Spotting RSV Symptoms

This common lung infection can cause mild to severe respiratory symptoms

If you start sneezing, coughing and blowing your nose, you’re likely to blame the common cold as the culprit — especially if it’s fall or wintertime. However, respiratory syncytial virus (RSV) is another possibility.

This highly contagious lung infection is very common — so much so most people have been infected with it by age 2. It causes a range of respiratory symptoms, from those resembling the common cold to more severe conditions like bronchiolitis and pneumonia.

But while RSV is generally mild in healthy adults and older children, it can be severe in certain people, including:

Premature infants
Infants under 6 months old
Children and adults with weakened immune systems (such as those being treated for cancer)
Children and adults with chronic heart or lung conditions
People over age 65

Like a cold virus, RSV spreads through direct contact or through infected respiratory droplets in the air. The virus also can live for hours on hard surfaces. It can enter the body through the eyes, nose or mouth — so if you touch a contaminated object and rub your eye, you’re likely to be infected.

“Unfortunately, people don’t form long-lasting immunity from RSV and can get the virus multiple times, sometimes in the same year,” says Nicole Samies, DO, a pediatric infectious disease specialist at Geisinger. “And RSV symptoms mimic several other common respiratory illnesses, so it’s important to know what to look for and when to seek medical attention for worsening symptoms.”

RSV symptoms

There’s no easy way to know for sure if someone has RSV. Symptoms of RSV are similar to many other common respiratory illnesses, like the common cold, flu or COVID-19. And they’re different for children and adults, so knowing what to look for matters.

RSV symptoms in adults

RSV symptoms in adults can range from mild to severe and include:

Congested or runny nose
Coughing
Sneezing
Sore throat
Wheezing
Fever
Reduced appetite
Headache

RSV symptoms in infants

RSV can look different for infants or small children (the populations most susceptible to RSV). Besides the adult symptoms, babies and young children may have:

Fast breathing
Rhythmic grunting while breathing
Flaring of nostrils
Head bobbing with breathing
Belly breathing
Wheezing
Retractions of muscles between ribs, under ribcage or above clavicles

“RSV symptoms will appear in stages — not all at once,” says Dr. Samies. “Irritability, poor feeding and decreased activity are also symptoms in infants and young children.”

How long is RSV contagious?

You’re most contagious for about a week after symptoms appear. For some, like young children or those with weakened immune systems, the virus can continue to spread even after symptoms go away, for up to 4 weeks.

RSV treatment

Because RSV is a virus, there’s no specific treatment — and antibiotics don’t work. It’s best treated at home by managing symptoms while the body fights off the infection, such as:

Taking over-the-counter pain and fever reducers, like ibuprofen and acetaminophen. Note: Children under 6 months old should not take ibuprofen. Children should also not take aspirin, which can lead to Reye’s syndrome, a potentially life-threatening illness.
Drinking lots of fluids to prevent dehydration.
Getting plenty of rest.
Using a humidifier to help ease congestion and soothe irritated airways.
Using saline drops or sprays to help relieve cough and congestion.

“A mild case of RSV can take about 1 to 2 weeks to resolve, but young kids and older adults with a severe case may need more time to recover,” says Dr. Samies.

If you or your child develop severe symptoms, supportive care in a hospital may be necessary.

When to seek medical attention for RSV symptoms

RSV can lead to more serious infections, like bronchiolitis (inflammation of the small airways in the lung) and pneumonia, and it’s the leading cause of hospitalization among children under 6 months of age.

Children with weakened immune systems from pre-existing conditions like congenital heart defects and chronic lung conditions are more likely to have complications from RSV.

“Watch for worsening symptoms. A barking, wheezing cough may be one of the first signs of a more serious illness,” says Dr. Samies. “And if you or your child have difficulty breathing, a persistent high fever or signs of dehydration like dark urine or less frequent urination, get medical attention immediately.”

RSV prevention

Prevention is key, especially if you’re at risk.

The best way to safeguard you and your family against RSV is to start with the vaccine. A monoclonal antibody treatment is available for babies and high-risk toddlers up to 19 months and the RSV vaccine is recommended for adults age 60 and older and pregnant women.

“The vaccine is a safe and effective single injection that reduces your risk of RSV and lowers your chances of severe illness that requires hospitalization, if you do get sick,” says Dr. Samies. “The monoclonal antibody treatment is different, however. It gives antibodies directly to the body to help fight off an RSV infection.”

In addition, practice good hygiene habits, such as:

Washing your (and your little ones’) hands frequently. Use soap and water, and wash for at least 20 seconds. If a sink isn’t available, use hand sanitizer.
Covering your coughs and sneezes with a tissue or your arm, not your hand.
Avoiding close contact with others, especially if you’re sick. This includes hugging, kissing, shaking hands and sharing utensils.
Sanitizing high-touch areas in your home, like light switches, cell phones and doorknobs.

“RSV can be as mild as a cold, or it can turn into something much more serious,” says Dr. Samies. “Watch for worsening symptoms, and if you feel like something isn’t right, don’t hesitate to contact your provider. It never hurts to err on the side of safety.”