Each year, as respiratory infections increase among young children, paediatricians encounter a familiar yet often underestimated clinical pattern. Many infants initially present with what appears to be nothing more than a common cold, runny nose, nasal congestion, and cough, but within the next 2-3 days, some develop rapid, laboured breathing as the infection progresses to RSV pneumonia or bronchiolitis. As per research, at the centre of this progression is Respiratory Syncytial Virus (RSV), which has been well recognised as one of the leading causes of pneumonia and other serious respiratory illnesses in infants .

Respiratory Syncytial Virus (RSV) is one of the leading causes of lower respiratory tract infections worldwide and a major cause of bronchiolitis and pneumonia in infants. Nearly every child is infected with RSV by two years of age. In older children and adults, the infection usually causes only a mild, self-limiting illness resembling the common cold. However, in infants, especially during the first year of life, RSV can spread to the small airways and lungs, causing inflammation, airway obstruction, bronchiolitis, pneumonia, and significant breathing difficulty that may require hospitalisation and, in severe cases, respiratory support.

RSV infection is highly contagious and spreads through droplets released during coughing or sneezing, close contact with an infected person, and contaminated hands, toys, or surfaces.

Although nearly all children are exposed to RSV during early childhood and most recover with simple supportive care, some infants develop severe disease. Premature babies, infants with congenital heart disease, chronic lung disease, or weakened immunity are at higher risk. Importantly, severe RSV infection can also occur in young, otherwise healthy, full-term infants.

"RSV infection is often underestimated because it begins like a common cold. However, in some infants, the illness can progress rapidly over the next few days to severe bronchiolitis or pneumonia requiring hospitalisation and even ventilatory support. Importantly, severe RSV disease can occur not only in high-risk babies but also in infants who were born full term and were previously healthy," says, Dr Shyam Kukreja, Senior Director and Head, Department of Paediatrics, Max Super Speciality Hospital, Patparganj, New Delhi.

"Until recently, management of RSV relied primarily on supportive care after the child became ill. Today, advances in preventive strategies have made it possible to reduce the risk of severe RSV disease in infancy through immunisation-based approaches. These preventive options have the potential to reduce hospitalisations and lessen the burden of severe RSV disease during the most vulnerable months of life," says Dr. Avadhesh Ahuja, Associate Director & Head, Department of Neonatology, Fortis La Femme Hospital, South Delhi.

How can parents help protect babies from RSV?

Preventive immunisation, combined with basic hygiene measures, can help lower the risk of severe RSV related infections.

  1. Practise good hand hygiene: Parents, caregivers and visitors should wash their hands before touching or feeding the baby, particularly after coughing, sneezing or blowing their nose.
  2. Avoid close contact with people who are unwell: Anyone with a cough, cold or other respiratory symptoms should avoid close contact with the baby and should not kiss the baby on the face.
  3. Reduce exposure to crowded spaces: During peak respiratory virus seasons, limiting unnecessary exposure to crowded indoor spaces and ensuring good ventilation can help reduce the risk of infection.
  4. Keep surfaces clean: Frequently touched surfaces, toys and other items around the baby should be cleaned regularly.
  5. Continue breastfeeding: Breastfeeding should generally be continued, including during periods when respiratory infections are circulating.

RSV can spread quickly and, in some infants, progress from what appears to be a common cold to serious respiratory illness within just a few days. That is why protecting babies early, before symptoms appear, is an important step in reducing the risk of severe disease. Parents should speak to their paediatrician about available RSV prevention options soon after their child is born.

The first year of life is a time to grow, play and explore, not one that should be disrupted by preventable hospitalisation. With greater awareness and timely protection, we can give infants a healthier start and reduce the burden of severe RSV disease. After all, when it comes to viral illnesses such as RSV, prevention and early protection can make an important difference, particularly because treatment after infection is largely focused on supportive care.



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