Respiratory syncytial virus (RSV) for health professionals

Respiratory syncytial virus (RSV) infection is caused by RSV. It is a nationally notifiable disease. We monitor and report on national case numbers and epidemiological trends. We publish case definitions and national guidance to support health professionals and health authorities.

For health professionals For everyone

Disease

  • RSV is a single-stranded, negative-sense ribonucleic acid (RNA) virus and a member of the Pneumoviridae family. The 2 major RSV subtypes are: 

    • RSV A 
    • RSV B. 

    Strains from both groups can co-circulate each season.

  • Most RSV cases present with a mild to moderate respiratory illness, but some groups of people may develop more severe disease. 

    Primary infection with RSV – most often seen in infants and young children aged under 2 years – is generally more severe than subsequent infections at older ages.

    Clinical features typically include:

    • fever
    • rhinorrhoea and nasal congestion
    • sore throat
    • cough
    • otitis media.

    Babies aged under 6 months can present with more severe clinical features, including: 

    • wheezing
    • dyspnoea
    • irritability
    • poor feeding. 

    Serious complications of RSV infection at any age can include:

    Read more about symptoms, diagnosis and treatment of RSV.

Public health importance

  • RSV is a leading cause of lower respiratory tract infection in young children and older adults. 

    The rate of hospitalisation as a result of RSV infection is: 

    • about 500 per 100,000 children aged under 5 years 
    • about 3,100 per 100,000 babies under 3 months – the highest rate of RSV-associated hospitalisations compared with other age groups.

    In addition, Aboriginal and Torres Strait Islander children have twice the rate of RSV-associated hospitalisation as non-Indigenous children.

    RSV-associated deaths are rare in immunocompetent people, but can occur in young infants and, more commonly, in older adults.

  • RSV typically causes seasonal outbreaks during autumn and winter, with peaks between April and July, which can vary year-to-year. In tropical regions, RSV outbreaks may coincide with rainy seasons.

    Almost all children have had an RSV infection by 2 years of age. RSV reinfection can occur throughout life. 

    For the latest information on cases of RSV in Australia see the:

Spread of infection

  • Person-to-person transmission most commonly occurs by direct contact of nasopharyngeal or ocular mucous membranes with virus-containing secretions or fomites. 

    RSV can persist for up to several hours on hard surfaces and skin.

    RSV can also be spread by breathing in respiratory droplets containing RSV. 

  • The incubation period can range from 2 to 8 days.

  • The infectious period is likely from before symptoms start until recovery (usually up to 10 days).

Priority populations

Prevention

  • RSV vaccination is recommended for:

    • all people aged 75 years or over
    • Aboriginal and Torres Strait Islander people aged 60 years or over
    • people with medical risk factors for severe RSV disease aged 60 years or over
    • people who are pregnant, to protect newborn infants.

    RSV monoclonal antibodies are recommended for:

    • young infants whose mother or birthing parent did not receive RSV vaccine in pregnancy or who were vaccinated less than 2 weeks before delivery
    • young infants who are at increased risk of severe RSV disease, regardless of their mother or birthing parent’s vaccination status
    • young children who have medical risk factors for severe RSV disease in their second RSV season.

    See the Immunisation Handbook for more information, including who is eligible for free RSV vaccination under the National Immunisation Program.

  • Other prevention measures include good hygiene practices, including: 

    • hand hygiene
    • respiratory hygiene
    • regular cleaning of frequently touched objects and surfaces.

    People with acute respiratory symptoms should stay home and avoid:

    • public gatherings
    • crowded settings
    • public transport
    • school, childcare or work
    • residential care facilities or hospitals.

  • It is particularly important for people at increased risk of severe illness to:

    • get vaccinated, if eligible
    • take precautions to protect themselves. 

    In the lead up to winter, extra public health initiatives aimed at preventing RSV and other respiratory virus infections may be implemented for these groups. This may include:

    • encouraging eligible people to get vaccinated
    • educating people on how to prevent the spread of infection.

Diagnosis and clinical management

  • RSV is usually diagnosed through laboratory testing. Polymerase chain reaction (PCR) is the most common test in Australia. This test involves taking samples from the nose and throat.

    Rapid antigen tests (RATs) that detect RSV are also available. RATs are not as sensitive as PCR at detecting infections. 

  • Read more about laboratory testing and the laboratory case definition.

  • RSV infections are normally self-limiting and most people will recover in 1 to 2 weeks. 

    Read more about the clinical management of RSV cases.

Notification and reporting

Public health response

  • No public health investigation or response is required for individual RSV cases. 

    Public health messaging recommends that people with RSV infection should:

    • stay at home until acute symptoms have resolved
    • avoid contact with people at increased risk of severe disease
    • take extra steps to minimise the risk of transmission to others if leaving home is necessary, such as:
      • wearing face masks
      • avoiding public transport and crowded, indoor areas.

  • Contact tracing and management of contacts is usually not required for individual RSV cases. 

  • The public health response to RSV outbreaks generally focuses on high-risk settings. 

    Control measures used during outbreaks may include:

    • encouraging vaccination
    • tailoring health education and messaging
    • isolating or grouping people with RSV symptoms
    • increasing infection control, such as
      • providing hand hygiene or personal protective equipment supplies
      • increasing surface cleaning 
      • laundering or throwing out soiled articles.

  • Special situations and high-risk settings might require extra infection and control actions. These include:

Resources

We are adding new content to this website and expanding these pages, including a suite of disease-related information. In the meantime, information about diseases in Australia is available on the Department of Health and Aged Care’s website. 

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