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 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.
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
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 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
Nasal congestionSore throatCoughHeadacheFatigueFever
Severe Symptoms
Severe symptoms of RSV in older children and adults include:
Significant coughingWheezingChest tightnessProblems 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:
Older adults (especially those who are 65 years or older) Those with chronic heart or lung conditions (e. g. , asthma or congestive heart failure) Those with a weakened immune system
Causes
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.
Diagnosis
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.
Treatment
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.
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).
Prevention
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.
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.
