Respiratory Syncytial Virus (RSV): What Every Parent Needs to Know

Medically Reviewed By Nick Villalobos, MD
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Respiratory syncytial virus (RSV) is a very common respiratory virus that most people get at some point in their lives. Although most older children and healthy adults can recover from RSV, the virus can be very dangerous for infants and people in other high risk groups.  The Centers for Disease Control and Prevention (CDC) notes that nearly every child contracts RSV by the age of 2 years. In most cases, RSV causes mild, cold-like symptoms that last about 1–2 weeks.

However, some groups are at higher risk of more serious complications from RSV. Such groups include infants younger than 6 months. It is important for parents and caregivers to recognize the symptoms of RSV and know when to seek medical attention for an infant with RSV. 

This article explains what RSV is, how it differs from COVID-19, and how you can treat RSV.

What is RSV? 

Young girl sick on couch under blanket with toy doll
Courtney Rust/Stocksy United

Often a routine childhood illness, RSV is a very common and contagious respiratory virus. Adults can get RSV as well, though the infection is usually less severe.

RSV symptoms are similar to those of the common cold or flu in healthy children and adults. In some people, RSV can lead to serious lung infections, such as bronchiolitis (inflammation of small airways in the lung) and pneumonia. 

Typically, mild cases of RSV do not require a doctor’s attention. However, if symptoms of a lung infection occur — such as difficulty breathing, a cough that produces mucus, and fever — contact a doctor immediately.

Sometimes, hospitalization is necessary for those at highest risk of lung infections. There is currently no treatment for the virus itself, only the symptoms that RSV causes. 

RSV vs. COVID-19

COVID-19 and RSV are both respiratory viruses, so they can feel very similar — especially at the beginning of an infection. In fact, without testing, you may not be able to tell which virus your child has. 

What you can do, however, is know the symptoms of each virus, monitor your child for complications, and know when to call for medical assistance, if needed.

Learn more about COVID-19, including prevention and tips for safe travel, here.

In older children and adults

For adults and infants older than 6 months, symptoms of RSV and COVID-19 typically break down as follows.

SymptomRSVCOVID-19

fever (100.4ºF or 38ºC)

XX

a runny nose

XX
a coughXX
a sore throatXX
wheezingX
decreased appetiteX
a new loss of smell or tasteX
shortness of breathX
fatigueX
muscle or body achesX
diarrheaX

In young infants

In infants younger than 6 months, RSV and COVID-19 symptoms can differ from those in older children and adults.

SymptomRSVCOVID-19
being less active than usualXX
taking pauses during breathing or having difficulty breathingX
a reduced appetiteX
irritabilityX
fever (100.4ºF or 38ºC)X
a runny noseX
a coughX
vomitingX
diarrheaX
not eating wellX

There are many types of viruses that can cause symptoms similar to those of RSV and COVID-19 in infants. If your child shows any of these symptoms, contact a pediatrician right away for an accurate diagnosis so that you can start prompt, effective treatment.

Any infant younger than 6 months with a temperature over 100.4ºF (38ºC) should see a doctor right away.

Stages of RSV symptoms

RSV symptoms tend to occur in stages. The approximate timeline for RSV infection, transmission, and symptoms is:

  • days 3–5: incubation period, from the time of exposure to RSV to the development of illness
  • days 1–6 for adults or days 38 for children: viral shedding, when someone may be contagious even if they do not have symptoms yet
  • day 5: period of symptoms peaking
  • days 7–10: period of symptoms improving
  • up to 4 weeks: a cough or wheeze that may linger

Is RSV contagious?

RSV is a contagious virus that can spread very quickly, especially among children. RSV is most prevalent during its peak seasons of fall, winter, and spring.

RSV is contained within respiratory droplets, so it can spread directly from person to person through sneezing, coughing, and other forms of direct contact. Additionally, RSV can live for up to 6 hours on surfaces, making transmission possible through doorknobs, toys, and shared cups or utensils.

People with an RSV infection are contagious during the course of the illness, which typically lasts 3–7 days

An RSV infection does not give lifelong immunity, so you can contract RSV again in the future. However, the CDC notes that subsequent infections are typically less severe. 

When should you contact a doctor for RSV?

Most people with RSV will recover without needing to contact a doctor. 

In some children and adults, RSV can lead to complications. These include pneumonia, which is a lung infection, and bronchiolitis, which is inflammation in the breathing tubes of the lungs. 

Serious symptoms of RSV in infants

Because RSV can lead to serious complications, there are times when it is safest to contact your child’s pediatrician. The American Lung Association advises calling a doctor if your infant has:

  • a barking or wheezing cough
  • nasal flaring, wherein the nostrils widen significantly when the child breathes out
  • symptoms of chest retractions, which is when their chest appears to cave in when they breathe
  • rapid breathing
  • any bluish tinge to their mouth, lips, or fingernails
  • a poor appetite
  • difficulty breathing
  • a shallow cough

Symptoms of bacterial infection

RSV can lead to bacterial infections, such as pneumonia or ear infections. Call your doctor if RSV symptoms do not improve after 7 days or if you notice any of the following:

  • chest pain or tightness
  • ear pain, fullness, or drainage or a child or infant tugging at an ear
  • fatigue, weakness, or poor sleep
  • high fever (101ºF or 38ºC)
  • a cough that produces mucus

What are the risk factors for RSV?

Anyone can get RSV. For adults, the virus is usually not serious. However, in infants, very young children, and other vulnerable people, RSV can be severe. 

Those most at risk of developing severe RSV infections include:

  • older adults
  • children and adults with chronic heart or lung disease
  • children and adults with weakened immune systems due to illnesses or medications
  • children with neuromuscular disorders
  • infants 12 months of age or younger
  • premature infants

The CDC notes that RSV is the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age.

What are the treatments for RSV?

There is no RSV treatment to clear the virus itself, so treatment focuses on managing the symptoms and providing additional supportive care in cases of hospitalization. 

If you have an infant who is at high risk of serious RSV infection or complications, their doctor may prescribe a drug called palivizumab (Synagis) for them. Synagis is a monoclonal antibody that can help prevent the development of serious RSV. It cannot, however, prevent RSV infection or cure someone who already has it.

Home care for RSV

Home treatment is typically effective for mild cases of RSV. You can care for your infant by: 

  • making sure they stay hydrated as much as possible through breast or formula feeding
  • using gentle suction with nasal saline to make breathing easier
  • running a cool mist humidifier to help break up congestion
  • for children older than 6 months, offering acetaminophen or ibuprofen as recommended by a doctor for pain and fever 
  • avoiding acetaminophen or over-the-counter cold medications unless advised by a doctor, as some types of these medications can be dangerous for infants
  • ensuring your child gets plenty of rest

If your infant displays any symptoms of difficulty breathing or has worsening symptoms, call a doctor right away. RSV can develop into a lung infection or inflammation, which may require additional medical treatment.

Hospitalization for RSV

Statistics show that 57,000 children under the age of 5 years are hospitalized with RSV every year. Hospital stays for RSV usually require medical care to support breathing, such as oxygen, intubation, or mechanical ventilation. In most cases, children will be discharged after a few days of hospital care. 

Summary 

RSV is a common respiratory virus that most people will contract at some point. Most people recover from RSV in 1–2 weeks without any incident. Although RSV is not dangerous for most people, it can become severe for people in high risk groups, including infants younger than 6 months, older adults, and those with weak immune systems.

RSV, especially in infants, can develop into an infection and inflammation in the lungs that can interfere with breathing. If your child has symptoms including fever, extreme tiredness, and difficulty breathing, seek medical attention right away for an accurate diagnosis and treatment.

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Medical Reviewer: Nick Villalobos, MD
Last Review Date: 2022 May 27
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