Bronchiolitis and RSV resources for professionals

About RSV

Respiratory Syncytial Virus (RSV) is one of the common viruses that cause coughs and colds in winter.

It is a common seasonal winter virus which causes mild respiratory infection in adults and children, but it can be severe in infants who are at increased risk of acute lower respiratory tract infection. RSV is the most common cause of bronchiolitis in children aged under 2 years.

The RSV season in the UK typically begins in the autumn, earlier than the adult flu season, and runs through winter.

During the last year there has been a remarkable reduction in respiratory viral infections other than COVID-19. This means that there is an increasing number of young children who have never been exposed to these common viruses.

Around the world we have seen evidence of unseasonal outbreaks of these infections as measures such as social distancing and mask wearing are relaxed.

Public Health England (PHE) modelling on the impact of an increase in cases of RSV this season is work in progress however, it has listed three possible scenarios with the first listed being most likely and the third least likely.

An earlier outbreak with 20-50% increase in total number of RSV cases / admissions.
A normal or quieter than normal RSV season (particularly if Non-Pharmaceutical Interventions are maintained).
Larger outbreak with 100% increase in total number of RSV cases / admissions.

What's new this year?

NHS England began planning for the potential rise in paediatric respiratory infections in April 2021, with paediatric units bringing forward their usual winter planning, escalation and emergency processes which will support an increased capacity in terms of beds, workforce and ward supplies.

As part of NHS preparedness and in response to summer case detections by PHE surveillance, the offer of the preventative medicine palivizumab has been brought forward from the usual October start date and the number of doses has been extended from 5 to 7.

Palivizumab will also be offered to a young children who are at the highest risk of complications from RSV, reducing the risk of hospitalisation in those most vulnerable.

PHE has also extended its surveillance system to ensure early signals of respiratory illnesses are being reported from a sample of NHS trusts. This usually ends in May and resumes in October, but will now continue into the summer months.

Prevention in primary care and community services.

Transmission can be reduced through standard infection control practices: such as respiratory hygiene, hand washing with soap and warm water, and cleaning of surfaces.
Ideally, people with colds should avoid close contact with newborn babies, infants born prematurely (before 37 weeks), children under 2 born with heart or lung conditions, and those with weakened immune systems.
Smoking around young children is also a risk factor for severe RSV infection.
Sustaining broader support for families in the community needs to be a priority if RSV and broader harms are to be prevented, identified and mitigated.
Community-based support can remind parents / signpost to information and support.
We advise that professionals supporting children and families should not be redeployed and should be supported to continue to provide services.
There should be agreement with the Local Authority commissioner where specific, specialist nurse skills and experience may be required.
Where these public health and specialist nurses have specific skills and experience that is required locally individual discussions should take place, and if these individuals are redeployed this should be for shortest possible time.

Information for professionals

Government guidance and support on Respiratory syncytial virus (RSV): symptoms, transmission, prevention, treatment can be found here.

Further Government guidance information on Respiratory syncytial virus (RSV): guidance, data and analysis can be found here.

Bronchiolitis teaching resources and information

Bronchiolitis Webinar (2 hours)

Hamilton ventilator set up

Oxylog ventilator set up

Babypac ventilator set up

Time to get better Care bundle

Respiratory Education materials