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Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two. RSV can be more severe for some groups of people. People in these groups are at a higher risk of needing to be hospitalized, though most often their symptoms can be managed at home.

About RSV

Certain groups of adults and children are more likely to develop a severe case of RSV.

Adults

  • Older adults
  • Adults with chronic heart or lung disease
  • Adults with weakened immune systems
  • Adults with certain other underlying medical conditions
  • Adults living in nursing homes or long-term care facilities

Children

  • Premature infants born before 37 weeks gestation
  • Infants up to 12 months old, especially those 6 months and younger
  • Children younger than 2 years with chronic lung disease or congenital (present from birth) heart disease
  • Children with weakened immune systems
  • Children with neuromuscular disorders (disorders that affect how the nervous system and muscles work together). This includes children who have trouble swallowing or clearing mucus on their own

See the CDC website for more information about adults or children at highest risk for severe RSV.

RSV is spread in the following ways:

  • If a person with RSV coughs, sneezes, or blows their nose near you
  • Touching, kissing, or shaking hands with someone who has RSV
  • Touching shared surfaces or objects also touched by someone with RSV, such as a doorknob or toys

RSV can spread quickly through enclosed, shared spaces, such as day care centers, schools, nursing homes, or crowded households.

In children and babies under 12 months in the United States, the most common complications of RSV are bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs).

In adults, RSV can cause pneumonia (infection of the lungs) or worsening of chronic conditions, such as asthma, chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF).

Prevention and vaccines

You should follow the recommendations below. If you have a child, you should help your child do the following:

  • Cover your coughs and sneezes with a tissue or your shirt sleeve, not your hands.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Avoid close contact with others. This includes shaking hands and sharing cups and eating utensils.
  • Clean frequently touched surfaces such as doorknobs and mobile devices.
  • If a child is in the highest of risk groups mentioned above, consider limiting time spent in crowded or shared spaces, such as day care, grocery shopping or indoor shopping areas.
  • Encourage breastfeeding or breastmilk, as it will provide infants with maternal antibodies.

These prevention tips will help prevent any respiratory illness, not just RSV, and are good practice for the entire family.

A vaccine for RSV is approved by the Food and Drug Administration (FDA) for adults ages 60 and older and pregnant people.

Older adults are at high risk for severe disease. This includes those with heart and lung disease or weakened immune systems. If you are 60 years or older, you should talk to your healthcare provider to see if the vaccine is for you. See the CDC website for more information.

Pregnant people can receive this vaccine to help protect their infant after birth. This protection is especially important during the baby's first six months when they are at high risk for severe RSV. For more information, see the FDA website.

If you are eligible, you can get the RSV vaccine at your local pharmacy. Contact your care team if you have questions about whether you should get the vaccine.

There is no RSV vaccine for children. However, there are two approved monoclonal antibody treatments — nirsevimab (Beyfortus) and palivizumab (Synagis) — that can help protect babies and young children from a severe RSV infection. Monoclonal antibodies are not vaccines. They provide an extra layer of defense against RSV infections.

Nirsevimab

Nirsevimab is recommended for the following groups of children:

  • All infants who are younger than 8 months and born during — or entering — their first RSV season (typically fall through spring).
  • Children aged 8 to 19 months old if they are at increased risk for severe RSV disease and are entering their second RSV season.

Nirsevimab treatment is not available yet. We will provide information about availability as we learn more.

Palivizumab

Palivizumab is limited to the children under 24 months of age who are most likely to be affected by severe RSV. This includes:

  • Infants born at 35 weeks or less who are six months or younger at the beginning of RSV season.
  • Children under 24 months at the beginning of RSV season who have chronic lung or heart conditions.

If you have questions, you can ask your child’s care team. For more information, see the CDC website.

Symptoms

People infected with RSV usually show symptoms within 4- 6 days after getting infected. Symptoms usually appear in stages and not all at once. In very young infants with RSV, the only symptoms may be irritability, decreased activity and breathing difficulties. 

Mild symptoms – Supportive care at home

What are mild symptoms?

Mild symptoms include a runny nose, coughing, sneezing, mild congestion, and low-grade fever. Low-grade fevers are:

  • Babies younger than three months: anything between 99°F (37.2°C) and 4°F (38°C)
  • Everyone else: anything between 100.4°F (38°C) and 102.4°F (39°C)

You or your child may have decreased appetite but taking enough fluids. You can tell if your child is taking in enough fluids by how often they urinate. In babies and toddlers, this means a wet diaper at least every 8 hours. For children ages 3 years and older, as well as adults, this means urinating at least once every 10 hours.

What do I if my child or I have mild symptoms?

Rest, drink plenty of fluids and monitor symptoms. In most cases, you or your child should start feeling better within a few days.

Do my child or I need to be tested for RSV or other viruses?

There are many respiratory viruses that can cause cold-like symptoms. Most cases of RSV and other viruses go away on their own in 1-2 weeks. Since the symptoms of RSV and other respiratory viruses are similar to COVID-19, you or your child can test for COVID-19 at home. If your child tests positive for COVID-19, follow the CDC isolation guidelines. If you or your child has mild symptoms, it is not necessary to test for other viruses.

Moderate symptoms – Call your care team

Children

Call your child’s care team if your child shows any of the following symptoms:

  • High fever:
    • In babies younger than three months: Fever over 100.4°F (38°C)
    • In babies and children of any age: Fever over 105°F (40.5°C) or a fever over 102.4°F (39°C) that does not respond to fever medication or lasts for more than 3 days
  • Increased work of breathing. This includes short, shallow, and unusually fast breathing or caving in of the space between the ribs, or nostrils spread out with every breath
  • Wheezing (a whistling noise when breathing)
  • Not taking fluids and/or decreased urination. For babies, this means not having a wet diaper for 8 hours. In children ages 3 years or older, no urine output in 10 hours.
  • Excessive tiredness or sleeping excessively
  • Ear pain or severe sore throat
  • Develops a rash covering much of the body
Adults

Call your primary care physician if you develop any of the following symptoms:

  • High fever – a fever over 102.4°F (39°C)
  • Severe cough
  • Shortness of breath
  • Wheezing (a whistling noise when breathing)

Severe symptoms – Emergency  

Go to the Emergency Department if you or your child is having severe symptoms, such as:

  • Difficulty breathing
  • Pauses in breathing for 20 seconds or more
  • Inability to wake or stay awake 
  • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

Treatment

There are no RSV-specific medications for treatment. Antibiotics do not treat RSV. For severe cases being treated in the hospital, you or your child may receive:

  • Oxygen supplementation
  • IV fluids for dehydration

You or your child may also receive other medications depending on their underlying conditions.

More information

Updated September 7, 2023