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. RSV tends to circulate more between October and April each year.

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

How is RSV Spread?

How is RSV Treated?

RSV Vaccines and Monoclonal Antibody Information for Healthcare Providers

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 Information for Healthcare Providers

The Ontario 2024-25 Respiratory Syncytial Virus (RSV) prophylaxis program information has been updated. As the respiratory season is coming to a close in the spring of 2025, the following changes will be initiated:

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 2024-25 RSV prevention program has ended for infants, high-risk children and pregnant individuals. Therefore, doses of Beyfortus and Abrysvo should no longer be administered to these individuals.

It is recommended that children receive their dose of Beyfortus in the fall, as it will provide 6 months of protection through the next RSV season. Pregnant individuals will also be eligible at that time, between 32-36 weeks of pregnancy prior to their baby being born during RSV season. Eligibility for babies born within 2025 will be announced in the fall.

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

• Beyfortus will not be available to order at this time.
• Publicly funded Abrysvo and Beyfortus can be kept in fridges at healthcare provider offices until the next RSV season, pending expiry date.
• Please do NOT return these vaccines to MLHU unless they have expired.
• Consider putting a notation on the boxes to not administer doses until the dates and eligibility for the 2025-26 season has been announced.
• 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.