Respiratory Syncytial Virus (RSV)

What is RSV?

Respiratory syncytial virus (RSV) is a virus that infects the lungs, nose, and throat. It is a common cause of respiratory illness, especially in young children. 

RSV infections can range from mild to severe. In most people, RSV causes mild, cold-like symptoms. But in some cases, RSV can be life threatening. Infants, older adults, and people with weak immune systems are at higher risk for severe illness with RSV.

How RSV spreads

RSV spreads easily from person to person:

• Through droplets in the air when someone coughs or sneezes
• By touching surfaces that have the virus
• By direct contact with someone who has RSV

A person with RSV can spread the virus for 3–8 days. But some people are contagious for several weeks, even after symptoms improve.

Symptoms of RSV

RSV symptoms can depend on a person’s age, health, and severity of infection. 

Common signs and symptoms of RSV include:

• Runny nose
• Congestion 
• Fever
• Cough
• Sneezing
• Wheezing or trouble breathing 
• Decreased appetite

RSV can cause more severe symptoms such as:

• Trouble breathing
• Rapid breathing 
• Wheezing or crackling sounds in the lungs
• Bluish lips or face 
• Dehydration (not peeing, lack of tears)

RSV in babies

Infants may show different signs, such as irritability, problems feeding, or pauses in breathing (apnea). Signs of dehydration may include fewer wet diapers or lack of tears when crying.

Talk to your health care provider about any symptoms that worry you. If you notice any severe symptoms, seek medical care right away.

Risk factors for RSV

RSV is very common. Most children get infected with RSV at some point before their second birthday. People can have repeat infections throughout life.

Certain groups are at higher risk for severe RSV infections, including:

• Infants under 6 months old
• Premature babies 
• Children with lung or heart conditions
• People with weak immune systems
• Adults over age 65

These groups need close monitoring and extra care if they become infected with RSV. 

How to test for RSV

A lab test can diagnose RSV. This is usually done in a clinic or at a doctor’s visit. Your health care provider will swab the nose or the back of the throat to collect a sample. The sample is then tested to see if it is positive for the RSV virus.  

Testing is often done for infants, older adults, or people at higher risk of serious illness. 

In otherwise healthy people, RSV may be diagnosed based on symptoms.

How to treat RSV

There is no specific antiviral medicine for RSV. Treatment focuses on relieving symptoms and helping the body fight the virus. 

Care for RSV at home

• Give over-the-counter medicines to reduce fever and manage other symptoms. Check with your health care provider to know which medicines are OK for your child. Do not give children aspirin. 
• Be sure your child drinks plenty of fluids to prevent dehydration. 
• Use a cool-mist humidifier to keep air moist and ease breathing.
• Use nasal saline drops or suction for an infant with a stuffy nose.

Treatment for severe RSV

More serious RSV infection can cause bronchiolitis (inflammation of the small passages in the lungs) or pneumonia (lung infection that causes inflammation and fluid buildup). In severe cases, hospitalization may be needed to give oxygen, IV fluids, breathing support through a breathing tube, or other supportive care. 

Monitor your child for worsening symptoms, such as difficulty breathing or dehydration.

How to prevent RSV

There are several ways to reduce the risk of RSV infection:

• Clean hands often. Wash your hands with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer.
• Avoid close contact with people who are sick.
• Clean and disinfect frequently touched surfaces, like doorknobs and toys. 
• Avoid touching your eyes, nose, or mouth.
• Cover coughs and sneezes with the inside of your elbow or a tissue.
• Keep infants and high-risk people away from crowded areas. 
• Know when RSV is most common where you live. In the United States, RSV season generally occurs in the fall and winter. 
• Talk to your doctor about RSV immunization if your child is 19 months or younger at the start of the RSV season.

RSV immunizations

RSV immunizations work by helping the immune system recognize and fight the virus before it causes severe illness. They are used to protect people at higher risk of severe RSV infections.

RSV immunizations are recommended for certain groups:

• Pregnant women between 32–36 weeks of pregnancy during the RSV season so they can pass the protection on to their babies
• Infants whose mothers did not get the RSV vaccine during pregnancy  
• Babies born during or entering their first RSV season
• Babies ages 8–19 months who are at increased risk for severe RSV at the start of their second RSV season
• Adults over age 60 at increased risk for severe RSV
• All adults over age 75 

Two main types of RSV immunizations are available to protect against the virus: 

• RSV vaccines: Vaccines are given to pregnant women and older adults to help their bodies build immunity against RSV. 
• Monoclonal antibodies: Monoclonal antibodies, such as nirsevimab, are given to infants and young children to provide immediate protection by helping their bodies fight off the virus during RSV season.

When to call your care team

Most RSV cases are mild, but seek medical care if you notice:

• Fever above 104°F (40°C)
• Trouble breathing or rapid breathing
• Chest pain or pressure 
• Wheezing or crackling sounds in the chest
• Confusion 
• Decreased alertness
• Lips or face turning blue 
• Dehydration  
• Symptoms that get worse or do not improve after a few days

In emergencies, call 911 if you live in the United States or go to the nearest emergency room.

Questions to ask your care team

• Is my child at higher risk for severe RSV?
• When is RSV most common? 
• How is RSV different for babies and adults?
• How can I protect my family from RSV?
• What treatments are available if my child gets RSV?
• How can I manage RSV symptoms at home?
• When should I seek medical care for RSV symptoms?
• When can my child return to school or daycare after RSV?

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