When to Test for Respiratory Syncytial Virus (RSV)

Respiratory Syncytial Virus (RSV) is a common virus that infects children and some adults. We are experiencing higher levels of RSV in our community, and it is important to understand the expected course of symptoms for adults and children, how to identify patients who are at risk for respiratory complications, and who may benefit from testing.

The Centers for Disease Control and Prevention (CDC) considers patients under the age of 2 years to be at the greatest risk of a serious case of RSV. RSV testing is mostly reserved for this age group.

If your young child is experiencing cold-like symptoms, follow the guidance below.

• Hydrate with formula, breastfeeding, or water, if age appropriate.
• Clear any nasal drainage and congestion with saline nose drops, bulb syringe, or a nasal aspirator (NoseFrida).
• Use over-the-counter fever reducers per package instructions for temperatures over 100.3 °F.
• Monitor for signs of severe illness in young children and infants, including rapid, shallow breathing; periods of not breathing; retractions or “sinking-in” of the spaces between the ribs or below them; flaring or “spreading-out” of the nostrils; or if skin turns blue around the mouth or fingertips.
• Watch for signs of dehydration, as well, such as poor feeding, reduced wet diapers, dry mouth, reduced energy levels, or uncommon drowsiness.
• If any of these signs or symptoms develop, please have the infant or child seen by a healthcare provider immediately.

In most cases, RSV causes mild common cold-like symptoms. Neither children nor adults with common cold-like symptoms need testing for a diagnosis. Most RSV infections resolve in 1 – 2 weeks, but the cough can last up to 4 weeks.

For those NOT at high risk, follow the guidance below.

• Infections of COVID-19 and RSV are very similar and can happen at the same time. Patients with respiratory symptoms should use an at-home rapid antigen test for COVID-19.
• If you test positive for COVID-19, follow the instructions for isolation as listed on the Vermont Department of Health website.
• If you suspect you have RSV, stay at home and away from others, rest, increase fluids, and try over-the-counter fever-reducing medications, such as ibuprofen and acetaminophen. Most people with this illness will have mild symptoms and will not need medical care. 
• Testing is not required, as a healthcare provider can reasonably make a diagnosis of RSV, based on an exam, particularly if community levels are high.
• You can reduce your risk of contracting RSV by avoiding those who are ill and washing your hands consistently.

Crystal Labbe-Hasty, PA, is a physician assistant at SVMC’s Respiratory Evaluation Center/ExpressCare in Bennington. The practice is part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care.