Can RSV Cause an Ear Infection?

RSV is a viral infection that can cause cold or flu like symptoms in healthy children and adults. Symptoms typically resolve within 1 to 2 weeks, but some people may develop ear infections. It’s very common for a young child to develop an ear infection following a viral respiratory illness. Lets take a look at why this happens and also delve deeper into what a RSV infection is.

📝 What is RSV?

Respiratory syncytial virus (RSV) is a highly contagious respiratory virus belonging to the same family as the human parainfluenza viruses and mumps and measles viruses. It can cause a variety of respiratory tract infections and symptoms in adults, infants and young children. It mostly causes the common cold, but can also cause lower respiratory tract infections, like bronchiolitis and pneumonia.

According to the Centers for Disease Control and Prevention (CDC), 100,000–150,000 adults ages 60 and older in the United States are hospitalised due to cases of RSV.

📝 When is RSV season?

RSV spreads in the autumn and winter along with other respiratory viruses, usually peaking in December and January. Symptoms of respiratory syncytial virus infections make it difficult to distinguish from the common cold or other viral infections like the flu or COVID-19.

📝 How does RSV spread?

This respiratory virus is very infectious spreading through close contact with a person who has the virus. When an infected person sneezes or coughs (secretions) the virus goes into the air around them and can land in someone else’s eyes, nose or mouth. RSV can also live on hard surfaces like counters for hours. If you touch something that the virus lands on then you touch your face, you may pick up the virus.

📊 Symptoms of RSV

Most individuals will show upper respiratory infection symptoms 2-8 days after exposure, similar to the common cold:

• Runny nose
• Nasal congestion
• Ear infections
• Headache
• Sore throat
• Cough
• Fatigue
• Fever
• Lack of appetite

Can RSV cause an ear infection?

Yes. The answer is often down to the simple anatomy of the ear. The eustachian tube joins the middle ear to the back of the throat. One of the symptoms of a viral infection is mucus build-up, inflammation and swelling causing a blocked eustachian tube. Blockage results in middle ear fluid becoming infected. It causes the eardrum to bulge and cause pain turning into a bacterial infection. This type of ear infection in the middle ear is known as otitis media or middle ear infection.

In young children, especially those younger than 2 years of age, ear infections are more common, as the eustachian tube is shorter, and they may be encountering the virus for the first time. With age the eustachian tube stretches out and drains downwards, making it less likely for fluid to build up and infections to develop in adulthood.

Common symptoms of an ear infection include:

• Pain in the ear
• Drainage from the ear
• Ear noise or buzzing
• Feeling of fullness in the ear
• Trouble hearing or muffled sounds

High risk groups of RSV infection

While most adults and older children only experience mild respiratory illness with RSV, for others in high risk groups, RSV can cause more severe symptoms such as difficulty breathing, rapid breathing and high fever. Severe illnesses such as bronchiolitis or pneumonia may develop leading to hospital care.

Risk factors in older adults

Adults at highest risk for severe RSV disease include:

• Adults 75 years of age and older
• Adults with heart disease
• Adults with chronic lung disease and other lung conditions e.g. asthma, COPD (chronic obstructive pulmonary disease)
• Adults with weakened immune systems e.g. having a previous organ transplantation
• Adults with certain other underlying medical conditions
• Adults living in nursing homes
• Adults who work in hospitals

Risk factors in young children and babies

Some age groups are at high risk of RSV complications:

• Babies 12 months old and under
• Children 2 years old and under with medical conditions or a weak immune system
• Children 2 years old and under, born prematurely or have a low birth weight
• Children with Down syndrome
• Previous congestive heart failure
• Children attending nursery/day-care
• Exposure to tobacco smoke

🩺 How is RSV diagnosed?

To confirm diagnosis, a healthcare professional or in the case of a child, a pediatrician will take a nose or throat swab along side signs and symptoms. If needed, a chest X-ray may be carried out.

💊 Treatment

There are currently no specific treatments for RSV, but doing some of the following will help relieve symptoms:

• Use saline drops or saline nose spray to help remove thick mucus from the nose
• Over the counter pain relief, such as paracetamol or ibuprofen
• Stay hydrated with plenty of fluids
• Throat lozenges
• Decongestants, if suitable

Severe RSV infection symptoms, such as trouble breathing, require immediate medical attention. If your symptoms do not improve you may need to contact a healthcare provider to treat complications and severe cases. In general, they may:

• Give you oxygen through a mask
• Remove mucus from airways
• Give you fluids through an IV (intravenous, through your vein) to treat or prevent dehydration

📝 Preventing RSV

There are things you can do to lower your risk of getting sick or developing complications, even though catching RSV is not in your control:

• Take a RSV vaccine – Antibody products such as nirsevimab and palivizumab are available for certain groups of people including pregnant people
• Regular hand washing with soap and water, particularly before preparing food and eating
• Cover your nose and mouth when sneezing or coughing
• Disinfect surfaces that have come into contact with people who have cold symptoms
• Discourage close contact with infected people. Avoid large indoor events during RSV season or avoid visiting family or friends when they’re sick
• Wear a mask in public spaces to limit exposure
• Conclusion

RSV can cause ear infections in young children due to the build of mucus in the nose. Treatment options include clearing the mucus with saline or using a cool-mist humidifier or vaporiser to moisten the air to help ease congestion.

Sources

• Respiratory Syncytial Virus: A Cause of Acute Otitis Media – AAFP
• Respiratory syncytial virus and its impact on the NHS – House of Lords Library
• Respiratory syncytial virus (RSV) – NHS
• RSV vaccine – NHS
• Respiratory syncytial virus (RSV) – NHS inform
• How RSV Spreads – RSV | CDC
• Respiratory syncytial virus (RSV) – Symptoms & causes – Mayo Clinic