RSV (Respiratory Syncytial Virus)
RSV is a common virus similar to a cold. It usually causes mild symptoms, but this past fall more children in the U.S. got sick enough to go to hospitals.
Health experts think RSV was a bigger problem in 2022 because many children under 5 were not in daycare or school the previous two years. With less exposure to other people, their immune systems weren’t as used to fighting viruses.
If your child does not have serious symptoms, contact your provider before coming to the emergency room. If you don't have a provider, you can call OHSU at 833-647-8222 with questions, 8 a.m. to 8 p.m. seven days a week. You can also visit 211info.org or call 211.
What is RSV?
RSV, also called respiratory syncytial virus, infects the nose, throat and lungs. About 2 million children under 5 get it each year. Most children have had an RSV infection by age 2.
In babies and young children, RSV is the top cause of serious lung disease, such as pneumonia and bronchiolitis.
RSV is usually most common in fall and winter. Last year it began spreading in late summer.
How RSV spreads
RSV spreads through:
- Droplets, such as when an infected person coughs, sneezes or talks.
- Direct contact with:
- Someone who has RSV.
- Something with the virus on it. RSV can survive for many hours on hard surfaces and for 30 minutes on unwashed hands.
How long people with RSV are contagious
People with RSV are usually contagious for three to eight days. They can be contagious a day or two before they show symptoms. Babies and people with weakened immune systems (immunocompromised) who get the virus can spread it for up to a month.
Caring for a child with RSV
Most children can recover at home over a week or two.
Seek emergency care for your child if:
- The inside of the child’s mouth is blue
- Their breathing is extremely labored (see "How hard is your baby breathing? What to look for")
- They aren’t taking in or holding down fluids and haven’t urinated in eight hours
- They are severely lethargic and you are struggling to wake them
Call your primary care doctor if your child:
- Has symptoms that are getting worse or not improving after seven days
- Is younger than 3 months (12 weeks) and has a fever (with a rectal temperature of 100.4 degrees F or higher)
- Has a fever that rises above 104 degrees F repeatedly
- Is having trouble sleeping
- Is very fussy
- Has chest pain
- Is tugging at the ears or has fluid or wax draining from the ears
If you don't have a doctor: Call OHSU at 833-647-8222. We can answer your questions 8 a.m. to 8 p.m. seven days a week.
Same-day care at OHSU: Find care for all ages in person or virtually.
RSV symptoms show up four to six days after someone gets infected.
Cold symptoms usually appear first. They include:
- Runny or stuffy nose
- Low appetite
- Fussiness in babies and toddlers
Cold symptoms may be followed by symptoms of pneumonia or bronchiolitis, both lung infections. These symptoms include breathing that:
- Is faster than normal
- May include:
- Flaring nostrils and nodding head
- Ribs pulling in with each breath
Care and treatment of RSV
Care at home
Most of the time, RSV can be treated at home and goes away on its own in a week or two. OHSU experts suggest:
- Eating regularly.
- Drinking lots of fluids.
- Plenty of sleep.
- Treating pain or fever with:
- Acetaminophen (Tylenol).
- Ibuprofen (Advil, Motrin or PediaCare).
- (Note: Aspirin should not be given to children.)
- Babies may need mucus cleared from their noses with a bulb syringe.
When to call a doctor for RSV
Someone with RSV should see a doctor if:
- They have trouble breathing or are wheezing.
- They have trouble eating because they aren’t breathing normally.
- They are very inactive or not alert.
- They are dehydrated:
- Their urine is dark yellow.
- Babies and toddlers stay dry longer than usual.
- Their skin, lips, tongue or nails are turning blue.
- Their symptoms don't improve after a couple of weeks.
To avoid getting or spreading RSV, health experts suggest:
- Washing hands often.
- Not touching the face.
- Covering coughs and sneezes.
- Avoiding sick people.
- Cleaning and disinfecting frequently used surfaces and items, including toys.
- Not sharing eating utensils.
- Staying home if you have symptoms.
- Wearing a mask in indoor public spaces.
- Staying in well ventilated public spaces.
- Staying up to date on vaccines, including flu and COVID-19 vaccines.
- Keeping babies away from frequent visitors and crowds.
Is there an RSV vaccine?
In May, the FDA approved an RSV vaccine for adults ages 60 and older. The vaccine maker, GSK, said it plans to release the vaccine in the fall, before the next RSV season.
The vaccine is called Arexvy.
In healthy adults, RSV is similar to a cold. But RSV can move into the lungs and cause pneumonia in adults who:
- Are older.
- Have heart or lung conditions.
- Have weakened immune systems (immunocompromised).
Other RSV vaccines are in the works, including one that could be given to pregnant people to protect their newborns. RSV is the top reason children under age 1 end up in the hospital.
Who’s most at risk for RSV
Health officials are most concerned about:
- Children who are younger than 2, especially those:
- Under 6 months.
- Who were born early.
- Had a low birth weight.
- Have neuromuscular disorders, including those who have trouble swallowing or clearing mucus.
- People with chronic heart and lung disease.
- People with weakened immune systems.
- Adults 65 and older.
- Respiratory syncytial virus infection (RSV), CDC
- RSV in infants and young children, CDC
- RSV, The Conversation
RSV: When It's More Than Just a Cold, American Academy of Pediatrics