Respiratory syncytial virus (RSV) is a viral infection affecting the lungs and respiratory tract. RSV is most common in children, causing symptoms such as a stuffy nose, sore throat, and lung mucus.
RSV can cause symptoms similar to the common cold.
Children are more at risk of developing RSV because they have less developed immune systems. The virus causes 63% of childhood upper respiratory infections and 80% of lung infections in children younger than age 1.
A typical RSV case causes:
- A wet, productive cough
- Congestion and a runny nose
- Fever
- Headache
RSV travels on airborne (respiratory) droplets and finds new hosts (humans) via your nasal passages and lungs. You can also contract it by touching surfaces with contaminated droplets and putting your fingers in your mouth or nose. It’s one of the reasons why kids develop RSV more than adults.
Once you contract RSV, symptoms generally follow a lifecycle, with most people recovering within a few days of becoming symptomatic.
Asymptomatic
Once RSV enters your body, it takes time for it to multiply. You will likely be asymptomatic, meaning you’re not experiencing any symptoms, during this time.
Initial RSV symptoms develop 4-6 days after the virus enters your lungs. At the end of this time, you may start experiencing classic RSV symptoms, including a headache, a low-grade fever, congestion, and a sore throat.
Symptomatic
RSV symptoms will likely progress to a thicker cough, a stuffier nose, and a higher fever. If you are an adult, you will generally have these symptoms for a few days.
Young children and infants may take a few more days to overcome their symptoms, but typically recover successfully at home. Most children (and adults) do not experience serious illness or long-term complications due to RSV.
Hospitalization
While more than 2.1 million children are treated for RSV in the U.S. each year, about 58,000-80,000 children ages 5 and under require hospitalization.
They may develop severe symptoms like wheezing, shortness of breath, or fevers over 104 degrees.
One in five kids admitted to a hospital with RSV needs to go to the intensive care unit (ICU) to treat these symptoms. However, children and infants hospitalized with RSV typically go home after 3-4 days.
Childhood RSV hospitalization levels are rising, however, the percentages of child hospitalization are still relatively low compared to how many children contract the virus each year.
Approximately 177,000 adults are hospitalized each year for RSV, with most cases affecting people ages 65 and over.
Complications
Complications are rare for children and even less common in adults. They occur when RSV causes organ or tissue damage due to cellular inflammation, mostly after hospitalization or ICU care.
Symptoms of this damage include long-term low oxygen intake with each breath, neurological complications like seizures, and anemia.
It’s always good to contact your healthcare provider when you feel sick.
Some extreme symptoms warrant immediate emergency evaluation, such as experiencing a high fever or shortness of breath. You may notice that your oxygen level is low if you see discoloration in your skin or lips:
- If you have lighter skin, you may notice that your skin or lips appear blue if you can’t get enough oxygen with each breath.
- If you have darker skin, you may notice your skin or lips appear gray.
If your case is severe and you need to go to the emergency room, you may be given intravenous (IV) fluids and humidified oxygen (O2) to make you more comfortable.
Questions To Ask a Provider
When you contact your healthcare provider, these questions may guide your conversation to make RSV recovery easier:
- Is RSV spreading in my community?
- Is my cough a sign of RSV, or something else?
- How long should my child or I stay home from work or school?
Infants younger than 8 months of age may receive Beyfortus (nirsevimab), an RSV antibody injection (vaccine) that reduces hospitalization by 76%.
Children younger than 24 months may also receive the vaccine Synagis (palivizumab). It prevents severe RSV symptoms in children in 70% of cases and prevents hospitalization 82% of the time.
Both medications require continuous doses and may be more effective for kids with compromised immune systems.
The U.S. Food and Drug Administration (FDA) approved the Arexvy (RSVPreF3 antigen-AS01E) vaccine in 2023 for adults aged 60 and older. It has an 82% efficacy rate against RSV.
