Respiratory syncytial virus causes infections of the lungs and respiratory tract. It is so common that most children are already infected with the virus by the time they are about 2 years old. Respiratory syncytial virus can also infect adults.
In healthy adults and older children, the symptoms of respiratory syncytial virus are mild and often resemble the common cold. Generally, you just need self-care measures to ease the discomfort.
Respiratory syncytial virus can cause serious infection in some people, including children 12 months of age and younger, especially premature babies and the elderly, people with heart and lung disease, or people with weak immune systems.
Signs and symptoms of respiratory syncytial virus most often appear four to six days after exposure to the virus. In adults and older children, RSV usually causes cold symptoms. These symptoms may include:
stuffy or runny nose
Respiratory syncytial virus can spread to the lower respiratory tract, causing pneumonia or bronchiolitis, an inflammation of the small airways that enter the lungs. Signs and symptoms may include:
wheezing, a high-pitched sound usually heard when exhaling
rapid breathing or shortness of breath – the person may prefer to sit rather than lie down
bluish skin color due to lack of oxygen (cyanosis)
Infants are more severely affected by RSV. Signs and symptoms of severe RSV infection in children include:
shallow, short, rapid breathing
severe difficulty breathing – pectoral muscles and skin are drawn in with each breath
unusual tiredness (lethargy)
Most children and adults recover within one to two weeks, although some may have recurrent wheezing. A serious or fatal infection requiring hospitalization can occur in premature babies or in people with heart problems or chronic lung disease.
Since respiratory syncytial virus and coronavirus disease 2019 (COVID-19) are both types of respiratory viruses, some symptoms of respiratory syncytial virus and coronavirus disease 2019 may be similar. In children, coronavirus disease 2019 often presents with mild symptoms such as fever, runny nose, and cough. In adults with coronavirus disease 2019, symptoms may be more severe and include breathing problems.
The presence of respiratory syncytial virus can lower immunity and increase the risk of contracting coronavirus disease 2019 in children and adults. These infections can coexist, which can exacerbate the severity of the 2019 coronavirus disease.
If you have symptoms of a respiratory illness, your doctor may recommend that you get tested for the 2019 coronavirus disease.
Seek medical attention right away if your child — or anyone at risk for a severe RSV infection — has difficulty breathing, a fever, or bluish skin, especially the lips or around the nails.
Your doctor may suspect you have respiratory syncytial virus based on the results of a physical examination and the time of year when symptoms appear. During the examination, the doctor may listen to the lungs with a stethoscope for wheezing or other abnormal sounds.
Laboratory tests or imaging studies are usually not required. But they can help diagnose complications of respiratory syncytial virus or rule out other conditions that can cause similar symptoms. Here are some of the tests:
blood tests to check the white blood cell count or to determine if viruses, bacteria, and other germs are present
chest x-ray to check for pneumonia
swabs of secretions from the mouth or nose to check for signs of the virus
pulse oximetry, a painless monitor on the skin, to detect lower than normal levels of oxygen in the blood
Treatment for respiratory syncytial virus usually includes self-help measures to make your child more comfortable (additional care). However, in case of severe symptoms, hospital treatment may be required.
Your doctor may recommend over-the-counter medications such as acetaminophen (Tylenol and others) to help reduce fever. (Never give your child aspirin.) Saline nasal drops and a suction cup will help clear nasal congestion. A doctor may prescribe an antibiotic if there is a bacterial complication, such as bacterial pneumonia.
Make sure your child is as comfortable as possible. Offer plenty of fluids and watch for signs of fluid loss (dehydration), such as dry mouth, little or no urine output, sunken eyes, extreme agitation or drowsiness.
If the RSV infection is severe, a hospital stay may be required. Hospital treatment may include:
respirator (ventilator), rarely
Inhalers (bronchodilators) or steroids do not help with respiratory syncytial virus infection.