What Is RSV?

A highly contagious viral illness in infants and young children

Table of Contents
View All
Table of Contents

Respiratory syncytial virus (RSV) is a common, highly contagious illness that often causes mild upper respiratory symptoms, similar to a cold. However, for infants, older adults, and people who have a weakened immune system or certain underlying health problems, RSV can cause serious lower respiratory illnesses, which means that it may involve the lungs.

There is no cure for RSV; rather, treatment involves managing the symptoms (e.g., drinking fluids and lowering fever), as well as monitoring closely for breathing problems, which may warrant hospitalization.

RSV infection occurs most commonly from December through March. with the vast majority of children have been infected with RSV at least once by the age of 2. However, the American Academy of Pediatrics (AAP) believes the 2022-2023 RSV season may last longer than usual.

RSV Symptoms

Though RSV can begin with the same symptoms as the common cold, this infection can have serious complications, especially for very young children. If a young child has symptoms, it's best to get them evaluated.

Respiratory Syncytial Virus Symptoms
Verywell / Gary Ferster

Infants and Young Children

Infants and young children usually have symptoms limited to the upper respiratory tract—nose, throat, and sinuses—and they tend to develop in stages.

For example, a baby or child may develop a clear runny nose and decreased appetite followed by a mild cough a couple of days later. This may then be soon followed by sneezing and a fever.

Very young infants may become irritable or less active than usual as their only symptom.

Severe symptoms of RSV may develop one to three days after the cold symptoms begin.

Severe Symptoms

Symptoms of a severe RSV illness in infants and young children may include:

  • High fever
  • Fast breathing rate
  • Wheezing
  • Coughing persistently
  • Problems eating due to fast breathing rate or severe nasal congestion
  • Apnea (a pause in breathing for more than 15 or 20 seconds)

This indicates that the illness has spread to the lower respiratory tract—causing pneumonia (lung infection) or bronchiolitis (infection of the tiny airways that lead to the lungs).

While any infant or young child is considered at risk for RSV, some particular groups are considered at high risk for developing severe RSV symptoms.

These groups include:

  • Premature babies
  • Infants younger than 6 months old
  • Children younger than 2 years old with chronic lung or heart disease
  • Children with weakened immune systems
  • Children with neuromuscular disease, congenital heart disease or lung malformations, or chronic lung disease

When to Seek Immediate Medical Attention

Call 911 immediately if any of these symptoms or signs occur:

  • Nasal flaring (wide flaring of the nostrils with each breath)
  • Difficulty breathing (e.g., fast breathing, labored breathing) or not breathing at all
  • Retractions (the skin around the ribcage is sucked in with each breath)
  • Grunting
  • Extreme drowsiness
  • Cyanosis (appearance of blue lips, fingernails, or skin)
  • Severe coughing spells
  • Pale skin
  • Anxious, agitated demeanor

Older Children and Adults

Healthy adults and older children with RSV usually develop a mild upper respiratory tract illness with cold symptoms, such as:

  • Nasal congestion
  • Sore throat
  • Cough
  • Headache
  • Fatigue
  • Fever

Severe Symptoms

Severe symptoms of RSV in older children and adults include:

  • Significant coughing
  • Wheezing
  • Chest tightness
  • Problems breathing

These symptoms indicate that the illness has progressed to a lower respiratory tract infection, such as pneumonia or bronchitis (infection of the large airways that lead to the lungs).

Adults who are particularly at risk for developing a severe RSV illness include:


RSV is a contagious virus that is spread through contact and droplet transmission. This means that anyone who comes in contact with the nasal or oral secretions of someone infected with RSV can become infected themselves.

For example, you may become infected if someone with RSV sneezes or coughs, and the virus particles gets into your eyes, nose, or mouth.

Touching a toy (or another object like a crib rail or doorknob) that a person with RSV has touched can also lead to RSV transmission.

Direct contact, such as kissing a child with RSV, can spread the virus as well.


The diagnosis of RSV is made by a medical history and physical examination. These will also help guide a healthcare provider in recommending a treatment plan and determining whether or not hospitalization is necessary.

For infants and children, a healthcare provider will ask about symptoms like a high fever or decreased activity, eating, or urination. They will also ask about underlying health problems like a history of heart or lung disease or prematurity.

If a baby or child has RSV, certain health conditions (e.g., congenital heart disease or neuromuscular disease) are associated with an increased risk of progressing to a lower respiratory tract infection like bronchiolitis.

They will check for wheezing, nasal flaring, an increased breathing rate, and/or low oxygen saturation.

Laboratory Testing

If a patient has a severe respiratory illness, or they have a respiratory illness and are considered high risk for developing severe illness if they have RSV, a laboratory test may be performed to see if the virus is present.

For infants and children, the rapid antigen test is often used. This test involves taking a swab of nasal secretions from the child's nose. Results are usually back within thirty minutes to an hour.

For older children and adults, the rapid antigen test is not as sensitive for detecting the RSV antigen. So a test called the polymerase chain reaction (PCR) is used. This test also involves taking a swab of nasal secretions. A benefit to the PCR test is that it looks for a spectrum of respiratory viruses, not just RSV.

Imaging tests, like a chest X-ray, are reserved for severe cases of breathing problems, like those that warrant a potential intensive care unit (ICU) admission.


There is no medication to cure RSV. For most children and adults, RSV infection causes only cold symptoms, and the treatment is no different than that used to treat any other cold at home.

However, for some people, especially babies, the breathing difficulties that result from RSV require hospitalization.

Home Care

Treatment for RSV is supportive, meaning it is intended to manage symptoms until the virus runs its course. In addition to supportive care (e.g., fever reduction and drinking ample fluids), it's important to closely monitor for worsening symptoms and to contact your healthcare provider with any concerns.

Fever Reduction

Be sure to also ask your healthcare provider about the specifics of when and how to treat fever. Never give aspirin to any child under the age of 18 because there is a risk of developing a serious illness called Reye's syndrome.

Hospital Care

In the hospital, close monitoring of oxygen levels is necessary. Supportive treatments may include oxygen therapy, nasogastric (through the nose) or intravenous (through the vein) fluid administration, and in severe cases, mechanical ventilation (a breathing machine).


There is no vaccine against RSV, although researchers are hard at work trying to develop one. At this time, the best way to prevent RSV infection is to use good hand hygiene.

Here are some helpful strategies to prevent RSV infection:

  • Wash hands thoroughly and frequently with soap and water.
  • Avoid close contact or shaking hands with others (especially if they are sick).
  • Do not share food utensils or cups.
  • Avoid touching your face (until you have washed your hands).
  • If possible, avoid high-risk settings (e.g., recreation centers, shopping centers).
  • Regularly clean and disinfect household and work surfaces that are frequently touched (e.g., doorknobs or light switches).
  • Everyone in a household, including infants 6 months and older, should get a flu shot every year as soon as they are available.

If you are a parent or guardian, these additional tips can help keep your little one protected:

  • Make sure anyone who touches your child washes their hands first.
  • Keep your child away from crowds and large groups, no matter the setting.
  • Keep your child away from tobacco smoke and secondhand smoke.
  • Whenever possible and reasonable, especially if your baby is at high risk for RSV infection, limit their participation in childcare settings during flu season.

It's also important to be mindful of others. If you are sick with cold symptoms, be sure to cover your mouth with a tissue when you cough or sneeze to minimize the spread of your illness. Also, stay away from those who are at high risk for a severe RSV illness.

Synagis (Palivizumab)

Synagis is an intramuscular (injected into the muscle) monoclonal antibody that helps prevent severe lower respiratory tract illnesses in premature babies and children at high risk of RSV. It's typically given once a month during RSV season for a maximum of five months.

However, due to the widespread and intense RSV circulation, for the 2022-2023 RSV season, the American Academy of Pediatrics (AAP) supports the continued use of palivizumab (more than the typical 5 months) in regions with high RSV activity.

This therapy is only indicated for children who are less than 24 months old; older children and adults are not candidates.

Synagis is not a vaccine and it cannot cure or treat a child who is already diagnosed with RSV. If your child is at very high risk for RSV infection, your pediatrician may discuss this option with you.

A Word From Verywell

The bottom line is that while RSV is a common illness that usually causes run-of-the-mill, cold symptoms, it can be very serious in certain individuals, especially infants, older adults, and those with a weakened immune system or certain underlying health conditions.

Educating yourself about this illness can help you be on the alert if you or a loved one contracts it. This is important for your own recovery and to prevent yourself from spreading it to others who might be susceptible to a serious bout of RSV.

Frequently Asked Questions

  • What is RSV?

    Respiratory syncytial virus is spread easily from person to person, usually causing a mild cold. It is very common among young children. Older children and adults often get it too, and usually don't need medical care or diagnostic tests to specifically identify the virus. People who are vulnerable to severe respiratory infections can develop pneumonia, bronchitis, or bronchiolitis from RSV.

  • Can adults get RSV?

    Yes, adults can get RSV. For healthy adults, the symptoms and disease course are similar to a common cold, but it can become severe for adults who are immunocompromised of who have underlying heart or lung conditions.

  • Is RSV contagious?

    Yes, this infection is highly contagious. It is spread from person to person through respiratory droplets, touch, and by touching objects that a person with RSV has recently touched. You can prevent the spread by avoiding contact with others who are sick, avoiding contact with others if you are sick, and washing your hands before you eat or touch your face.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Respiratory Syncytial Infection (RSV): For Healthcare Professionals.

  2. American Academy of Pediatrics. Updated guidance: use of palivizumab prophylaxis to prevent hospitalization from severe respiratory syncytial virus infection during the 2022-2023 rsv season.

  3. Christou E, Bourousis E, Pouliakis A, Douros K, Varela P, Delis D, Priftis KN. The differences between RSV and no RSV acute bronchiolitis in hospitalized infants: A cross-sectional study. Glob Pediatr Health. 2022 Dec 2;9:2333794X221138437. doi:10.1177/2333794X221138437

  4. American Academy of Pediatrics Policy Statement. Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection.Pediatrics Volume 134, Number 2, August 2014. doi: 10.1542/peds.2014-1665

  5. Stollar F, Alcoba G, Gervaix A, Argiroffo CB. Virologic testing in bronchiolitis: does it change management decisions and predict outcomes?Eur J Pediatr. 2014 Nov;173(11):1429-35. doi:10.1007/s00431-014-2334-2

  6. Smith DK, Seales S, Budzik C. Respiratory Syncytial Virus Bronchiolitis in Children. Am Fam Physician; 95(2):94-99. https://www.aafp.org/afp/2017/0115/p94.html#afp20170115p094-b7

  7. Centers for Disease Control and Prevention. RSV Prevention.

By Kristina Duda, RN
Kristina Duda, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention.