Respiratory Syncytial Virus (RSV)

RSV is a common respiratory virus that can lead to severe lung infections in infants, older adults, and people with certain health conditions. UI Health Care experts provide timely, comprehensive care to help patients of all ages manage their symptoms, prevent complications, and recover safely.
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Respiratory syncytial virus (RSV) is a very common respiratory virus. While it usually causes mild, cold-like symptoms, it can cause serious or life-threatening lung infections in infants, older adults, and those with certain medical conditions or weakened immune systems. Nearly all children will get RSV before the age of 2, and it is the leading cause of hospitalization for infants.

RSV is very contagious and spreads easily through respiratory droplets from coughing, sneezing, or close contact. It can also spread by touching contaminated surfaces and then touching the eyes, nose, or mouth.

RSV symptoms

The symptoms of RSV infection usually start about four to six days after exposure. Common symptoms in children and adults include:

  • Runny or stuffy nose
  • Cough
  • Wheezing
  • Fever
  • Decreased appetite
  • Headache
  • Fatigue
  • Fussiness or irritability, in children or infants
  • Decreased activity, in children or infants

Most children recover from RSV on their own. However, if your child is having difficulty breathing, is not drinking enough fluids, or seems unusually tired or irritable, contact their primary care provider or seek medical care.

Severe symptoms

RSV infections have the potential to spread into the lungs, causing more serious illness. Severe symptoms for children and adults may include:

  • Shallow, fast breathing
  • Trouble breathing
  • Wheezing
  • Bluish or grayish skin
  • Severe cough

For infants, symptoms may also include:

  • Flaring of the nostrils
  • Belly breathing
  • Grunting during breathing
  • Chest and skin pulling inward between the ribs when breathing
  • Pauses in breathing (apnea)
  • Refusing to eat or drink 

When to seek care

Most RSV infections go away on their own in seven to 10 days, but the cough can last two to three weeks. However, more severe RSV can cause serious or life-threatening complications such as bronchiolitis (inflammation of the small airways in the lungs) and pneumonia (infection of the lungs).

For adults

While most adults will recover on their own, you should call your primary care provider or seek medical care if you:

  • Have worsening shortness of breath or difficulty breathing
  • Are over the age of 65
  • Have a weakened immune system
  • Have a heart or lung condition
  • Have worsening symptoms after a week

For infants and children

You should call your child’s primary care provider or seek medical care if:

  • You notice signs of dehydration (fewer wet diapers, dry lips and mouth, no tears produced when crying, a sunken soft spot on your baby’s head)  
  • Your child has a fever over 100.4 degrees Fahrenheit that lasts longer than 72 hours.  
  • Your child isn’t feeling better after 10 days.

Seek emergency care if your child is:

  • Under 1 month of age and has a fever of 100.4 degrees Fahrenheit or higher
  • Grunting
  • Appearing gray or blue
  • Listless or unresponsive
  • Pauses in breathing (apnea)
  • Refusing to eat or drink 

RSV risk factors

RSV is a very common virus that almost everyone will get in their lifetime. However, some people have a higher risk of developing severe RSV. These include:  

  • Infants under 6 months old
  • Babies born prematurely
  • Children with chronic lung disease, congenital heart disease, Down syndrome, neuromuscular disorders, or weakened immune systems
  • Adults 65 and older (especially 75 and older)
  • Adults with chronic heart disease, lung disease, kidney disease, liver disease, diabetes, or severe obesity
  • Adults with weakened immune systems
  • Residents of nursing homes or long-term care facilities

RSV diagnosis

RSV is usually diagnosed based on symptoms and a physical exam. Unlike flu and COVID-19, there are currently no home tests available for RSV. If testing is needed, we offer on-site molecular testing, which gives fast and accurate results. If your provider is concerned about a more serious lung infection, they may order a chest X-ray.

Visits are available at our Quick Care, Urgent Care, and telehealth services.

RSV treatment

RSV is a viral infection, so there is no specific medication to cure it and antibiotics are not effective. Most adults and children recover at home within one to two weeks with plenty of rest and fluids.

For adults, over-the-counter medications — such as pain relievers (acetaminophen or ibuprofen), cough suppressants, and decongestants — can help manage symptoms.

For children, treatment focuses on comfort measures: acetaminophen or ibuprofen for fever and discomfort, and gentle nasal suctioning with saline drops to help clear congestion and make feeding easier. Caregivers should always check with a child’s primary care provider before giving any medications, as many over-the-counter cough and cold products are not recommended for young children.

In more severe cases, hospitalization may be necessary. Treatment in the hospital may include oxygen therapy, intravenous fluids, and occasionally, support with a ventilator to help with breathing.

RSV prevention

RSV infections typically occur during the winter months, but outbreaks can occur at other times as well.

You can protect yourself and others from RSV by:
  • Staying home when sick. Stay home until your symptoms are improving, and you have been fever-free for at least 24 hours without fever-reducing medication.
  • Washing your hands frequently with soap and water or hand sanitizer.
  • Covering your coughs and sneezes with a tissue or your elbow. Dispose of tissues promptly and wash your hands. Wearing a face mask when you’re feeling unwell can also help reduce spread.  
  • Disinfecting high-touch surfaces. Keep surfaces such as doorknobs, light switches, and countertops clean to help kill germs that can spread illness.
  • Protecting young children. Infants are especially vulnerable to RSV. During RSV season, consider limiting visitors around newborns. Ask visitors to wash their hands before holding the baby, avoid kissing the baby's face, and stay away if they are feeling unwell.
RSV prevention medication for children

RSV spreads very easily, and it is very hard to prevent infection in young children. However, immunizations such as nirsevimab (Beyfortus) and clesrovimab (Enflonsia) can help protect infants from severe RSV illness. This one-dose injection delivers ready-made antibodies that protect against severe RSV for several months – enough to cover the RSV season.

Infants under 8 months who are not already protected through maternal RSV vaccination should receive RSV immunization (nirsevimab or clesrovimab) at the beginning of their first RSV season, or shortly after birth if born during RSV season.

High-risk children aged 8-19 months may also be eligible for a second dose of nirsevimab before their second RSV season. Talk to your child’s provider to determine the best option.

RSV vaccine for adults

Adults age 75 and older should receive a single dose of an RSV vaccine. Adults aged 60-74 who are at increased risk for severe RSV – including those with chronic heart or lung disease, diabetes, obesity, weakened immune systems, or who live in a nursing home – should also receive a single dose. Three vaccines are available (Arexvy, Abrysvo, and mResvia); talk to your provider about which is right for you.

A single dose of RSV vaccine (Abrysvo) is recommended for pregnant individuals at 32–36 weeks of pregnancy during RSV season (September through January). The vaccine helps protect newborns from severe RSV during their first months of life. Infants whose mothers received this vaccine during pregnancy typically do not need additional RSV immunization. This vaccine is given once and is not currently recommended in subsequent pregnancies; infants born after future pregnancies should receive RSV immunization (such as nirsevimab or clesrovimab) instead.

Each year in the United States:

58,000-80,000
children younger than 5 are hospitalized due to RSV
60,000-160,000
older adults are hospitalized due to RSV
6,000-10,000
older adults die from RSV

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