Respiratory Syncytial Virus (RSV) FAQs

• Premature babies born before 37 weeks gestation
• Babies and children under 2 years old with chronic (long-term) lung disease and/or congenital (present at birth) heart disease
• Children and adults with weakened immune systems (system in the body that helps fight germs and illness)
• Children with neuromuscular disorders (disorders that affect how the nervous system and muscles work together), including children who have trouble swallowing or clearing mucus (thick, sticky liquid that lines the lungs, throat, mouth, and nose) on their own
• Older adults, especially those 65 years and older
• Adults with chronic heart or lung disease

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, 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).

• Wash your hands often with soap and warm water. Scrub your hands with soap for at least 20 seconds before rinsing. If soap and water are not available, use alcohol-based hand sanitizer.
• Keep your hands away from your face, nose, and mouth.
• Cover coughs and sneezes with a tissue or the inside of your elbow. Wash your hands after you cough or sneeze. Throw the used tissue in the trash.
• Clean high-touch surfaces (surfaces that are touched often and by multiple people). This can include doorknobs, counters, and toys.
• Avoid close contact with anyone who has RSV or another illness.
• Limit time and consider wearing a mask (if older than 2 years of age) in crowded or shared spaces, such as day care, grocery shopping, or indoor shopping areas.
• If possible, stay home if you or your child are sick.

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

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, 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. If the symptoms are mild, it is not necessary to know what virus is causing symptoms. Most cases of RSV and other viruses go away on their own in 1-2 weeks. If you are concerned about COVID, you or your child should take a COVID-19 home test.

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

There are no RSV-specific mediations 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.

Yes. Palivizumab is a medication to lessen the chances of babies and children developing severe RSV. It can also help prevent serious complications from RSV. It is given as an injection every month during RSV season, which generally starts in the fall and peaks in the winter in most locations in the United States. Palivizumab does not treat RSV.

Palivizumab is intended for babies under 6 months of age and children who are at risk of developing severe RSV. This includes babies and children with any of the following:

• Chronic lung conditions
• Congenital heart and/or lung conditions
• Weakened immune system
• Down syndrome
• Born very prematurely (29 weeks of gestation or less)

There is no vaccine available for RSV yet. Vaccine companies are working to develop an RSV vaccine. These vaccines are in various stages of development.