RSV (Respiratory Syncytial Virus)
A common respiratory virus, sometimes serious in the young and old
Quick Facts
- Type: Contagious respiratory virus
- Usually: Cold-like symptoms
- High risk: Infants, older adults, weakened immunity
- Peak season: Fall and winter
Overview
Respiratory syncytial virus (RSV) is a common and very contagious virus that infects the nose, throat, and lungs. Almost all children are infected with RSV by the age of two, and people can get it again throughout life. For most healthy children and adults, RSV causes mild, cold-like symptoms that clear up within a week or two.
However, RSV can be serious in certain groups. In infants, especially those under 6 months, it is a leading cause of bronchiolitis (inflammation of the small airways) and pneumonia. It can also cause severe illness in older adults and people with heart, lung, or immune conditions. RSV tends to circulate in the fall and winter. Recognizing the signs of serious illness, particularly trouble breathing, is the most important part of managing it.
Symptoms
Symptoms usually appear a few days after exposure and often start like a common cold:
- Runny or stuffy nose
- Cough
- Sneezing
- Fever
- Sore throat
- Decreased appetite
In young infants, RSV may show up mainly as irritability, poor feeding, and breathing changes rather than the usual cold symptoms. Signs of more serious illness include fast or labored breathing, wheezing, flaring of the nostrils, the skin pulling in around the ribs with each breath, a bluish color of the lips or skin, and dehydration. These warning signs need urgent medical attention.
Causes
RSV is caused by the respiratory syncytial virus and spreads easily from person to person:
- Respiratory droplets: Coughing and sneezing release virus into the air.
- Direct contact: Touching contaminated surfaces, such as toys or doorknobs, then touching the eyes, nose, or mouth.
- Close contact: Kissing or sharing cups and utensils with an infected person.
The virus can survive for hours on hard surfaces, which is why it spreads readily in households, childcare settings, and crowded places, particularly during the fall and winter season.
Risk Factors
- Infants, especially premature babies and those under 6 months
- Children with congenital heart or chronic lung disease
- Adults 60 and older
- People with weakened immune systems
- People with chronic heart or lung conditions such as COPD or asthma
- Crowded settings such as childcare or long-term care facilities
Diagnosis
RSV is often diagnosed based on symptoms and the time of year, with testing in some situations:
- Clinical assessment: Evaluating symptoms, breathing, and oxygen levels, especially in infants and high-risk patients.
- Swab tests: A nasal swab can confirm RSV when the diagnosis would change care, such as in hospitalized or high-risk patients.
- Additional tests: A chest X-ray or blood oxygen measurement may be used if serious lung involvement is suspected.
Many mild cases do not require specific testing.
Treatment
Most RSV infections are mild and treated with supportive care at home:
- Fluids and rest: Encouraging plenty of fluids to prevent dehydration.
- Fever and comfort: Acetaminophen or ibuprofen used appropriately for age (never aspirin in children).
- Nasal care: Saline drops and gentle suctioning can help infants breathe and feed.
There is no specific antiviral cure for typical RSV; antibiotics do not help because it is a virus. Severe cases, particularly in infants and older adults, may need hospital care with oxygen, help with breathing, and intravenous fluids. Preventive options, including immunizations and protective antibody products for certain infants and older adults, are available and should be discussed with a doctor.
Prevention
- Wash hands often with soap and water
- Avoid close contact with people who are sick, and stay home when ill
- Cover coughs and sneezes and clean frequently touched surfaces
- Keep infants away from crowds and smoke during RSV season
- Ask your doctor about RSV immunization or protective antibody products for eligible infants, pregnant people, and older adults
When to See a Doctor
Contact a doctor if a baby, older adult, or person with heart, lung, or immune problems develops RSV symptoms, or if symptoms worsen. Call emergency services or seek emergency care immediately for:
- Fast, labored, or shallow breathing, or pauses in breathing
- The skin pulling in around the ribs or neck with each breath, or nostril flaring
- Bluish or gray lips, face, or skin
- Signs of dehydration, such as few wet diapers, or a child who is very drowsy or hard to wake
These are signs of serious illness that need urgent treatment.
Frequently Asked Questions
What is RSV?
RSV, or respiratory syncytial virus, is a common, contagious virus that infects the nose, throat, and lungs. It usually causes mild, cold-like symptoms, but it can lead to serious lung infections such as bronchiolitis and pneumonia in infants, older adults, and people with weakened health.
Who is at risk for severe RSV?
Infants, especially premature babies and those under 6 months, adults 60 and older, and people with chronic heart or lung disease or weakened immune systems are most at risk for severe illness. In these groups RSV can cause serious breathing problems requiring hospital care.
How is RSV treated?
Most cases are treated at home with rest, fluids, and fever relief using acetaminophen or ibuprofen (never aspirin in children). Antibiotics do not help because RSV is a virus. Severe cases may need hospital care with oxygen, breathing support, and IV fluids. Some immunizations and protective antibody products are available.
When is RSV an emergency?
Seek emergency care for fast, labored, or shallow breathing, pauses in breathing, the skin pulling in around the ribs, bluish lips or skin, or signs of dehydration such as few wet diapers or extreme drowsiness. These signal serious illness, especially in infants and older adults.
How does RSV spread and how can I prevent it?
RSV spreads through coughs and sneezes, close contact, and touching contaminated surfaces. Prevent it with frequent handwashing, avoiding sick contacts, cleaning surfaces, and keeping infants away from crowds and smoke during RSV season. Ask your doctor about RSV immunizations for eligible infants, pregnant people, and older adults.
References
- Centers for Disease Control and Prevention (CDC). Respiratory Syncytial Virus (RSV).
- American Academy of Pediatrics (AAP).
- MedlinePlus, U.S. National Library of Medicine. RSV.
- National Institute of Allergy and Infectious Diseases (NIAID).