What To Know About RSV, the Respiratory Infection on the Rise Just in Time for Holiday Travel

This year’s crisp fall weather brought more than pumpkin-spiced everything into the collective consciousness. It also brought burgeoning cases of respiratory syncytial virus (RSV), a mild flu-like condition that can become dangerous for young babies, older adults, and those who are immunocompromised. As the air’s chill thickens and stories of RSV sickness flood the news, more and more people are thinking about holiday travel plans, and wondering if concerns about RSV need to be factored in.

RSV sickness isn’t new. Most adults and older children have been exposed to RSV many times. Before COVID-19 upended, well, everything, virtually all children became infected with RSV before their second birthday. So, why are experts so concerned now? Read on to find out what RSV is, what’s different about this year’s onslaught, and what it may mean for you and your family during the holiday season.

What is RSV?

“RSV is a virus that generally manifests with mild, cold-like symptoms. It’s most noticeable in the very young and very old. RSV causes inflammation in the lower part of the lungs. In vulnerable populations, this can lead to bronchiolitis, pneumonia, and hospitalizations,” says Vidya Mony, MD,  a pediatric infectious disease specialist at Santa Clara Valley Medical Center.

In terms of who might want to be extra careful this season, it depends on your personal health risk. “RSV is most dangerous for children born prematurely and those under 6 months old. Adults with chronic lung disease, congenital heart disease, weakened immune systems, and/or neuromuscular disease, where it is difficult to clear mucus from the lungs, are also at risk,” says Joyce Baker, RRT, RRT-NPS, AE-C, Fellow of the American Association for Respiratory Care (AARC).

RSV is also highly contagious. It’s spread primarily through viral droplets expelled from coughs and sneezes. Showering your baby’s face with kisses is a surefire way to get or give RSV if one of you is infected. So is attending (or visiting) daycare centers or schools. RSV lives on hard surfaces for many hours. It also lives on hands and soft surfaces, like tissues, for 30 minutes or more. “I recommend very frequent hand washing and surface cleaning as the best measures for preventing RSV transmission. If you’re comfortable with mask-wearing, that will also help you avoid RSV and other viruses, like the flu and COVID-19,” says Dr. Mony.

The incubation period for RSV sickness is typically around four to six days. Unlike COVID, which is transmissible almost immediately upon contraction, you won’t transmit RSV until a day or two before symptoms start. Most people remain contagious for about a week, but infants and adults with compromised immune systems may continue to spread RSV for up to a month after catching it.

All of this means that RSV may be a sneaky, unwanted passenger on the plane or train you’re booked for holiday travel.

Why is RSV so bad this year?

If RSV has been around forever, you may be wondering why it’s sounding alarms right now. “I don’t like to use the word ‘scary,’ but we are in the middle of a potential crisis here. Part of the problem is timing. A big concern is that cases of RSV, the flu, and COVID-19 are all happening at once and may overwhelm hospitals,” says Dr. Mony. She notes that viruses such as croup and hand, foot, and mouth disease, are also occurring earlier than usual, adding to the strain.

“RSV season usually starts mid-to-end January and runs through April. This year, we’re seeing higher numbers of RSV hospitalizations in October, which is significantly earlier than the typical respiratory virus season. This unanticipated surge is putting a strain on the healthcare system, where nursing and respiratory therapist shortages continue, and global supply chain issues remain a problem, says Baker.

Lack of exposure to viruses over the last few years is thought to have created this log jam. “For children who have spent much of the past two years in quarantine, RSV poses a new threat. Children that go to daycare are typically exposed to so many infections that by the time they reach kindergarten, they don’t get as many illnesses. We’re not seeing that this year because kids have been living in quarantine. Now, their bodies are in shock,” says Dr. Mony. She also notes that newborns and infants were kept indoors for longer than usual, so they’re getting RSV when they’re older.

Safety tips for avoiding RSV sickness during holiday travel

All of that said, there are ways to help prevent the spread of RSV at home or away. While there is no vaccine for RSV, vaccination should still be an important part of your disease-fighting arsenal. “You won’t like hearing this, but RSV and flu can occur together in the same patient. So can RSV and COVID. When you’re eligible for vaccinations and boosters, get them. This is your best bet for avoiding severe disease and hospitalization,” says Dr. Mony.

If you’re looking forward to a much-needed vacation, it can be awful to cancel it because you’re sick. However, that’s exactly what you should do. No matter what nasty bug is causing your sneezing, fever, and cough, stay home so other more vulnerable people won’t get what you have. If you must travel, wear a mask and socially distance yourself from others as much as possible. You can also follow these CDC guidelines for preventing RSV:

• Cough or sneeze into a tissue or your upper sleeve
• Wash your hands often and thoroughly with soap and water for at least 20 seconds
• Clean surfaces that are frequently touched, like doorknobs and crib rails
• Avoid close contact with people who may be sick
• Keep people who may be sick away from those most vulnerable to RSV, like premature infants and babies under two years old
• If your child is sick, keep them home from daycare or school