Understanding RSV

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What you need to know about respiratory syncytial virus

Sometimes it feels like there’s always a season to be sick. First, it’s cold season. Then it’s allergy season. Next comes flu season. And COVID variants are always in season.

This time of year, it’s hard to tell what could be causing that stuffy nose and cough. 

It could be something more serious

Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus you may not know much about. RSV can cause mild, cold-like symptoms that usually last a week or two. RSV can be serious, especially for infants and older adults. RSV is the most common cause of bronchiolitis and pneumonia in children younger than twelve months old in the United States.

“RSV has been around seasonally each year, says  Kristen White, MD, a pediatrics specialist at Adena. “With more available testing, social media and health care availability, I think that parents are more knowledgeable and informed than ever about RSV. Previously, we would diagnose a viral illness without the ability to know if RSV vs other viruses in a child. Now, we have the capability to quickly diagnose a specific virus such as RSV, flu or COVID within the office.”

Healthy adults and infants with RSV usually won’t need to be hospitalized. Some people with RSV may need to be hospitalized if they are having trouble breathing or are dehydrated. In severe cases, a person may require additional oxygen, IV fluids, or intubation (a breathing tube).

According to the Centers for Disease Control and Prevention (CDC), RSV and RSV-related emergency visits and hospitalizations are on the rise, with some regions nearing seasonal peak levels.

Symptoms of RSV

If you or a loved one have been infected with RSV, you will usually show symptoms within four to six days. Symptoms of RSV can include:

  • Coughing
  • Decrease in appetite
  • Fever
  • Runny nose
  • Sneezing
  • Wheezing

These symptoms usually appear in stages and not all at once.


Most RSV infections go away in a week or two. There is no specific treatment for RSV, but there are steps you can take to relieve your symptoms, such as:

  • Using over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen.
  • Drinking plenty of fluids - It’s important to prevent dehydration.

RSV in infants and children

RSV can be most dangerous for infants and young children. According to the CDC, 58,000 to 80,000 children younger than five years old are hospitalized for RSV. Those at the highest risk include:

  • Premature babies
  • Infants, especially six months and younger
  • Children younger than two years old with chronic lung disease or congenital (present from birth) heart disease
  • Children with weakened immune systems or neuromuscular disorders, including kids who have difficulty swallowing or clearing mucus from their throat.

Young infants with RSV may only show symptoms such as irritability, decreased activity and difficulty breathing. RSV may not be severe at first, but it can worsen after a few days. Early symptoms of RSV may also include:

  • Runny nose
  • Decrease in appetite
  • Cough


RSV season starts in the fall and peaks in the winter. RSV can spread when:

  • An infected person coughs or sneezes
  • You get virus droplets from a cough or sneeze in your eyes, nose or mouth
  • You have direct contact with the virus, like kissing the face of a child with RSV
  • You touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands

People infected with RSV are usually contagious for three to eight days and may become contagious a day or two before they start showing signs of illness. Some infants and people with weakened immune systems can continue to spread the virus for up to four weeks after they stop showing symptoms. Children are often exposed to RSV at school or childcare centers and can the virus to other members of the family at home.

RSV can survive for many hours on hard surfaces such as tables and crib rails. It typically lives on soft surfaces such as tissues and hands for shorter amounts of time.

If you are around infants or young children, you should take extra care by:

  • Washing your hands often – Use soap and water for at least 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer. Washing your hands will help protect you from germs.
  • Keeping your hands off your face – Don’t touch your eyes, nose, and mouth with unwashed hands.
  • Avoid contact with people who may be sick – Avoid close contact and sharing cups or eating utensils with people who have cold-like symptoms.
  • Covering your coughs and sneezes – Cover your mouth and nose with a tissue or your upper shirt sleeve when coughing or sneezing.
  • Cleaning and disinfecting surfaces – Also clean objects that people frequently touch, such as toys, doorknobs and smartphones.
  • Staying home when you are sick – Don’t go to work, school or public areas if you are sick. This will help protect others from catching your illness.

RSV and COVID-19

Because RSV and COVID are respiratory viruses, some symptoms of RSV and COVID-19 can be similar. In children, COVID-19 often results in mild symptoms such as fever, runny nose and cough. For adults with COVID-19, symptoms may be more severe and may include trouble breathing.

Having RSV may lower immunity and increase the risk of getting COVID-19, and these infections can occur together, worsening the severity of COVID-19 illness.

If you have symptoms of a respiratory illness, your doctor may recommend testing for COVID-19.

Talk to your doctor

People are typically infected with RSV for the first time as infants or toddlers. Nearly all children have had RSV before their second birthday. Repeat infections may occur throughout life, and people of any age can be infected. If you have a compromised immune system or are older with underlying health issues, talk to your doctor about RSV. You should also seek immediate medical attention if your child or anyone at risk of RSV has trouble breathing, a high fever or a blue color to the skin, particularly on the lips and in the nail beds.