A single infection doesn't confer lasting immunity, so reinfection is common.
Each winter, a virus older than memory returns to test the resilience of the very young and the very old — respiratory syncytial virus, or RSV, a near-universal childhood encounter that most weather easily but that can become dangerous for those whose defences are already strained. Australia is watching its case numbers rise as the cold season deepens, while regulators weigh two vaccine candidates that could, for the first time, offer older adults meaningful protection. It is a moment that sits at the familiar intersection of biological inevitability and the slow, careful work of medical progress.
- RSV is circulating early and broadly across Australia this winter, with nearly 20,000 of the year's 32,000-plus cases falling in children aged four and under — a concentration that signals real pressure on paediatric care.
- Queensland is seeing an unusually early surge in both RSV and influenza, echoing patterns that preceded difficult respiratory seasons in the northern hemisphere.
- For infants, the elderly, and the immunocompromised, the virus can escalate into bronchiolitis or pneumonia, with no antiviral treatment available — only supportive care, fluids, and, in serious cases, hospitalisation.
- The United States approved the world's first RSV vaccine in May 2023, and Australia's TGA is now evaluating two candidates — one on a standard timeline, one on an accelerated priority review — with decisions expected within months.
- Until a vaccine is available, prevention rests entirely on hygiene and distance: handwashing, masking in high-risk settings, and keeping symptomatic individuals away from the most vulnerable.
As winter settles over Australia, respiratory syncytial virus — RSV — is making its seasonal return. Nearly every child encounters it before turning two, and most recover without serious difficulty. But for infants, older adults, and those with compromised immune systems, RSV can escalate into bronchiolitis or pneumonia, or tip existing asthma into crisis.
The virus travels through respiratory droplets and contaminated surfaces. Symptoms — fever, runny nose, cough, wheezing — typically appear three to ten days after exposure and resolve within two weeks, though the cough can persist for a month. Contagiousness peaks roughly three to eight days after onset, and longer in those with weakened immunity. Because a single infection offers no lasting protection, reinfection is common throughout life.
Australia's national surveillance system has recorded 32,259 RSV cases through mid-May, with nearly two-thirds occurring in children four and under. Queensland is reporting an unusually early surge in both RSV and influenza. Nationally, RSV case numbers are tracking close to influenza, while COVID-19 notifications remain roughly ten times higher. The true burden is almost certainly larger, since mild cases often go unreported.
There is no antiviral treatment. Management means rest, fluids, and pain relief for most; hospitalisation for intravenous fluids and oxygen in severe cases. Prevention follows familiar principles — handwashing, elbow-coughing, masking in high-risk environments, and keeping symptomatic people away from the vulnerable.
The vaccine horizon, however, is brightening. The United States approved Arexvy, made by GlaxoSmithKline, in May 2023 — the first RSV vaccine cleared anywhere in the world, for adults aged 60 and over. GSK Australia lodged a TGA application in January. Separately, the TGA has granted priority review to an mRNA vaccine candidate targeting the same age group, compressing its evaluation to 150 working days. Neither is yet available in Australia, but both are advancing through regulation as the country moves deeper into its peak respiratory season.
As winter settles in across Australia, a virus that most people have encountered by childhood is circulating again—respiratory syncytial virus, or RSV. It's so prevalent that nearly every child will catch it before turning two, though most will recover without serious trouble. For the very young, the very old, and those with weakened immune systems, however, RSV can turn dangerous, triggering chest infections like bronchiolitis and pneumonia, or worsening existing asthma.
RSV spreads the way most respiratory viruses do: through droplets expelled when someone coughs, sneezes, or talks, and through contaminated surfaces touched and then brought to the face. Symptoms typically begin three to ten days after exposure—fever, runny nose, cough, wheezing, loss of appetite. Most people shake it off within two weeks, though the cough can linger for a month. The virus remains contagious for roughly three to eight days after symptoms start, longer in people whose immune systems are compromised.
There is no antibiotic cure, because antibiotics don't work on viruses. Treatment means rest, fluids, and over-the-counter pain relief for most cases. Infants, young children, older adults, and those with certain underlying conditions may need hospitalization for intravenous fluids and supplemental oxygen. A single infection doesn't confer lasting immunity, so reinfection is common.
Australia began tracking RSV cases through its national surveillance system in July 2021. The most recent data showed 6,356 reported infections across the country, a slight uptick from the previous fortnight. Nearly two-thirds of all cases this year have been in children four years old or younger—19,641 out of 32,259 total cases through mid-May. Queensland Health noted an unusually early surge in both RSV and influenza this year compared to 2022, mirroring patterns seen in the northern hemisphere ahead of their winter season. The federal Department of Health and Aged Care reports that RSV case numbers are running roughly equal to influenza, while COVID-19 notifications are running about ten times higher.
These figures capture only reported cases, so the true burden is likely higher, especially given that most RSV illness is mild and may go unreported. Prevention follows familiar logic: regular handwashing, hand sanitizer, coughing or sneezing into your elbow, and masking in crowded or high-risk settings like hospitals and aged care facilities. People with symptoms should keep their distance from infants, elderly relatives, and immunocompromised individuals.
The vaccine landscape is shifting. In May 2023, the United States approved Arexvy, made by GlaxoSmithKline, for people aged 60 and over—the first RSV vaccine cleared for use anywhere. GSK Australia submitted an application to the Therapeutic Goods Administration in January, with a standard evaluation window of 255 days, though decisions typically come faster. Separately, the TGA granted priority review status to an mRNA vaccine candidate targeting the same age group, compressing the evaluation timeline to 150 working days. Neither vaccine is yet available in Australia, but both are moving through the regulatory process as the country heads into its peak respiratory season.
Citações Notáveis
A single RSV infection does not result in long-lasting protective immunity and repeat infections can occur in children.— Queensland Health spokesperson
RSV and influenza notifications to NNDSS were very similar, with COVID-19 having roughly 10 times the notifications over the same period.— Federal Department of Health and Aged Care
A Conversa do Hearth Outra perspectiva sobre a história
Why does RSV matter now if it's been around forever and most cases are mild?
Because it's winter, and vulnerable people—infants, the elderly, immunocompromised folks—face real danger. A mild cough for a healthy adult becomes pneumonia for someone in aged care. The surveillance data shows we're tracking it now in a way we didn't before, which means we're taking it seriously.
So if antibiotics don't work, what do doctors actually do for someone who gets really sick?
For most people, it's supportive care—rest, fluids, pain relief. But if you're hospitalized, they'll give you intravenous fluids and oxygen to help your body fight it while your immune system does the real work. There's no magic bullet, just time and support.
The case numbers seem high—6,356 in one fortnight. Is that alarming?
Not necessarily. Remember, those are only reported cases. Most RSV infections are mild, so people don't get tested or reported. The real number is probably much higher. What matters more is the pattern: cases are peaking earlier this year than last, which Queensland Health says mirrors what happened in the northern hemisphere.
Two vaccines are in the pipeline. How long before Australians can actually get one?
The standard timeline is about 255 days for the TGA to evaluate, but they usually move faster. The mRNA vaccine got priority status, which cuts it to 150 working days. So we're looking at months, not years. But approval isn't guaranteed—the data has to meet strict safety and efficacy standards.
Who should be most worried about RSV right now?
Parents of very young children, people over 60, and anyone with a compromised immune system. For everyone else, it's the same precautions you'd take against flu: wash your hands, cover your cough, stay home if you're sick. The virus doesn't discriminate, but its consequences do.