Respiratory Syncytial Virus (RSV)

Medically Reviewed by Neha Pathak, MD on May 22, 2024
Written by Kara Mayer Robinson
10 min read

Respiratory syncytial virus (RSV) is a common, contagious virus that affects your respiratory system. It spreads easily and leads to cold-like symptoms such as a runny nose and cough.

Most people with RSV have mild symptoms that go away on their own in a week or two. But RSV can lead to serious complications, especially for babies, older adults, and people with certain conditions. 

If you have RSV and you can’t breathe well or you’re dehydrated, you may need to go to the hospital. You may need IV fluids, oxygen, or ventilation (which helps with your air flow).

In the U.S., RSV season begins in the fall, peaks in the winter, and starts to slow down at the end of spring. But it varies from year to year.

RSV in babies

RSV is common, even in babies. Most children get it at least once by the time they’re 2 years old. Since RSV is very contagious, babies who are in child care or have siblings who are in child care or school are more likely to get RSV.

Infants have a higher risk of a severe or life-threatening infection. Premature infants and babies who are 6 months and younger have the highest risk.

RSV in children and teens

RSV is common in children and teens but less likely to lead to problems.

Your child or teen may have a higher risk of complications if they have a weakened immune system from things like cancer or chemotherapy treatment.

The risk is also higher for children with neuromuscular disorders like muscular dystrophy and conditions like congenital heart disease and chronic lung disease.

RSV in adults 

Adults often get RSV. The risk of problems is lower than it is for infants and older adults.

If you have certain health conditions, like heart disease or lung disease, you may have a higher risk of RSV leading to other health problems.

RSV in older adults 

If you’re an older adult, RSV can be more dangerous. If you’re 60 or older, your doctor may recommend an RSV vaccine to prevent problems.

RSV often looks like a common cold. You may have mild symptoms that go away on their own in a week or two.

Common RSV symptoms include:

  • Congested or runny nose
  • Dry cough
  • Headache
  • Loss of appetite
  • Low-grade fever
  • Runny nose
  • Sneezing
  • Sore throat
  • Wheezing

You may develop RSV symptoms about 4-6 days after you’re infected. They can show up in different stages or all at one time.

With RSV, you may develop more serious symptoms. When RSV goes into your lower respiratory tract, it may lead to pneumonia or bronchiolitis. Bronchiolitis is when the small airways that lead to your lungs get inflamed.

Severe RSV symptoms include:

  • Bluish skin color
  • Difficult or rapid breathing
  • High fever
  • Severe cough
  • Wheezing

RSV symptoms in babies 

RSV may look different in babies, especially if they’re young.

While babies may have mild cold-like symptoms from RSV, they have more risk of serious complications.

With a young baby, the first signs of RSV are:

  • Breathing changes
  • Irritability or fussiness
  • Less activity than normal

Symptoms of severe RSV in babies include:

  • Cough
  • Irritability
  • Lethargy, or extreme tiredness
  • Poor ability to feed
  • Short, shallow, and rapid breathing
  • Severe trouble breathing, which may look like chest muscles and skin pulling inward as they breathe

If your baby is less than 6 months old and has signs of RSV, call your pediatrician.

RSV symptoms in children and teens 

Older children often have mild, cold-like symptoms from RSV like the ones listed above. They may have other symptoms like an ear infection, eye redness, eye irritation, or eye discharge. Most symptoms go away in 7-21 days.

If your child or teen has severe RSV, common symptoms may include a cough and a sore, scratchy throat. 

RSV symptoms in adults

For adults, RSV symptoms are similar to typical cold-like symptoms, such as a congested or runny nose, headache, or a sore throat. They may be mild and go away on their own.

RSV cough 

An RSV cough is usually dry. If it’s a serious case of RSV, the cough may sound more severe.

Children with RSV may develop croup, or a cough and a sore, scratchy throat. If you have severe RSV, you may develop bronchiolitis, which may make you cough more.

RSV rash 

When your immune system fights a virus like RSV, you may develop a rash. But rashes are often caused by something else. 

With an RSV rash, you may notice bumps, blotches, or spots on your skin. They may appear anywhere on your body and may spread to other areas.

A rash isn’t something you need to worry about with RSV. It’ll likely go away in a few days without treatment.

Emergency symptoms of RSV

RSV can quickly go from mild to serious, especially in children.

Young babies have a high risk of severe RSV, so if your baby is less than 6 months old, seems sick, and has signs of RSV, call your doctor.

It’s also important to call your doctor if your child has a high risk of complications.

Call your child’s pediatrician if you notice symptoms such as:

  • A cough that lasts more than 4 days
  • A fever
  • No desire to eat or drink
  • No energy
  • Thick mucus that’s yellow, green, or gray
  • Trouble breathing

It’s possible to get a fever. But you may also have RSV without a fever. RSV can also cause a headache, an ear infection, eye discharge, or hives.

It’s not common to have RSV and diarrhea, vomiting, or loss of smell.

If you have mucus with RSV, colors to watch for include yellow, green, or gray. Call your doctor if you see these colors.

RSV travels on small droplets through the air. It enters your body through your eyes, nose, or mouth.

RSV may live for hours on hard surfaces like countertops and toys. It has a shorter lifespan on soft surfaces like tissues.

Is RSV contagious?

Yes. RSV is contagious and spreads easily. You may get it when:

  • Someone sneezes or coughs
  • You kiss someone
  • You shake someone’s hand
  • You touch a doorknob or other contaminated surface, then touch your face

RSV incubation period

When you get RSV, you may be contagious for about 3-8 days. You’re most contagious during the first week, but you may be contagious 1-2 days before you notice any symptoms.

Babies and people with weak immune systems may be contagious longer, up to 4 weeks after symptoms go away.

To find out if you have RSV, your doctor will ask about your symptoms and medical history. They may listen to your lungs, check your blood oxygen level, and do a swab test on your mucus.

Your doctor may look for signs of complications by doing tests like a chest X-ray.

RSV test

Your doctor probably won’t do a test for RSV unless you or your child has high risk factors or signs of severe RSV.

If so, they may take a sample of nose fluids by using a cotton swab or bulb syringe. They’ll test it for RSV.

RSV vs. cold

RSV symptoms are similar to the common cold. 

Your doctor probably won’t try to figure out whether you or your child has a cold or RSV unless you have a high risk or signs of severe RSV.

RSV vs. flu

Symptoms of RSV and the flu may be similar, but RSV usually stays in your upper respiratory tract. If you or your child has diarrhea, nausea, or vomiting, it’s a sign of something else, like flu or COVID-19.

Another sign that it’s the flu instead of RSV is if the sickness starts with a high fever. RSV usually starts with cold-like symptoms.

RSV vs. COVID

The symptoms of RSV and COVID can be alike. But RSV usually only affects your upper respiratory tract.

If you or your child has gastrointestinal symptoms like diarrhea, nausea, or vomiting, it may be COVID.

There’s a lot you can do to stop the spread of RSV, including:

  • Cover your mouth when you cough and sneeze
  • Wash your hands often or use hand sanitizer
  • Clean objects and surfaces like doorknobs, countertops, handles, and toys often
  • Open windows, use an air purifier, or spend time outdoors
  • Stay home when you’re sick
  • Don’t share drinking glasses with others
  • Don’t smoke. Babies who breathe in tobacco smoke have a higher risk of RSV and complications
  • Wear a mask

RSV vaccine

Some cases of RSV can be prevented through a vaccine. There are two vaccines: Abrysvo and Arexvy.

Your doctor may recommend an RSV vaccine if:

  • You’re 60 or older
  • You’re 32-26 weeks pregnant, to protect your baby after they’re born
  • Your infant or young child can get an RSV preventative antibody called palivizumab

When you have RSV with mild, cold-like symptoms, it usually goes away on its own.

In most cases, you don’t need a special treatment like RSV medication. You can use over-the-counter medication like ibuprofen or acetaminophen to treat a fever. Staying hydrated helps, so try to drink plenty of water.

If your child has trouble breathing, your doctor may recommend an RSV nebulizer with albuterol to help them breathe better.

If your baby or toddler has RSV, they may need to go to the hospital so doctors can watch them closely and give them treatment for breathing problems or dehydration.

Only 2% of people with RSV need to go to the hospital for a more serious treatment.

If you go to the hospital, you may get:

  • IV fluids
  • Mucus removed from your airways 
  • Oxygen through a mask, nasal prongs, or a ventilator

RSV and antibiotics

RSV is a virus, so antibiotics don’t help. Antibiotics fight bacteria, not viruses.

There’s a lot you can do to feel more comfortable when you have RSV.

  • Use a cool-mist vaporizer to help with breathing and coughing
  • Try saline nose drops for a stuffy nose
  • Use a baby aspirator to clear your baby’s stuffy nose
  • Try an over-the-counter medication like acetaminophen or ibuprofen
  • Drink a lot of fluids

Watch out for things that may be harmful with RSV. Consider these safety tips:

  • Always clean a cool-mist humidifier so it doesn’t grow mold and bacteria
  • Don’t use a hot-water or steam humidifier
  • Don’t give your child aspirin, which is linked to a life-threatening condition called Reye syndrome
  • Don’t give your child over-the-counter cold medicines, which may be harmful to young children

If your baby has RSV, they may not want to drink anything. Try to offer fluids often, in small amounts.

RSV may lead to complications, especially in young babies, older adults, and people with other high-risk conditions.

RSV complications may include:

  • Pneumonia
  • Bronchiolitis
  • Middle ear infection
  • Asthma
  • Repeated infections

In some cases, you or your child may need to go to the hospital for severe cases on RSV.

  • RSV is a common, contagious virus that typically has mild, cold-like symptoms
  • RSV usually goes away on its own, in about a week or two
  • There’s no specific RSV treatment
  • It’s usually just a matter of time before you feel better. But RSV may get serious quickly, especially in young babies, older adults, and people with high-risk conditions or a weakened immune system
  • It’s important to watch for symptoms of severe RSV, especially in babies

What are the major symptoms of RSV?

Common RSV symptoms include:

  • Congested or runny nose
  • Dry cough
  • Headache
  • Loss of appetite
  • Low-grade fever
  • Runny nose
  • Sneezing
  • Sore throat
  • Wheezing

How long will RSV last?

RSV usually lasts 1-2 weeks.

Why is RSV so serious?

RSV may get serious quickly. If it spreads, it may lead to pneumonia or bronchiolitis. When RSV leads to lung inflammation, it may be very serious, especially for young infants and toddlers, older adults, and people who are immunocompromised or have chronic heart or lung disease.

Can adults get RSV from kids?

Yes. RSV is very contagious, and kids may bring it home from school or child care. You can also get RSV if your baby has it and you kiss their face.

What are the stages of RSV?

You may notice RSV symptoms about 2-5 days after you’ve been exposed to it. The first stage is mild and feels like a cold. Then it may move into the lungs and lead to coughing or wheezing. Then it may lead to respiratory disease, which you need to be hospitalized for.

What is the fastest way to get rid of RSV?

There’s no specific treatment to get rid of RSV quickly. It usually takes 1-2 weeks to go away. Staying hydrated may help.

What is the best medicine for RSV?

You can use over-the-counter pain relievers and fever reducers to help with pain and fever. But there’s no specific RSV medication.

Does RSV go away on its own?

Yes, RSV usually goes away on its own. But if there are complications, you or your child may need to go to the hospital for special treatment.

What is a good remedy for RSV?

Try at-home remedies like drinking fluids, using saline nasal drops, and using a cool-mist vaporizer.