Respiratory syncytial virus (RSV) is a very common and contagious viral infection that can cause symptoms ranging from mild to severe.
RSV season seems to get longer and more serious each year.
While not a threat to most adults, RSV disease can lead to a serious lung infection called bronchiolitis in some children. RSV is the leading cause of hospitalizations of infants around the world each year.
“When adults get RSV, they just get kind of a cold. They don’t typically get tested for it, and they usually don’t even go to the doctor,” said Brian Curtis, MD. Board certified in internal medicine and a vice president of clinical specialties for OSF HealthCare, Dr. Curtis has seen the impact of RSV infection.
Why children are different
Children respond differently to illnesses like RSV.
“They have a younger immune system that’s very reactive. They also have smaller airways all the way to the bottom of their lungs. When they get filled with mucus, they can get in a lot more trouble than adults do,” Dr. Curtis said.
Any child younger than grade-school age could be at risk of complications from RSV. But, in general, the highest risk is for those who are the youngest.
Children under 1 year old are generally considered high risk for complications from RSV, as are those with certain medical conditions, including:
- Prematurity (born before 37 weeks gestation)
- Lung and heart problems
- A compromised immune system because of illness or medical treatment
RSV symptoms in babies
Babies are at highest risk when it comes to severe cases of RSV. Look for these symptoms:
- Cold symptoms – runny nose, sneezing
- Trouble breathing
- Extreme tiredness
- Loss of appetite
- Pauses in breathing
- Short, rapid breathing
RSV cough sounds like a wet, forceful cough. It sometimes may sound like a barky cough. Your baby may also have wheezing and labored breathing. RSV causes mucus to form in the chest, so their cough may also sound wet and rumbly.
RSV in adults
RSV looks a little different for adults. And even though it may not affect adults as severely, they should still stay away from those with weakened immune systems, including children and the elderly.
Signs of RSV in adults include:
- Mild cough
- Mild fever
- Sore throat
- Stuffy or runny nose
If you’re experiencing these symptoms, consider making an appointment with your primary care provider to get tested.
For older adults at higher risk of serious infection, other complications can arise. Severe cases of RSV can cause bronchitis and pneumonia. It can also further complicate existing health conditions, such as heart disease.
What is the difference between croup and RSV?
Cases of croup and RSV have similar symptoms. One of the main symptoms of croup is a barking cough. And like RSV, croup is contagious.
However, an RSV cough is lower in the respiratory tract while a croup cough is higher in the chest. You should be able to tell by listening to your child’s cough.
If it sounds like it’s coming from deeper or lower in their chest, it’s more likely to be RSV. If their cough sounds like it’s coming from the top of the lungs and airway, it’s more likely to be croup. Croup cough sounds like a barking animal – like a seal.
Because RSV is caused by a virus, it cannot be treated with antibiotics. Treatment instead is focused on relieving symptoms and keeping children as comfortable as possible while their immune system fights off the virus.
If your child has only mild symptoms, try to keep them comfortable at home. Keep them out of school and their child care centers until their RSV passes. If your child has a fever, check with your pediatrician or family doctor about what medications you can safely use.
You can also use nasal suction (a saline spray or suction tool) to keep their nose and airways clear. This is especially important when they are sleeping and eating.
When to see a doctor
Is it RSV?
“If you start to worry about your child breathing on their own, or if they seem like they are spending all their energy on breathing, that would be a worrisome symptom and reason to seek medical attention,” Dr. Curtis said.
Chest retractions are a hallmark sign of difficulty breathing. If you can see the lines between your child’s ribs, a pronounced line between their ribs and stomach, a notch between their clavicles (collarbones) or their skin pulls in toward the lungs with each breath, they should be seen by a medical provider immediately.
“The most significant thing you can look out for in kids who are under 6 months old would be pauses in breathing. If it’s 15 to 20 seconds, that could be very worrisome, and you should seek medical attention immediately,” Dr. Curtis said.
You should also be on the lookout for signs of dehydration: fewer than four wet diapers in a day or a significant decrease in how much your child is eating, drinking or urinating.
How long does RSV last?
How long RSV lasts depends on the severity of the case. For some, it lasts between five days and a week. For others, symptoms linger for weeks.
How to avoid RSV
To keep from getting RSV:
- Wash your hands, especially when you are caring for a very young infant.
- Keep young children away from others (adults or children) who show signs of illness. For children under 2 months of age, even mild illnesses like colds or sniffles could be dangerous.
- Don’t send your child to daycare if they are sick. Children can safely go to daycare once their symptoms are improving and they do not have a fever.
If you’re often around children, take as many RSV precautions as possible to stay healthy and prevent RSV.
The monoclonal antibodies in the vaccinations help create immunity to RSV.
Last Updated: December 1, 2023