25 Aug 2021

GPs in St Helens are warning parents of a rise in cases of respiratory syncytial virus (RSV) – also known as bronchiolitis – during late summer and autumn which is much earlier than usual.

Preventative measures to guard against Covid-19 such hand-washing, wearing masks and social distancing means that a higher number of children and adults have not been exposed to usual respiratory viruses.  This also means that cases could potentially rise to 20-50% above usual levels.

Dr Mike Ejuoneatse, St Helens GP and Medical Director at St Helens Clinical Commissioning Group, says:  “RSV is the most common childhood respiratory infection and most children will have had it by their second birthday. 

“Most cases of respiratory illness in children aren’t serious and clear up within 2 to 3 weeks, but the symptoms which include a high temperature, a dry and persistent cough and wheezing can be confused with Covid-19 so it’s a good idea to get tested to rule that out.

“For some infants and babies, such as those born prematurely or with a heart condition, RSV can be more severe.

“Very young children and vulnerable children (usually under 3 months of age) are at particular risk because their airways are smaller and inflammation (bronchiolitis) can cause breathing difficulties.  Parents should contact NHS 111 or their GP for medical advice if they are concerned.”

Symptoms of RSV / bronchiolitis

The early symptoms of RSV/bronchiolitis are similar to those of a common cold such as a runny nose and a cough.  Further symptoms then usually develop over the next few days, including:

  • a slight high temperature (fever)
  • a dry and persistent cough
  • difficulty feeding
  • rapid or noisy breathing (wheezing)

Symptoms are similar to Covid-19 so please take a PCR test to rule out coronavirus.

When to seek medical help

Most cases are not serious and clear up within 2 to 3 weeks but contact NHS 111 or GP if:

  • you're worried about the child
  • the child has taken less than half their usual amount during the last 2 or 3 feeds, or they have had a dry nappy for 12 hours or more
  • the child has a persistent high temperature of 38C or above
  • the child seems very tired or irritable

A diagnosis of bronchiolitis is based on a child's symptoms and an examination of their breathing.

You should only dial 999 for an ambulance if:

  • your child is having difficulty breathing
  • your child’s tongue or lips are blue
  • there are long pauses in the child’s breathing.


There's no medication to kill the virus that causes RSV/bronchiolitis, but the infection usually clears up within 2 weeks without the need for treatment.

Most children can be cared for at home in the same way that you'd treat a cold.  Make sure your child gets enough fluid to avoid dehydration. Give paracetamol or ibuprofen to bring down a temperature if the fever is upsetting them. 


It's very difficult to prevent RSV/bronchiolitis, but there are steps you can take to reduce your child's risk of catching it and help prevent the virus spreading:

  • wash your hands and your child's hands frequently
  • wash or wipe toys and surfaces regularly
  • keep infected children at home until their symptoms have improved
  • keep newborn babies away from people with colds or flu
  • avoid smoking around your child, and do not let others smoke around them.

For more information, St Helens CCG has produced ‘The Big 6’ – a series of advice leaflets for parents giving advice on what to do if your child has one of the six most common conditions that babies, children and young people present with to urgent care.