Can RSV Occur Without Fever? Signs, Symptoms And Prevention

Respiratory Syncytial Virus (RSV) is one of the common viral infections most children experience before their second birthday. For most, RSV manifests as a mild cold. However, for some, the virus can cause serious respiratory problems and is the number one cause of hospitalizations for infants under one year. While fever is often seen with viral infections, RSV can occur without this classic symptom, especially in specific populations. This brings up questions about how to identify and control the virus effectively.

RSV is a contagious virus that causes respiratory infections. It is spread through direct contact with respiratory secretions, such as saliva, mucus, or nasal discharge, and can also be spread by contaminated surfaces. In the U.S., RSV infections typically occur between late fall and early spring, though the exact timing may vary by region.

As per the words of Dr. Arun Chowdary Kotaru, Head and Senior Consultant of Pulmonology & Sleep Medicine, "RSV is the most common cause of hospitalization in children under age one. Infants with severe RSV may require oxygen or intravenous fluids, but most recover within a few days."

Recognizing the Symptoms of RSV

The symptoms of RSV take four to six days after exposure before they manifest. It manifests as follows: initial signs are very similar to a mild cold, such as sneezing, a runny nose, cough, and decreased appetite. Beyond that, infants may present with irritability, tiredness, and labored breathing. The symptoms mainly manifest in stages rather than at once.

When RSV spreads to the lower respiratory tract, it results in bronchiolitis or pneumonia with wheezing or barking cough. Parents should continue to be cautious since these can become medical issues.

Can RSV Occur Without Fever?

According to Dr. Kotaru, fever is not a specific symptom of RSV. "Fever can be absent, especially in infants and young children. The immune response is variable, and in some cases of RSV, symptoms are only mild, for example, congestion or cough," he notes. In some populations, the incidence of RSV without fever is higher.

Infants less than six months old: These young patients might experience apnea, or cessation of breathing, or be generally lethargic and not display fever.

Aged: Seniors have much milder symptoms, such as a runny nose and general fatigue, but no elevated temperature.

Other immunocompromised individuals: Immunocompromised may not display fever even though they have been infected with RSV.

How to Detect RSV Without Fever

Diagnosis of RSV may be challenging if the patient is not febrile. Dr. Vipin Kumar Consultant Pulmonologist, says that "As in some cases, RSV infection may even present with mild or even atypical features; this becomes difficult to diagnose and therefore the diagnosis of RSV infection without fever requires a combination of physical examination, medical history, and laboratory tests".

Common diagnostic techniques include:

1. Rapid Antigen Tests: These tests detect RSV antigens in respiratory secretions and give quick results.

2. Polymerase Chain Reaction (PCR): PCR tests are more sensitive and identify RSV genetic material.

3. Viral Cultures: Though less commonly used due to time constraints, these tests confirm the diagnosis by growing the virus in a laboratory setting.

Treatment for RSV

There is no specific antiviral treatment for RSV, but supportive care is the cornerstone of management. In most cases, RSV resolves on its own within one to two weeks. Dr. Kotaru advises focusing on symptom management to ensure comfort and recovery:

• Hydration: Encourage fluid intake to prevent dehydration.
• Nasal Suction: Clearing mucus can ease breathing.
• Humidifiers: Humidification in the air assists to calm the cough and helps break up the mucus.
• Fever Management: If the child has fever, then there can be medications prescribed by a doctor such as acetaminophen or ibuprofen.

In more serious cases, children are admitted to hospitals to receive oxygen therapy or respiratory assistance.

Steps to Prevent RSV

Prevention is essential, especially for the infant and older adult populations who are more susceptible to complications. The most important steps include the following:

• Frequent handwashing with soap and water
• Avoid close contact with persons who are sick
• Clean high-touch surfaces and disinfect frequently
• Limit exposure to crowded areas during RSV season.

Importance to protect high-risk populations, according to Dr. Kumar. "Simple precautions can significantly reduce the risk of RSV transmission, especially in households with infants or elderly members."

When to Seek Medical Attention

Dr Vipin says, "It is important to seek medical attention if symptoms worsen or if you experience difficulty breathing, chest pain, or severe headache. Early detection and treatment can help prevent complications and improve outcomes." Parents and caregivers should be vigilant about worsening symptoms. Seek immediate medical attention if you notice:

• Difficulty breathing or wheezing.
• Signs and symptoms of dehydration, including parched mouth, or decreased rate of urination.
• Ongoing irritability or lethargy.

Early evaluation and treatment also prevent complications as well as allow for better care.

The virus is common, but can manifest differently in different people, sometimes without associated fever. Knowing atypical symptoms and consulting a medical professional promptly is vital, especially for those already vulnerable, such as infants, the elderly, and those who have compromised immune systems. Being informed about RSV and taking steps ahead of the illness will make families able to move through the illness with greater clarity and less impact from it.

Dr Vipin Kumar is Consultant Pulmonology at Max Super Speciality Hospital Patparganj in India

Dr. Arun Chowdary Kotaru is the Head and Senior Consultant of Pulmonology & Sleep Medicine at Artemis Hospitals in India