What is RSV?

RSV stands for Respiratory Syncytial Virus, which is a virus that causes respiratory illness in individuals of all ages. If the illness is in the upper respiratory tract, it usually results in the common cold. It can also affect the lower respiratory tract, resulting in bronchiolitis and viral pneumonia. 

How common is RSV?

RSV is the number one cause of pneumonia and bronchiolitis in children under one year of age. Most children will be infected by age two, and reinfection is common as well. In the United States, RSV infections usually increase in the fall and winter and continue through the early spring. 

What are the signs and symptoms of RSV?

RSV can cause symptoms of the common cold, such as runny nose, sore throat, and cough. Some individuals may have fever. Bronchiolitis and pneumonia may start as a runny nose and cough, then progress to shortness of breath, fast breathing, and wheezing. Young infants may also be lethargic, irritable, and feed poorly.

How serious is RSV?

Most healthy people with no underlying medical conditions who get RSV will just have a common cold. However, RSV can cause severe illness resulting in hospitalization in infants and young children under two years of age. Older children are also at risk for hospitalization if they have an underlying medical condition, like congenital heart disease or chronic lung disease.

Is RSV contagious?

RSV is very contagious. It can be spread by droplets from an infected person when they talk, laugh, or cough without a facemask and within six feet. You can infect yourself by touching a contaminated surface and then touching your face.

How is RSV treated?

Antibiotics do not work against RSV because it is a virus. Treatment is supportive, by giving oxygen when help with breathing is needed, and giving fluids for dehydration as appropriate. 

When should you call a doctor?

You should seek medical attention if any of the following occur:

  • difficulty breathing, shortness of breath or fast breathing
  • your child becomes drowsy or hard to rouse
  • there are no tears produced when crying, dry mouth, and/or little or no urine production

Can adults get an RSV infection too?

Yes, people of all ages can get RSV. Adults may just experience common cold symptoms. However, RSV infection can result in hospitalization in adults over the age of 50 and in individuals with underlying medical conditions such as chronic heart or lung disease.

Can RSV infection be prevented?

Preventive measures for RSV are similar to those for other respiratory viruses (including COVID-19):

  • frequent handwashing
  • cough etiquette
  • keep children with colds home from school and daycare
  • avoiding exposure to tobacco smoke

Preventative measures for young infants and children

Young infants and children (under two years of age) who are at high risk for severe disease from RSV may qualify to receive a monthly injection of a monoclonal antibody against RSV called Palivizumab during the RSV season. Qualifying conditions include prematurity, congenital heart disease, chronic lung disease, and neuromuscular disorders.

In 2023, the FDA approved a new drug to protect infants against RSV called Nirsevimab. Nirsevimab is a long-acting monoclonal antibody against RSV that is given by a single injection and offers protection up to 5 months after administration. Nirsevimab is recommended for all infants up to 8 months of age born during or entering their first RSV season. Nirsevimab is also recommended for infants and toddlers 8 to 19 months of age at increased risk for severe RSV disease entering their second RSV season.

Conditions that place children at increased risk for severe RSV disease include:

  • a severely compromised immune system
  • chronic lung disease of prematurity requiring medical support
  • cystic fibrosis

Children who receive Nirsevimab should not receive Palivizumab for the same RSV season.

Preventative measures for adults

Adults age 60 years and older at increased risk for severe RSV disease can now receive a single dose of the RSV vaccine. Conditions that place a person age 60 years and older at increased risk for severe RSV disease include:

  • Asthma
  • chronic obstructive pulmonary disease (COPD)
  • congestive heart failure
  • diabetes mellitus
  • a moderate or severely compromised immune system

Any person age 60 years and older should speak to their doctor about their risk for severe RSV disease and if they would benefit from receiving the RSV vaccine.

Additional information on RSV can be found at the Centers for Disease Control and Prevention website

 Tanya Orie Rogo, MD

Tanya Orie Rogo, MD, MPHTM

Dr. Tanya Orie Rogo is a pediatric infectious diseases specialist with Rhode Island Hospital and Hasbro Children's Hospital.