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Respiratory Syncytial Virus Infections
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Lungs Breathing

Respiratory Syncytial Virus Infections

Respiratory syncytial virus (RSV) is a common virus that typically causes mild, cold-like symptoms but can lead to severe lung infections in vulnerable populations.

Overview

Respiratory syncytial virus (RSV) is a common respiratory virus. While it often results in mild symptoms, it can cause serious lung infections, particularly in infants, older adults (65+), and individuals with chronic heart or lung disease or weakened immune systems.

Transmission

RSV spreads through the air via coughing and sneezing, direct contact (such as kissing), or touching contaminated surfaces and then touching the eyes, nose, or mouth. Infected individuals are typically contagious for 3 to 8 days, though infants and those with weakened immune systems may remain contagious for up to 4 weeks.

Symptoms

Symptoms usually appear 4 to 6 days after infection and often develop in stages:

  • Runny nose
  • Decreased appetite
  • Cough
  • Sneezing
  • Fever
  • Wheezing

In infants, symptoms may manifest only as irritability, decreased activity, and breathing difficulties. Severe cases can lead to bronchiolitis (inflammation of small airways) or pneumonia (lung infection).

Diagnosis

Providers diagnose RSV through a medical history, physical exam, and lab tests of nasal fluid or respiratory specimens. In severe cases, chest x-rays or blood and urine tests may be used to check for complications.

Treatment & Management

There is no specific treatment for RSV; most infections resolve on their own within one to two weeks. Management focuses on:

  • Over-the-counter pain relievers (Note: Do not give aspirin to children or cough medicine to children under four).
  • Ensuring adequate fluid intake to prevent dehydration.
  • Hospitalization for severe cases, which may include oxygen, breathing tubes, or ventilators.

Prevention

Preventive measures include vaccines for adults 60 and older and for pregnant individuals (between 32 and 36 weeks) to protect newborns. Specialized medicines (injections) are available for infants and high-risk children to prevent severe illness. General hygiene steps include:

  • Washing hands frequently with soap and water for at least 20 seconds.
  • Avoiding touching the face with unwashed hands.
  • Avoiding close contact with sick individuals.
  • Cleaning and disinfecting frequently touched surfaces.
  • Covering coughs and sneezes.
  • Staying home when sick.

Frequently Asked Questions

Most children are contagious for three to eight days after symptoms begin, but infants and children with weakened immune systems can remain contagious for up to four weeks. Return to daycare policies vary, but generally, a child should be fever-free for at least 24 hours without the use of fever-reducing medication and should be able to participate in normal activities. Because RSV spreads easily through droplets and surfaces, many facilities require a note from a healthcare provider confirming the child is no longer highly infectious, especially if they have had severe symptoms like wheezing or difficulty breathing.
RSV vaccines are highly effective at preventing severe lower respiratory tract disease, hospitalization, and death in adults aged 60 and older. Eligibility is broad, but healthcare providers may recommend the vaccine more strongly for those with chronic medical conditions such as heart disease, lung disease, diabetes, or a weakened immune system. The decision to vaccinate is based on shared decision-making between the patient and their doctor, considering the individual's health status and risk factors. It is important to note that the vaccine is not a treatment for an active RSV infection but is intended for prevention.
Parents should seek immediate care if an infant shows signs of respiratory distress, such as breathing faster than 60 times per minute, ribs pulling in with each breath, or nasal flaring. Other critical signs include grunting sounds when exhaling, a bluish tint to the lips or skin (cyanosis), and extreme lethargy or difficulty waking the baby for feeds. Dehydration is another serious concern; if the infant has fewer than four wet diapers in 24 hours or has no tears when crying, they may need urgent medical evaluation for fluid support.
No, over-the-counter cough and cold medicines are not recommended for children under four years of age and are generally not effective for RSV in older children either. These medications can cause serious side effects, including rapid heart rate, agitation, and seizures. The primary management for RSV is supportive care, which includes using a cool-mist humidifier to ease congestion, using saline nasal drops with a bulb syringe to clear the nose, and ensuring adequate fluid intake to prevent dehydration. Always consult a pediatrician before giving any medication to a child with a respiratory infection.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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