Respiratory syncytial virus (RSV) is a viral infection that causes symptoms of a cold, such as a runny nose, fever, and cough. Usually, this common infection resolves on its own without causing any serious consequences.
However, people who have a weakened immune system—such as young babies, older adults, or people who take immunosuppressants—can have a severe RSV infection.
RSV is the most common cause of inflammation in the small airways of the lungs and pneumonia in babies. It’s so common, most children get the virus by age 2. This article focuses on how the symptoms present in adults (which are typically mild and mimic the common cold), as well as the impact on children.
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What Are the First Signs of RSV?
Typically, RSV causes symptoms that may last several days and up to a few weeks. The condition is highly contagious. It can be transmitted to children and adults who have been around other people with RSV infection.
Because RSV is contagious before it becomes symptomatic, you may not know you have been exposed to this common virus until you develop symptoms.
Early symptoms of RSV infection in children and adults include:
- Runny, stuffy nose
- Low-grade fever
- Fatigue and feeling rundown
- Sore throat
- Decreased appetite
You may have one or two days of noticeable symptoms. Some people may experience a few lingering symptoms for longer than that.
RSV Symptoms in Kids
Kids can have the same symptoms as adults, but very young children cannot usually express their discomfort or describe their symptoms. Children can also show other signs of RSV that parents may notice.
Signs to look out for in babies and children include:
- Irritability, fussiness, crying
- Diminished interest in playing or interacting with others
- Avoiding food or drinks
- Quieter than usual
- Sleeping for longer than usual
- Trouble sleeping and frequently waking up
If your child has any of these symptoms, contact a healthcare provider.
Symptoms in Severe Cases
In general, RSV is an upper respiratory tract infection. This means that it affects the sinuses, nasal passages and throat without spreading down into the lungs.
While it’s not common, RSV can cause a lower respiratory tract infection involving the lungs, or the infection may spread to other areas of the body beyond the respiratory tract. If this happens, you may need medical care in the hospital.
Less common symptoms of RSV may include:
- Grunting or other noises when breathing
- Rapid, shallow breaths
- Trouble catching your breath
- Difficulty breathing
- Pauses in breaths
- Chest pain, especially when taking a breath
- Retractions of the chest while breathing (the chest muscles appear to “pull in" with breaths)
- High fever, over 102 degrees F
- Dehydration, with dry mouth, lightheadedness, rapid pulse, and low amount of urine
- Lingering symptoms lasting for weeks or longer
- Lethargy and decreased responsiveness
If you or your child is having symptoms that are not typical, or if symptoms are causing substantial concern or discomfort, it is important that you call a healthcare provider for advice.
RSV Can Cause More Serious Health Problems
When RSV leads to medical complications, it can be life-threatening. This can happen if the infection spreads beyond the upper respiratory tract.
Complications of RSV can include:
- Dehydration: You might not be drinking enough fluids if you have a diminished appetite, and this may cause dehydration. Symptoms can include lightheadedness, dry mouth, and decreased urination.
- Pneumonia: A lung infection may cause difficulty breathing, fatigue, or coughing up blood.
- Bronchitis: An infection of the airways may cause low oxygen in the body.
- Bronchiolitis; An infection of the small airways of the lungs can cause symptoms similar to those of pneumonia and bronchitis.
- Meningitis: An infection that spreads to the fluid and lining around the brain can cause headaches and a stiff neck.
- Septicemia and sepsis: Septicemia is an infection that spreads to the blood, and sepsis is a severe systemic reaction to infection throughout the body. This can cause loss of consciousness and organ failure.
- Encephalitis: An infection of the brain tissue may cause confusion or seizures.
Complications of RSV infection are rare. You could be at a higher risk of complications if you have an underlying health problem, such as immune deficiency due to medication, cancer, human immunodeficiency virus (HIV), chronic liver disease, or another immune disorder. Additionally, very young babies and older adults could be at a higher risk of complications.
High Risk of RSV Complications
It’s important to call your healthcare provider if your child has symptoms of a cold and is younger than 1 year of age, has a heart or lung condition, or has a neuromuscular condition.
Adults who have symptoms of a cold and who have a weak immune system or a chronic medical condition should contact their healthcare provider.
How Do You Know It’s RSV?
Most of the time, RSV is diagnosed based on symptoms. In these cases, your healthcare provider might listen to your description of your symptoms and do a physical examination. While they might suggest that you could have RSV, the exact virus can't be verified without a laboratory test.
Because there isn't a specific treatment for the virus and the infection usually resolves on its own, it's usually not necessary to identify the virus. Sometimes laboratory testing is done to identify the virus. This can include a viral culture, antigen test, or real-time reverse transcription-polymerase chain reaction (rRT-PCR).
How RSV Is Treated?
In general, treatment for RSV is symptomatic. This means that the symptoms are managed, and there is no treatment that can kill the virus or shorten the duration of the illness.
If complications occur, then medical management in a hospital is necessary. Hospital treatment may include:
- Intravenous (IV) fluid and electrolyte supplementation for treating dehydration
- Oxygen supplementation for low oxygen due to pneumonia or bronchitis
- Respiratory support for severe breathing difficulties
- Control of blood pressure and heart rate for managing the effects of sepsis
You would need close medical monitoring while being treated in the hospital, and the results can guide your healthcare providers in adjusting your care. This includes having your blood pressure, pulse, respiratory rate, oxygen saturation, and blood tests checked.
How to Relieve RSV Symptoms at Home
If you or your child has a mild case of RSV, you will not need medical treatment. It can be a good idea to call your healthcare provider if you have any concerns, but you will likely be able to manage your symptoms at home.
It's important to take time to rest. This means staying home from work or school, taking it easy, and sleeping if you need to. Your infection should clear up within a few days, or up to two weeks.
Things you can do at home for comfort as you recover:
- Take sips of water or other drinks to prevent dehydration.
- Use cough drops if you are coughing or if your throat feels sore.
- Wear comfortable clothes, socks, and cover up with a cozy blanket if that feels good.
- Don't forget to eat. Consider warm soup, crackers, or whatever doesn't bother your throat or your stomach.
- Adults may use over-the-counter (OTC) Tylenol (acetaminophen) or Advil (ibuprofen) to treat a fever. Consult with your child's healthcare provider for advice on treating a fever.
When to See a Healthcare Provider
It’s important to know when you should seek medical care. If you have any concerns about your symptoms or your child’s symptoms, you should call your healthcare provider. They will advise you regarding treatment, making an appointment, or getting emergency care.
Certain symptoms indicate a medical emergency. Get prompt medical attention if you or your child experiences any of the following:
- Decreased responsiveness
- Diminished level of consciousness
- Severe neck pain or neck stiffness
- Back pain
- Coughing up blood
- Low output of urine
- Dizziness or light-headedness
- Feeling like you have a fast pulse or a rapid heartbeat
- Passing out
- A seizure
These symptoms are indicative of a severe, dangerous infection. If you have any of these symptoms, you will need to have prompt medical evaluation and treatment. You should call 911 or go to the nearest urgent care center or emergency room.
RSV is a common viral respiratory infection that causes symptoms of a typical cold. You can expect symptoms to get better a few days after they begin. Sometimes, mild, lingering symptoms can last up to a few weeks.
Very young babies, older adults, or people with weak immune systems are at a high risk of complications. Symptoms of complications can include a stiff neck, fever, coughing up blood, or diminished responsiveness.
Talk to your healthcare provider if your symptoms seem to be getting worse or lingering for longer than expected. If you develop shortness of breath or signs of serious complications, getting prompt medical attention is important.