A person under a blanket on a couch hides from an evil germ.

Respiratory Syncytial Virus (RSV): The Basics

Reviewed by: HU Medical Review Board | Last reviewed: September 2022 | Last updated: December 2023

Respiratory syncytial virus (RSV) is a common respiratory virus that causes cold-like symptoms such as runny nose, cough, congestion, and shortness of breath. RSV can affect people of all ages.1,2

Most people who get RSV will have mild illness and will recover within 1 to 2 weeks. But for people who live with certain chronic health conditions, RSV can lead to more serious symptoms and complications. These conditions include:1,2

How does RSV spread?

RSV most commonly spreads through respiratory droplets in the air. This can happen when an infected person coughs or sneezes.3

RSV is very contagious and spreads easily. In the United States, RSV infection rates tend to spike in the fall, winter, and spring, during typical cold and flu seasons.3

Generally, people with RSV stay contagious for about 3 to 8 days. But infants or people with weakened immune systems can continue to spread the virus for as long as 4 weeks. They may be able to spread the virus even after symptoms are gone.3

The virus also can live on hard surfaces for several hours. So, if a person touches a surface (such as a doorknob) with the virus on it and then touches their eyes, nose, or mouth, they can become infected.3

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What are the symptoms of RSV?

Symptoms of RSV in older children and adults are similar to cold and flu symptoms. They may include:4,5

  • Cough
  • Runny nose
  • Sneezing
  • Fever
  • Headache
  • Sore throat
  • Low appetite
  • Wheezing and trouble breathing

In infants, the only symptoms present may be:5,6

  • Irritability
  • Decreased activity
  • Decreased appetite
  • Pauses in breathing

Who is most at risk for severe disease?

While most cases of RSV are mild, certain people have an increased risk of getting severely ill and may need to be hospitalized. RSV is more dangerous in:6,7

  • Premature infants, because their lungs are not fully developed
  • Infants younger than 6 months, because their immune systems are still developing
  • Infants born with heart or lung problems
  • People with chronic health conditions like asthma, COPD, heart failure, and type 2 diabetes
  • Adults with weakened immune systems
  • Adults over the age of 65

When these at-risk people become infected with RSV, complications can include:2,7

  • More severe RSV symptoms, such as trouble breathing
  • Bronchiolitis – inflammation in the small airways of the lungs
  • Pneumonia – an infection that causes fluid to build up in the lungs
  • Congestive heart failure – when the heart cannot pump enough blood and oxygen to the rest of the body

These complications can be dangerous and even deadly if left untreated. If you are having any of these severe symptoms, contact your doctor immediately.2,7

How is RSV treated

If you have RSV, make sure to get plenty of rest and fluids. There is no specific treatment for RSV, but you can take over-the-counter medicines like ibuprofen and acetaminophen to manage fever and pain.5

Before taking any medicine or giving any medicines to your child, check with your doctor first. Never give aspirin to a child.5

How can RSV be prevented?

RSV prevention is key, especially for those who are at higher risk of severe infection. Take these extra precautions during RSV season to reduce your chance of getting RSV:7

  • Avoid close contact with anyone who is sick.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Clean and disinfect surfaces regularly.
  • Use a tissue to cover your mouth and nose when coughing or sneezing, then throw away the tissue.
  • Stay at home if you are sick.

If you are 60 or older, you also can get one of the RSV vaccines, Arexvy or Abrysvo. This vaccine will help protect you from serious RSV symptoms and complications. If you are a pregnant person 32 to 36 weeks pregnant, you can get Abrysvo to protect your infant from RSV.8-10

Two RSV antibody products, nirsevimab (Beyfortus™) and palivizumab (Synagis®), can help prevent severe RSV disease in infants and young children.11

Nirsevimab is recommended for:11

  • Infants younger than 8 months born during RSV season or entering their first RSV season. (Most infants younger than 8 months of age do not need nirsevimab if they were born 14 or more days after their mother got the RSV vaccine, except in rare circumstances.)
  • Some children aged 8 through 19 months who are at increased risk for severe RSV disease and entering their second RSV season.

Palivizumab is an injected biologic drug used to help prevent serious lung disease caused by RSV. This drug is used in children who:12

  • Were born premature and are less than 6 months old
  • Have a chronic lung condition called bronchopulmonary dysplasia (BPD) and are less than 2 years old
  • Have certain heart problems and are less than 2 years old

Palivizumab may not be right for your child. Talk to your child’s doctor about whether they recommend it as an option.

Questions to ask your doctor

If you live with a chronic health condition that could put you at risk for severe RSV infection, talk with your doctor about your concerns. Here are some questions to consider asking your doctor:13

  • Am I at risk for serious complications from RSV?
  • How can I prevent becoming infected with RSV?
  • Am I eligible for the RSV vaccine?
  • Are there any tests I should get?
  • What is the best RSV treatment for me?
  • What can I do to reduce my risk of spreading RSV to others?

Knowing your risk and following preventive measures can keep you and others safe from RSV infection.13

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