Respiratory Syncytial Virus (RSV)

Symptoms

RSV symptoms usually happen within four to six days after getting infected and are similar to cold, flu or COVID-19, including:

• Runny nose
• Decrease in appetite
• Coughing
• Sneezing
• Fever
• Wheezing

Very young infants may only experience irritability, decreased activity, and breathing problems.

While most RSV symptoms will go away within a week, individuals should seek medical attention if they are not drinking enough fluids or experience worsening symptoms.

Anyone who has trouble breathing should seek immediate medical attention.

Testing

Symptoms of RSV are not specific and can overlap with other respiratory infections. Most people with mild illness will not need to get tested, but people admitted to the hospital may have a nose swab done to confirm the diagnosis.

Treatment

Most people who get RSV recover on their own. RSV is a virus and antibiotics will not help. Antiviral medication is not routinely recommended to fight a RSV infection. However, RSV can cause severe illness in some people and medical attention and supportive treatment may be needed.

How to manage symptoms of RSV at home:

• Reduce fever and pain with over-the-counter reducers and pain relievers, such as acetaminophen or ibuprofen. Do not give aspirin to children
• Drink plenty of fluids to prevent dehydration (loss of body fluids)
• Consult with a health care provider before giving your child over-the-counter cough and cold medicines

For additional information for parents on how to manage their child’s symptoms and when to seek medical attention, visit the Ministry of Health’s Respiratory Syncytial Virus web page.

If you have questions about your illness and you don’t start to feel better after a few days, or your symptoms get worse, call your health care provider or 811 (TTY: 1-866-797-0007) to talk to a registered nurse 24 hours a day, 7 days a week. Calls to 811 do not require you to provide your OHIP number; all information is free, secure, and confidential.

RSV spreads easily from person to person through coughing or sneezing. The virus can also spread by touching a surface or object (a door handle or countertop) that has the virus on it and then touching one’s mouth, nose, or eyes before washing hands.

People infected with RSV are usually contagious for three to eight days and may be contagious a day or two before they start showing signs of being sick. However, some infants and people with weakened immune systems can continue to spread the virus even after their symptoms have resolved, for as long as four weeks.

You can help stop the spread of RSV by: 

• Staying home if you feel sick
• Cleaning your hands often with soap and water or alcohol-based hand rub
• Wearing a well-fitting, high-quality mask in crowded indoor settings
• Covering your cough and sneeze with a tissue or your shirt sleeve, not your hands
• Cleaning frequently touched surfaces such as doorknobs and mobile devices
• Getting an RSV vaccine if you are eligible (more information for RSV vaccine for 60 years of age and older is outlined in the next section)

The Ontario Ministry of Health recently expanded the RSV program to include universal RSV immunization with a monoclonal antibody called Beyfortus® (nirservimab) for all infants during their first RSV season and higher-risk children up to 24 months of age.

Monoclonal antibody immunization is safe and effective for infants and children

Scientific evidence identifies that monoclonal antibody immunization is long-acting and protects infants and young children from severe outcomes due to RSV, including reducing the risk of hospitalization and ICU admissions of infants. Monoclonal antibody immunization is recommended for infants entering their first RSV season and any infant considered at high risk entering their first and second RSV season.

RSV immunization will be provided during the RSV season (November to April) to infants and high-risk children who are:

• Born in 2024 before the RSV season (the National Advisory Committee on Immunization recommends that infants 8 months of age or less be immunized)
• Born during the 2024/25 RSV season
• Up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season, following discussion with a health care provider, including:
  • Chronic lung disease of prematurity (CLD), including bronchopulmonary dysplasia/chronic lung disease
  • Hemodynamically significant congenital heart disease (CHD)
  • Severe immunodeficiency
  • Down Syndrome/Trisomy 21
  • Cystic fibrosis with respiratory involvement and/or growth delay
  • Neuromuscular disease
  • Severe congenital airway anomalies impairing the clearing of respiratory secretions

Please contact a health care provider to obtain an RSV monoclonal antibody immunization for eligible infants and children.

Canada’s National Advisory Committee on Immunization (NACI) recommends giving the monoclonal antibody (nirservimab) to an infant offers infants better protection against RSV compared to vaccination during pregnancy.

However, pregnant individuals who do not wish or are unable to have their infant receive nirservimab at birth may choose to receive a single dose of the RSV vaccine (Abrysvo™) between 32 and 36 weeks of pregnancy. The vaccine helps to create antibodies in the pregnant individual’s immune system to protect the baby from RSV from birth until six months old. It is given near the start of or during the RSV season.

If an RSV vaccine were administered during pregnancy, the infant would not generally be recommended to receive RSV monoclonal antibody immunization at birth, except in certain circumstances.

Please speak to a health care provider to determine the best approach for you and your unborn infant.

Adults 60 years of age and older

Arexvy and Abrysvo are both Health Canada approved vaccines to prevent lower respiratory tract disease caused by RSV in people 60 and older.

The Ontario Ministry of Health is offering a publicly funded vaccination program in the 2024-2025 season for individuals 60 and older who are:

• Living in a long-term care home, elder care lodge or retirement home
• Hospitalized and receiving alternate level of care (ALC)
• Hemodialysis or peritoneal dialysis recipients
• Recipients of solid organ or hematopoietic stem cell (HSC) transplant
• Experiencing homelessness
• First Nations, Inuit, or Métis

Anyone aged 60 years or older not eligible for the publicly funded vaccine can speak to their health care provider about accessing the RSV vaccine through private purchase.

Arexvy and Abrysvo are given as a single vaccine dose that provides multi-year protection. Individuals who received an RSV vaccine last season are still protected and will not need an additional dose this fall.

Side Effects & Risks

RSV vaccinations may cause some side effects which, in most cases, are mild and last only a few days. Common side effects of RSV vaccination may include:

• Pain, redness, and swelling where the needle was given
• Fatigue (feeling tired)
• Fever or chills
• Headache
• Muscle or joint pain

Swelling of lymph nodes and allergic reactions such as rash, nausea, or stomach pain are uncommon. Serious side effects from the vaccine are rare.

Please inform your health care professional or call York Region Public Health at 1-877-464-9675 ext. 73452 if you experience a serious side effect following immunization.

Speak to your Health Care Provider

Always tell your health care provider if you have allergies or had side effects from another vaccine in the past. You should wait for the vaccine if you are ill or have a fever. Check with your health care provider to determine if the RSV vaccine is right for you.

Health care providers can now order RSV vaccines for eligible clients 60 years and older through York Region Public Health. RSV vaccine information for health care providers is available at york.ca/VaccineInventory