RSV in Adults

What is RSV in adults?

Respiratory syncytial virus (RSV) is a virus that can lead to an upper respiratory infection in adults of all ages. Most people think of RSV as a virus that affects babies and kids. RSV spreads easily among children and can lead to severe symptoms, especially in infants. But RSV affects adults, too, and can sometimes be life-threatening.

Usually, RSV causes mild illness in adults. Most adults who catch RSV just think they have a common cold because the symptoms are the same. However, RSV can also make you very sick. It can cause lower respiratory infections like pneumonia and bronchitis in older adults or adults with other health problems.

Lower respiratory infections like these can be harder to fight off if you’re 65 or older. In part, that’s because your immune system gets weaker as you age. Some underlying medical conditions, especially those involving your heart or lungs, also make you more vulnerable to complications from RSV.

The U.S. Food and Drug Administration (FDA) recently approved RSV vaccines for adults over age 60. Getting vaccinated when you’re eligible can help you avoid serious illness. Plus, there’s a lot you can do in your daily life to stay healthy. From handwashing to avoiding people who are sick, simple steps can go a long way toward helping you avoid seasonal respiratory viruses like RSV.

How common is RSV in adults?

Because an RSV infection usually feels like a cold, many adults don’t get tested or find out they have it. So, it’s hard to know exactly how common it is.

We do know that RSV causes at least 60,000 to 160,000 hospitalizations per year among adults age 65 or older in the U.S. Some need care in the intensive care unit (ICU). RSV is responsible for about 6,000 to 10,000 deaths among older adults each year.

What are RSV symptoms in adults?

Adults usually have typical cold symptoms, including:

• Congestion.
• Cough.
• Fever.
• Lack of energy.
• Mild headache.
• Runny nose.
• Sore throat.

Severe RSV symptoms in adults

When RSV leads to complications like pneumonia or bronchitis, additional symptoms can develop. You might have one or more of the following:

• Extreme tiredness or weakness.
• Low appetite.
• Persistent cough.
• Wheezing.
• Shortness of breath.
• Bluish skin, lips or nails.
• Sudden change in mental state.

What causes RSV?

A virus causes an RSV infection. RSV stands for respiratory syncytial virus, which is the specific virus that makes you sick.

Is RSV contagious?

Yes, RSV is contagious. It’s a viral infection that spreads through respiratory droplets. You can catch RSV when someone who has the infection coughs or sneezes and those droplets land in your eyes, nose or mouth. You can also catch it from touching droplets or a contaminated object (like a table or doorknob) and then touching your face.

What are the complications of RSV?

Possible complications of RSV in adults include:

• Pneumonia.
• Acute bronchitis.
• Bronchiolitis.
• Worsening of existing conditions like asthma, congestive heart failure or chronic obstructive pulmonary disease (COPD).
• Respiratory failure.

You have an increased risk of complications if you:

• Are over age 65.
• Have a chronic lung condition like asthma or COPD.
• Have congestive heart failure or certain other types of heart disease.
• Have a compromised immune system from medications or other health problems.

Among adults with compromised immune systems, the risk of severe illness appears to be the highest among people who:

• Received a bone marrow transplant.
• Received a lung transplant.
• Are undergoing chemotherapy for leukemia or lymphoma.

How is RSV diagnosed?

Healthcare providers diagnose RSV by talking to you about your symptoms and doing a physical exam. They may also do a swab test to check your mucus for the presence of RSV.

What is the RSV treatment in adults?

There are antiviral treatments for RSV but they’re generally only used in adults with immune problems. Healthcare providers recommend you manage your symptoms and stay comfortable with the treatments you’d use for a cold. These include:

• Drinking plenty of fluids to stay hydrated.
• Getting enough rest.
• Using a cool mist vaporizer.
• Using over-the-counter (OTC) medications and home remedies to manage a fever. Talk to your provider before taking any cold medications. Some may interact with other medications you’re taking.

Continue taking prescription medications for asthma, COPD or other conditions as your provider recommends.

If you develop complications, you may need care at a hospital. A healthcare provider will tailor care to your needs. In general, they may:

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

Can antibiotics treat RSV?

No. Antibiotics don’t work against RSV because RSV is viral, not bacterial. Antibiotics only treat bacterial infections.

Your healthcare provider may prescribe antibiotics if testing shows you have bacterial pneumonia or another type of bacterial infection in addition to the RSV.

How can I prevent RSV?

Viruses like RSV are often hard to avoid. But there’s still a lot you can do to lower your risk of getting sick or developing complications:

• Get an RSV vaccine. Adults over age 60 are eligible. Talk to your healthcare provider to learn more.
• Stay current on other vaccines. Ask your provider which vaccines they recommend you get and when. These might include vaccines to protect you against the flu, COVID-19, pneumonia and other common infections. Recommendations change according to your age and risk factors.
• Disinfect commonly touched surfaces. Cleaning isn’t the same as disinfecting. Cleaning is when you wipe surfaces to remove visible dust and dirt. Disinfecting is when you destroy viruses and bacteria on those surfaces after you clean them. Check the labels on your cleaning products and follow the instructions for disinfecting.
• Wash your hands. It’s always important to wash your hands at certain times, like before you prepare food or eat. But it’s especially important to wash hands regularly throughout your day during respiratory virus season (fall and winter in the U.S.). This is when viruses like the flu, RSV and COVID-19 circulate more widely.
• Limit exposure to germs. This looks different for everyone. It’s not always possible to avoid spaces where viruses might circulate, like at work. But if you face an increased risk of RSV complications, it’s a good idea to limit exposures as much as you can. For example, you might skip large indoor events during respiratory season or avoid visiting family or friends when they’re sick. Wearing a mask in public spaces is effective at limiting exposure if you need to be there.

How long does RSV last in adults?

Symptoms of RSV usually clear up within a week or two. You may be sick longer if RSV leads to complications like pneumonia.

RSV timeline in adults

After you’re exposed to RSV, it takes about four to six days for symptoms to show up. They may appear in stages rather than all at the same time. Once you have symptoms, you can expect them to last two to eight days. Most people fully recover in one to two weeks unless complications develop.

Are there long-term effects of RSV in adults?

In most cases, no. But you may have long-term effects if you’re living with one or more of the following conditions:

• Asthma.
• Congestive heart failure.
• COPD.

RSV can make these existing conditions worse. You may have more severe symptoms or require additional care. If you have any of these conditions, talk to your healthcare provider about how viral infections might affect you and how to protect yourself.

When should I see my healthcare provider?

You might manage RSV just fine with at-home care. But you should call a healthcare provider if you develop a really bad cold and at least one of the following applies to you:

• You’re over age 65.
• You have a compromised immune system.
• You have a heart or lung condition.

Your provider will tell you if you should come in to see them. They’ll also explain signs and symptoms of a severe infection and when you should seek emergency care.

When should I go to the ER?

Call 911 or your local emergency number if you:

• Struggle to breathe or feel short of breath while sitting still.
• See a bluish skin color around your lips.
• Have new or worsening chest pain.
• Feel confused or can’t think clearly.

A note from Cleveland Clinic

There’s never a convenient time to get sick. But most adults are used to getting a cold or two per year and going about business as usual. RSV often feels just like that — a blip on the radar that passes quickly. But if you’re living with certain chronic conditions, or even just as you get older, RSV and other common respiratory viruses can become more dangerous.

That’s why it’s important to learn if you’re at risk for complications and take measures to protect yourself from infection. Talk to your healthcare provider to learn more about how RSV might affect you and ways to stay healthy.