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Diagnosing and Treating RSV

How RSV Is Diagnosed

Mild RSV infections usually affect the upper respiratory tract (nose, throat). The symptoms of a mild RSV infection are the same as the symptoms of a common cold, and testing usually isn't required to diagnose the infection.

Sometimes RSV affects the lower respiratory tract and causes bronchiolitis or pneumonia. The diagnosis is usually made on the basis of medical history and a physical examination.

Your doctor may suspect RSV-related bronchiolitis during periods when there are outbreaks of RSV in the community. Although the illness can occur at any time, it is much more likely during the cold months of the year. However, the exact timing of the RSV season differs between different regions of the country. RSV Census Regional Trends are tracked by the CDC.

In severe cases of RSV requiring hospitalization, specific testing to detect the virus is useful, so the patient can be properly isolated and the infection does not spread to others.

There are currently several testing methods that can give reliable results within a few hours. The testing is done on a small amount of secretions from the nose.

People who develop severe infection require additional tests to make sure that there are no other complications. These tests include:

  • Chest X-ray to make sure that there are no signs of pneumonia that will require treatment with antibiotics
  • Blood tests to check for signs of a bacterial infection and to make sure infants are properly hydrated
  • Blood and urine cultures may be necessary when infants are very sick (in very young infants, RSV-related bronchiolitis can occur with a urinary tract infection)
  • Tests to make sure that there is enough oxygen getting into the blood

How RSV Is Treated

Mild RSV infections require no specific treatment other than over-the-counter medications to help with symptoms and controlling fever with acetaminophen. Clearing the mucus from the nose with a bulb syringe may temporarily improve breathing in infants. It is often done just before feedings so infants can drink more easily.

Various treatments may be used in more severe illness. None of them treats the infection itself, but rather treats the symptoms and prevents complications. These may include:

  • Hydration: Infants, especially very young ones, can become dehydrated very easily. At home, breast or bottle-feeding should continue but may need to be given in frequent, small amounts. If an infant is unable to drink, the child may need to go to the hospital for an IV (intravenous hydration) or feeding tube. Hydration may be recommended in adults as well.
  • Oxygen: Hypoxemia (decreased oxygen levels) is one of the typical symptoms of RSV-related bronchiolitis. Oxygen given through small prongs through nostrils not only provides the necessary oxygen but also decreases the work that the patient has to do to breathe and prevents tiring of the respiratory muscles.

    This content was developed in partnership with the CHEST Foundation, the philanthropic arm of the American College of Chest Physicians.

    Page Last Updated: July 19, 2019

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