RSV (Respiratory Syncytial Virus)

What is RSV?

RSV (respiratory syncytial virus) is a virus that can lead to a respiratory infection in babies, children and adults of all ages. An RSV infection usually causes a mild, cold-like illness that goes away in one to two weeks. But RSV can sometimes cause severe symptoms and lead to complications, especially in children under age 5, adults over age 65 and people with a compromised immune system. 

Washing your hands often and avoiding large groups during respiratory season can help you and your family stay healthy. If you or your child come down with RSV, at-home care is often enough to manage symptoms until the infection clears. But some people need care at a hospital to fully recover.

What are common RSV symptoms?

RSV symptoms typically resemble those of a common cold and include: 

• Cough.
• Runny nose. 
• Congestion.
• Sneezing.
• Sore throat.
• Mild headache.
• Lack of energy.
• Fever.
• Decreased appetite.
• Lack of interest in playing (in babies and young children).

Babies younger than 6 months don’t always have typical cold symptoms. Instead, they may only:

• Seem fussy or irritable.
• Lack interest in playing.
• Have a decreased appetite.
• Have changes in their breathing patterns.

Severe RSV symptoms

Severe infections may lead to symptoms like: 

• Difficulty breathing. 
• Pauses while breathing or short, shallow and fast breathing.
• Flaring (spreading out) of the nostrils while breathing.
• Wheezing.
• Noisy breathing.
• Blue or gray skin color.

What causes RSV?

RSV is a virus. It isn’t a bacterial infection. The specific virus responsible is a respiratory syncytial virus, or RSV for short.

How is RSV spread?

You catch RSV from close contact with someone with the infection or by touching a contaminated object and then touching your eyes, nose or mouth. In either case, saliva, mucus and snot are the vehicles that carry the virus from one person to another.

RSV can live on hard surfaces like tables for several hours. Meanwhile, if you touch that surface, you can pick up the virus on your hands. Washing your hands removes the virus and ends its journey there. But if you touch your face first, the virus can enter your body and make you sick.

How contagious is RSV?

RSV is very contagious. You can easily spread the virus while you have symptoms, which is usually a period of three to eight days. RSV spreads through respiratory droplets that leave your body when you cough or sneeze.  

What are the complications of RSV?

Complications of RSV include:

• Bronchiolitis.
• Pneumonia.
• Acute bronchitis.
• Worsening of existing conditions like asthma, congestive heart failure or chronic obstructive pulmonary disease (COPD).
• Respiratory failure.
• Hypoxia or low oxygen levels.
• Dehydration.
• Ear infections.

Who’s most at risk of severe RSV?

Severe RSV infection and complications can affect children and adults of any age, including those who are otherwise healthy.

People most at risk include:

• Babies born early (premature birth).
• Children under 2 years of age.
• Children with certain underlying conditions like congenital heart disease or a compromised immune system.
• Adults over age 65.
• Adults with chronic lung conditions, heart disease or a compromised immune system.

How is RSV diagnosed?

Healthcare providers diagnose RSV by:

• Talking to you about your medical history and current symptoms.
• Doing a physical exam. This includes listening to your lungs with a stethoscope and checking your blood oxygen level with a pulse oximeter.
• Doing a swab test to check your mucus for RSV.
• Doing other tests like a chest X-ray to look for signs of complications.

What should I know about RSV treatment? 

There isn’t a specific treatment for RSV in children or adults. Antibiotics don’t treat RSV. Instead, healthcare providers recommend using treatments you’d typically use for a cold. For example, you might:

• Use over-the-counter (OTC) medications (like acetaminophen or ibuprofen) to bring down a fever. Always check with your provider or your pediatrician before using any medications.
• Use a cool-mist humidifier to help with breathing.
• Use nasal saline spray and suctioning for infants to relieve cough and congestion.
• Drink plenty of fluids to avoid dehydration.

The goal is to manage symptoms while the infection runs its course.

Treatment for severe RSV

Babies, children and adults with severe RSV may need to stay at a hospital (typically just for a few days) to recover. Providers may:

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

How can I prevent RSV?

It’s not always possible to prevent RSV. But you can take some steps to protect your family from RSV and other respiratory viruses:

• Wash your hands. Always wash your hands after using the bathroom and before eating or preparing food. It’s also a good idea to lather up after touching commonly shared objects.
• Limit exposure to germs. Infants are especially vulnerable to viruses like RSV because the immune system is still developing. Avoid taking your baby among large crowds, especially during respiratory season. Also avoid play dates or other close contact with kids who are sick.
• Clean commonly touched surfaces. Disinfect toys, tables, doorknobs and other surfaces that people in your house touch often.
• Stay current on vaccines. Talk to your healthcare provider and your child’s pediatrician about recommended vaccines and when’s best to receive them. These include annual flu and COVID-19 shots.

Is there an RSV vaccine?

Yes. There’s a vaccine for RSV that certain adults are eligible to receive. There’s also a monoclonal antibody immunization for infants.

Here’s what to know:

• Adults age 60 and above are eligible to receive the RSV vaccine. If you’re 60 or older, it’s a good idea to talk to a healthcare provider about the RSV vaccine and whether they recommend you get it. Your provider will consider your overall health, including any chronic conditions you have or other risk factors that make RSV dangerous for you.
• Pregnant people are eligible to receive the RSV vaccine between weeks 32 and 36 of pregnancy. This protects your infant during their first six months of life.
• Babies up to 8 months old can get a monoclonal antibody immunization against RSV (nirsevimab). They should receive this single dose during or when entering their first RSV season. Some babies and toddlers who are 8 to 19 months old may benefit from another dose when entering their second RSV season. Your pediatrician might recommend this second dose if your child is at risk for severe RSV. Some children under age 2 at risk of severe RSV are eligible for a different monoclonal antibody immunization (palivizumab) that they receive monthly during RSV season.

Talk to your healthcare provider about what’s best for you and your family.

How do the RSV vaccine and immunization differ?

The RSV vaccine tells your immune system to create antibodies that destroy RSV in your body before the virus can do much harm. The RSV monoclonal antibody immunization gives your infant ready-made antibodies so their immune system (which is still developing) doesn’t have to produce them. These antibodies protect your baby from serious illness and hospitalization.

How long does RSV last?

Most people develop symptoms four to six days after exposure to RSV. Once they appear, symptoms usually clear up within two weeks, but the cough can linger in a mild form for several weeks after the initial infection. Severe cases of RSV may last longer. 

How long is RSV contagious?

RSV is contagious while you have symptoms, which is typically three to eight days. You may be able to spread RSV a day or two before you develop symptoms. Some babies, as well as people with compromised immune systems, may be contagious even after symptoms go away, for up to four weeks.

Is RSV deadly?

RSV can be deadly due to its complications. Each year in the U.S., RSV causes:

• About 100 to 300 deaths in children under age 5.
• About 6,000 to 10,000 deaths in adults age 65 and above.

Thankfully, immunizations can help lower your risk of serious illness or death from RSV.

When should I see my healthcare provider?

You can often manage RSV symptoms on your own. But you should call a healthcare provider if you have symptoms 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 let you know if you should come in for a checkup. They’ll also help you identify signs of a severe infection that may need treatment.

Call a pediatrician if your child has RSV symptoms and is under the age of 3 months. You should also call if your child has any of the following:

• A temperature above 100.4 degrees Fahrenheit or 38 degrees Celsius (if your baby is under 3 months old).
• A fever above 104 degrees F and 40 degrees C (at any age).
• Symptoms that don’t improve or get worse after a week.
• Ear drainage or they tug at their ears. This may be a sign of an ear infection, which some babies with RSV also develop.

It’s also a good idea to call a pediatrician if your baby has any symptoms of RSV and is under 12 months old.

When should I go to the ER?

Visit the emergency room if you or your child has severe RSV symptoms, including changes to your breathing or blue or gray skin color.

What does RSV stand for? 

RSV stands for respiratory syncytial virus. Syncytial is pronounced sin-SISH-uhl.

Do antibiotics treat RSV?

No. Antibiotics treat bacterial infections and don’t work on viral infections like RSV. Your provider may prescribe antibiotics if you also develop a bacterial infection like bacterial pneumonia.

Can you get RSV twice?

Yes. It’s possible to get RSV many times throughout your life. Some people get it twice within the same year.

Is RSV seasonal?

Yes. RSV is a seasonal illness, like the flu. In most areas of the U.S., RSV is most active from October through March.

A note from Cleveland Clinic

RSV is never a welcome guest in your home. And sometimes even the most diligent preventive measures aren’t enough to keep it away. It’s hard dealing with seasonal viruses, and when they cause severe symptoms, the situation can get downright scary.

The good news is healthcare providers are prepared to handle RSV if it becomes serious. They can also treat complications. The key is recognizing when to seek care. Don’t hesitate to reach out to a provider if you or anyone in your family has RSV symptoms. Meanwhile, do whatever you can to stop the spread of RSV to others. From handwashing to staying home while sick, you can do a lot to help others stay healthy while you recover.