Respiratory Syncytial Virus (RSV)

Respiratory Syncytial Virus, or RSV, is a virus that usually causes mild cold-like symptoms in most people. However, it can be serious for certain groups, including older adults, young children, people with weak immune systems, those with lung or heart problems, and premature babies.

Anyone can get RSV, but many babies catch it in their first year. Even if you've had RSV before, you can still get it again later in life.

Signs and Symptoms

Signs and symptoms of RSV can range from mild cold symptoms to severe respiratory distress and can include:

• fever
• loss of appetite
• runny nose
• cough
• wheezing
• sore throat
• headache
• general feeling of being sick

Premature babies may not have respiratory symptoms and instead be very tired, irritable, feed poorly and may have short periods of interrupted breathing. Infection with RSV can make medical conditions such as asthma and chronic lung disease worse. Sometimes severe illness can result in pneumonia, bronchiolitis, ear infections and tonsillitis.

Symptoms generally begin 4-6 days after exposure. An ill person can spread the virus for up to 8 days and sometimes longer. It can take 1-2 weeks to feel better.

How is RSV Spread?

RSV spreads by respiratory droplets in infected persons through coughing, sneezing or talking. It is also spread through contact with surfaces contaminated with RSV, such as toys, eating utensils, and unwashed hands. The virus can live on surfaces for many hours and on unwashed hands for a half hour. RSV is not spread though the air.

You can lower the chance of getting sick with RSV by doing the following:

Wash your Hands

Make sure hands are properly washed after wiping a child’s nose, coughing, sneezing, blowing the nose, shaking hands, before eating, before touching the eyes, nose or mouth. If your hands are not visibly dirty, an alcohol-based hand rub can be added to your hand hygiene routine.

Cover your cough or sneeze

Coughing and sneezing can spread germs to others. Cough or sneeze into a tissue and throw it away. If you don’t have a tissue, cough or sneeze into your sleeve. Always clean your hands after coughing or sneezing.

Clean surfaces

Frequently clean and disinfect surfaces and objects that are touched a lot like doorknobs, keyboards, counter tops, sink taps, toys, light switches, hand railings, remote controls, phones etc.

Stay home if you are sick

Staying home when you are ill is important to help reduce the spread of illness.

How is RSV Treated?

Most cases of RSV do not require any treatment and the ill person recovers on their own. For severe cases, oxygen and/or an antiviral medication may be prescribed. It is important to drink lots of fluids to avoid dehydration and to watch for increased difficulty in breathing.

RSV Vaccines and Monoclonal Antibody Product for Healthcare Providers

For the 2024-2025 respiratory season, Ontario’s publicly funded RSV prevention programs are targeting the following two populations who are at increased risk for illness and severe outcomes:

• Older high-risk adults
• All infants and high-risk children up to 24 months of age (indications include guidance for pregnant individuals)

Older High-risk Adults

The chart below outlines Ontario’s 2024-2025 RSV Prevention Program targeting older high-risk adults and includes details of who is eligible for the program, which prevention product is recommended, and where eligible individuals will be able to access services.

• Click on the name of the prevention product for a link to the product monograph.
• For additional information and resources for Healthcare Providers, visit the Ministry webpage.
• Individuals who are 60 years and older who do not qualify for this publicly funded prevention program can purchase the vaccine at a pharmacy with a prescription from their healthcare provider.

Infants and High-risk Children

The chart below outlines Ontario’s 2024-2025 RSV Prevention Program targeting all infants and high-risk children up to 24 months of age.

• In order to provide RSV protection to an infant, a pregnant individual could receive Abrysvo vaccine between 32-36 weeks gestation, OR the infant can receive Beyfortus (Nirsevimab monoclonal antibody) at birth or within the eligible age range below.
• The National Advisory Committee on Immunization (NACI) recommends the monoclonal antibody product, Beyfortus®, over the vaccination of the pregnant individual based on its efficacy (i.e., how well it works), duration of protection, and safety profile.
• Click on the name of the prevention product for a link to the product monograph.
• For additional information and resources for Healthcare Providers, visit the Ministry webpage.

*See Ministry’s Infant and High-risk Children Respiratory Syncytial Virus (RSC) Prevention Program Guidance for Health Care Providers – Beyfortus (Nirsevimab) for dose calculations.

Ministry of Health’s Infant and High-risk Children Respiratory Syncytial Virus (RSV) Prevention Program - Vaccine for Pregnant Individuals

• Infant and High-risk Children Respiratory Syncytial Virus (RSV) Prevention Program – Immunity, Monoclonal Antibodies and Vaccination

Notes:

• Arexvy RSV vaccine is NOT licensed for use during pregnancy.
• Administration of both Abrysvo (vaccine) during pregnancy and Beyfortus (Nirsevimab monoclonal antibody) is not needed except under the following situations:
• The infant was born within 2 weeks of the gestational parent receiving the Abrysvo vaccine
• OR a child who is born with any of the health conditions noted as high risk in the chart above

Co-administration of RSV Prevention Products with Vaccines

• Arexvy and Abrysvo (vaccines) can be administered on the same day as or any time before or after other vaccines.
• Beyfortus (Nirsevimab monoclonal antibody) can be administered on the same day as or any time before or after childhood vaccines, including live vaccines.

Ordering

• RSV vaccines are available to order now.
• Monoclonal antibodies will be available to order mid-October.
• All HCPs who order vaccines (excluding pharmacies) must use the online Public Health Ordering System (PHOS).
• To register for PHOS, your organization’s primary contact must complete the online registration form.