19/02/2026
🫁 RSV Infection in Babies & Children
(Now preventable with newly available vaccines)
RSV (Respiratory Syncytial Virus) is very common, and most children will be infected at some point. In older children and adults it often looks like a simple cold, but in babies and young children RSV can be serious and may lead to bronchiolitis or pneumonia.
📅 RSV season in the Western Cape:
Mostly during the winter months, with a peak from March to August, although we see cases throughout the year.
👶 Why RSV can be dangerous for babies
* The younger the baby, the higher the risk — especially under 6 months of age
* RSV is the leading cause of bronchiolitis in infants and young children
* RSV accounts for more than 50% of paediatric hospital admissions during winter months
🚨 Warning signs – seek urgent medical care if you notice:
* Very fast, wheezy or laboured breathing
(rib muscles pulling in, nostrils flaring, chest sinking with each breath, or grunting when breathing out)
* Bluish lips, tongue, face or nails (low oxygen levels)
* Signs of dehydration (very dry mouth, fewer wet nappies, no tears when crying)
* Extreme sleepiness or poor feeding
* Fever lasting more than a few days
🛡️ Prevention & reducing risk
💉 Vaccines (3 options available):
* Synagis – given to high-risk babies (premature infants, heart or lung conditions, immune deficiencies)
➤ Given monthly during RSV season
➤ Extremely expensive
* RSV vaccine during pregnancy – given to the mother in the third trimester
* Beyfortus – for all babies entering their first RSV season
➤ Effective for about 5 months after administration
➤ Cost ± R6 500
➤ Expensive, but very worthwhile protection for young infants
🧼 Everyday prevention:
* Wash hands frequently
* Limit contact with sick people, especially for young babies
* Smoke-free environment
* Clean toys and frequently touched surfaces
* Breastfeeding where possible for immune support
* Pay attention to air quality and ventilation
🩺 What to expect during a clinical visit
* Assessment of breathing, oxygen levels, hydration and feeding
* Lung examination with a stethoscope
* Nasal swab tests may be done to identify RSV
* Treatment is mostly supportive care (fluids, rest, comfort)
* Antibiotics are only used if a bacterial infection is suspected
💊 Treatment – home vs hospital
🏡 Home care:
* Encourage plenty of fluids
* Use fever and pain relief as advised (paracetamol or ibuprofen, age-appropriate)
* Keep your child comfortable and slightly upright to ease breathing
🏥 In a medical setting:
* Oxygen therapy if oxygen levels are low
* IV fluids if your child is not drinking enough
* Some children may receive bronchodilators or other medications in selected cases (effectiveness varies)
* Hospitalisation may be needed for:
* Severe breathing problems
* Dehydration
* Very young infants
* Children with underlying medical conditions
👩👦 Quick caregiver tips
✔️ Monitor breathing and fluid intake
✔️ Follow your doctor’s instructions carefully
✔️ Do not give cough medicines to very young children unless advised
✔️ Seek medical care early if you are unsure or worried
Dr Willem Smit
Paediatrician