirds.

The federal Department of Health and Aged Care says RSV's epidemiology is similar to other respiratory viruses, so it's common for cases to peak in the winter months

It says RSV infection numbers are similar to flu cases for this year.

"If we compare the three conditions for the previous fortnight, we can see that RSV and influenza notifications to NNDSS were very similar, with COVID-19 having roughly 10 times the notifications over the same period," a spokesperson said.

"The department is closely monitoring all three conditions as we move towards the winter months."

It's important to remember that these numbers only represent the cases that have been reported, so the true figures could be different — especially given that RSV illness is mild in most cases. 

Queensland Health said there had been an early increase in RSV and flu infections this year compared to last year. 

"This is in line with the flu season in the northern hemisphere, which also saw an increase in both flu and RSV cases ahead of their own flu season," a spokesperson said. 

How long is RSV contagious?

For about three to eight days after symptoms begin, generally speaking. 

But NSW Health says this period could be longer in someone with a weakened immune system. 

How long after exposure will symptoms appear?

Usually between three and 10 days after contact with RSV. 

How do I protect myself from RSV?

It's the same drill as for the flu and COVID-19, so think regular handwashing and sanitiser. 

Cough or sneeze into your elbow and, if you've got symptoms, the federal health department says to wear a mask in crowded places and high-risk settings like aged care homes and hospitals. 

Symptomatic people should avoid contact with infants, older people and immunocompromised people. 

Keep up the good hand hygiene to help limit the spread of all viruses.  (ABC News: Dannielle Maguire)

Is there a vaccine for RSV?

There are some in the works. 

Earlier this month, the US approved the use of a vaccine called Arexvy for RSV for people aged 60 and over.

That's the first RSV vaccine approved for use in the US. 

Does Australia have an RSV vaccine?

Not yet.

Arexvy's manufacturers, GlaxoSmithKline Australia, submitted an application with Australia's Therapeutic Goods Administration in January. 

The legislated time frame for the TGA to complete an evaluation is 255 days.

"However, applications are generally completed before this time, noting time frames for evaluation of individual applications depend on when all data is provided by the sponsor," a Department of Health and Aged Care spokesperson said.

"Approval for use in specific demographics (including use in pregnancy) will ultimately depend on the data presented by the sponsor to the TGA.

"This data needs to meet the TGA's high standards for safety, quality and efficacy."

Meanwhile, in March, the TGA granted a priority determination for its mRNA vaccine for the prevention of RSV-associated lower respiratory tract disease in adults 60 years and older. 

A priority determination speeds up the evaluation, cutting the target time frame down to 150 working days. 

"This determination is the first step in the priority review process and does not guarantee an application has or will be made by the sponsor, or that an application will be approved."

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