Respiratory Syncytial Virus (RSV)

Notification requirement for RSV

Respiratory syncytial virus (RSV) is a 'routine' notifiable condition. It must be notified by pathology services to the Department of Health in writing within 5 days of diagnosis. This is a Victorian statutory requirement.

Pathology services must also notify notification details for all tests performed during a weekly period in relation to RSV. This notification must be in writing within 5 business days of the end of that period.

Medical practitioners are not required to notify cases of RSV.

Primary school and children’s services exclusions for RSV

Exclusion from school and childcare is recommended until symptoms resolve.

Infectious agent of RSV

RSV (RSV A and RSV B) is the causative agent of infection.

Identification of RSV

Clinical features

RSV can cause acute respiratory illness. Most cases are mild, particularly in older children and adults. Symptoms can include:

• fever
• runny nose
• sore throat
• cough
• sneezing
• decreased appetite.

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

• wheezing
• difficulty breathing
• irritability
• poor feeding.

Complications

Complications of RSV infection can include:

• acute otitis media
• pneumonia
• acute respiratory distress
• congestive heart failure
• myocarditis
• seizures and encephalopathy
• worsening of some chronic medical conditions, such as chronic lung or heart disease.

RSV can cause serious illness and complications such as bronchiolitis and pneumonia in young infants.

Diagnosis

A clinical diagnosis of RSV is most commonly confirmed by a polymerase chain reaction (PCR) test of an appropriate respiratory specimen, such as a nose and throat swab or nasopharyngeal aspirate.

Other diagnostic tests include a rapid antigen test (RAT) for RSV (although these are not as sensitive as PCR at detecting infection), serology performed on blood specimens taken through the acute and convalescent stages and culture of a respiratory specimen.

Incubation period of RSV

The incubation period ranges from 2 to 8 days, with an average incubation period of 5 days.

Reservoir for RSV

Humans.

Mode of transmission of RSV

RSV is most commonly spread by inhalation of respiratory droplets from an infected person, such as while talking, coughing or sneezing. It can also spread through direct or indirect (fomite) contact with respiratory droplets.

The virus may persist on hard surfaces for several hours.

Period of communicability of RSV

The infectious period is just prior to symptom onset until recovery (usually up to 10 days). Infants or people with immunocompromise may be infectious for up to 4 weeks.

Susceptibility and resistance to RSV

RSV is a common respiratory infection. Almost all children will have had an RSV infection by 2 years of age and reinfections can occur throughout life.

RSV vaccines and monoclonal antibodies are available to reduce the risk of infection and severe disease.

Public health significance and occurrence of RSV

Prior to RSV becoming nationally notifiable in 2021, estimating national rates of the disease was challenging and testing practices differed among locations and population groups.

RSV causes mild to moderate illness in most people. However, infants, older people and people with immunocompromise or chronic medical conditions are at increased risk of severe disease, hospitalisation and death. RSV is a leading cause of lower respiratory tract infection in young children and older adults.

RSV typically follows a seasonal pattern, with a predominance over the autumn and winter season. However, infections can occur throughout the year.

Control measures for RSV

Preventive measures

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 less than 24 months of age who have medical risk factors for severe RSV disease in their second RSV season.

RSV Mother and Infant Protection Program (RSV MIPP)

The RSV-MIPP introduced nationally in 2025, aims to protect infants from RSV through vaccination of pregnant women and targeted protection for at-risk infants.

Maternal Vaccination

• Abrysvo® RSV vaccine available year round, under the National Immunisation Program(NIP).
• A single dose is recommended for pregnant women at 28-36 weeks gestation.
• This vaccine provides protection against RSV through the passing of antibodies from the mother to the unborn baby.

Immunisation for infants

• The infant monoclonal antibody program is available during Victoria’s RSV season for infants most at risk of severe RSV disease.

The RSV-MIPP prioritises maternal vaccination, to provide the baby with passive protection against RSV during the first six months of infancy.

For more information see:

• Respiratory syncytial virus (RSV) immunisation
• National Immunisation Program - Australian Government Department of Health, Disability and Ageing

Control of case

There is no specific treatment for RSV. Most people recover in 1 to 2 weeks.

People with RSV should be advised on the following measures to prevent the spread of infection:

• Stay home if unwell.
• Cover the mouth and nose when coughing or sneezing, ideally using a disposable tissue.
• Regularly wash hands with warm water and soap or use hand sanitiser.
• Wear a mask if leaving the home while unwell.
• Regularly clean and disinfect surfaces and objects, such as toys, that may be contaminated using a household detergent.
• While unwell, avoid contact with groups at increased risk of severe disease, such as infants, young children, older people and people with immunocompromise or chronic medical conditions.

Control of contacts

Household and household-like contacts should monitor for symptoms of RSV. If symptoms develop, they should stay at home and consider seeking medical assessment and testing, particularly if they are at increased risk of complications..

Control of environment

The virus may survive on surfaces and objects for several hours. To reduce transmission, good hand hygiene and respiratory etiquette are essential. Regular cleaning and disinfection of frequently touched surfaces and objects contaminated with respiratory secretions is recommended.

Outbreak measures for RSV

The public health response to RSV outbreaks generally focuses on high-risk settings such as residential care facilities, healthcare facilities and childcare centres.

Special Settings

Aged and other residential care facilities, healthcare facilities and childcare centres are all settings at higher risk of RSV outbreaks.

Aged and residential care facilities

Prevention in these settings is best achieved by high rates of vaccination of residents, combined with the prompt identification, testing and isolation of residents with respiratory symptoms.

During an outbreak, infection control measures include:

• enhanced cleaning of surfaces (especially high-touch surfaces)
• use of appropriate personal protective equipment
• exclusion of sick staff members
• cohorting of resident cases
• active case finding
• reduced admissions and transfers.

See detailed guidance for managing respiratory outbreaks in aged care facilities.

Outbreaks of RSV and other respiratory illnesses should be reported to the Department of Health via the Communicable Diseases hotline on 1300 651 160. The Local Public Health Unit can provide support and advice.

Healthcare facilities

Outbreaks of RSV and other respiratory illnesses are managed by the hospital’s infection control unit. Support and guidance are available from the Local Public Health Unit as needed.

Childcare centres

Children should not attend childcare until their acute symptoms have resolved. Support and guidance are available from the Local Public Health Unit as needed.