How RSV Spreads
RSV can spread when:
- An infected person coughs or sneezes
- You get virus droplets from a cough or sneeze in your eyes, nose, or mouth
- You touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands
- You have direct contact with the virus, like kissing the face of a child with RSV
People infected with RSV are usually contagious for 3 to 8 days. However, some infants, and people with weakened immune systems, can continue to spread the virus even after they stop showing symptoms, for as long as 4 weeks.
Children are often exposed to and infected with RSV outside the home, such as in school or child-care centers. They can then spread the virus to other members of the family.
RSV can survive for many hours on hard surfaces, like tables and crib rails. It typically lives on soft surfaces such as tissues and hands for shorter amounts of time.
In the United States, RSV infections generally occur during fall, winter, and spring. The timing and severity of RSV circulation in a given community can vary from year to year.
Prevention
Take steps to help prevent the spread of RSV:
- Wash your hands often
Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer. Washing your hands will help protect you from germs.
- Keep your hands off your face
Avoid touching your eyes, nose, and mouth with unwashed hands. Germs spread this way.
- Avoid close contact with sick people
Avoid close contact, such as kissing, and sharing cups or eating utensils with people who have cold-like symptoms.
- Cover your coughs and sneezes
Cover your mouth and nose with a tissue or your upper shirt sleeve when coughing or sneezing. Throw the tissue in the trash afterward.
- Clean and disinfect surfaces
Clean and disinfect surfaces and objects that people frequently touch, such as toys, doorknobs, and mobile devices. When people infected with RSV touch surfaces and objects, they can leave behind germs. Also, when they cough or sneeze, droplets containing germs can land on surfaces and objects.
- Stay home when you are sick
If possible, stay home from work, school, and public areas when you are sick. This will help protect others from catching your illness.
Specifically, if you have cold-like symptoms you should:
- Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands
- Wash your hands often with soap and water for at least 20 seconds
- Avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others
- Clean frequently touched surfaces such as doorknobs and mobile devices
Ideally, people with cold-like symptoms should not interact with and should refrain from kissing children at high risk for severe RSV disease. If this is not possible, they should carefully follow the prevention steps mentioned above and wash their hands before interacting with such children.
Preventative Medicine
A drug called palivizumab (pah-lih-VIH-zu-mahb) is available to prevent severe RSV illness in certain infants and children who are at high risk for severe disease. The drug can help prevent serious RSV disease, but it cannot help cure or treat children already suffering from serious RSV disease, and it cannot prevent infection with RSV.
If your child is at high risk for severe RSV disease, talk to your healthcare provider to see if palivizumab can be used as a preventive measure.
Vaccines
Researchers are working to develop RSV vaccines, but none are available yet.
Symptoms
Call your healthcare professional if you or your child is having difficulty breathing, not drinking enough fluids, or experiencing worsening symptoms.
People infected with RSV usually show symptoms within 4 to 6 days after getting infected. Symptoms of RSV infection usually include:
- Runny nose
- Decrease in appetite
- Coughing
- Sneezing
- Fever
- Wheezing
These symptoms usually appear in stages and not all at once.
In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties.
Adults can sometimes get RSV infections and not have symptoms.
RSV can cause more serious health problems
RSV can also cause more severe infections:
- Bronchiolitis, an inflammation of the small airways in the lung
- Pneumonia, an infection of the lungs.
Healthy adults and infants infected with RSV do not usually need to be hospitalized. But some people with RSV infection, especially older adults and infants younger than 6 months of age, may need to be hospitalized if they are having trouble breathing or are dehydrated. In the most severe cases, a person may require additional oxygen or intubation (have a breathing tube inserted through the mouth and down to the airway) with mechanical ventilation (a machine to help a person breathe). In most of these cases, hospitalization only lasts a few days.
Care
Most RSV infections go away on their own in a week or two.
There is no specific treatment for RSV infection, though researchers are working to develop vaccines and antivirals (medicines that fight viruses).
Take steps to relieve symptoms
- Manage fever and pain with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. Never give aspirin to children.
- Drink enough fluids. It is important for people with RSV infection to drink enough fluids to prevent dehydration (loss of body fluids).
- Talk to your healthcare provider before giving your child nonprescription cold medicines. Some medicines contain ingredients that are not good for children.
RSV in Infants and Young Children
Virtually all children get an RSV infection by the time they are 2 years old. Most of the time RSV will cause a mild, cold-like illness, but RSV can be dangerous for some infants and young children.
Those at greatest risk for severe illness from RSV include:
- Premature infants
- Very young infants, especially those 6 months and younger
- Children younger than 2 years old with chronic lung disease or congenital (present from birth) heart disease
- Children with weakened immune systems
- Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions
Severe Illness
RSV can cause severe illness in children and infants such as:
- Bronchiolitis, an inflammation of the small airways in the lung
- Pneumonia, an infection of the lungs
RSV is the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age.
One to two out of every 100 children younger than 6 months of age with RSV infection may need to be hospitalized. Those who are hospitalized may require oxygen, intubation, and/or mechanical ventilation (help with breathing). Most improve with this type of supportive care and are discharged in a few days.
Symptoms
RSV may not be severe when it first starts. However, it can become more severe a few days into the illness. Early symptoms of RSV may include:
- Runny nose
- Decrease in appetite
- Cough, which may progress to wheezing
Infants who get an RSV infection almost always show symptoms. This is different from adults who can sometimes get RSV infections and not have symptoms. In very young infants (less than 6 months old), the only symptoms of RSV infection may be:
- Irritability
- Decreased activity
- Decreased appetite
- Apnea (pauses while breathing)
Fever may not always occur with RSV infections.
What you should do if your child is at high risk for severe RSV infection
If you have contact with an infant or young child, especially those who were born prematurely, are very young, have chronic lung or heart disease or a weakened immune system, you should take extra care to keep the infant healthy.
Parents of children at high risk for developing severe RSV disease should help their child, when possible, do the following:
- Avoid close contact with sick people
- Wash their hands often with soap and water for at least 20 seconds
- Avoid touching their face with unwashed hands
- Limit the time they spend in child-care centers or other potentially contagious settings, especially during fall, winter, and spring. This may help prevent infection and spread of the virus during the RSV season
See the Prevention section on this page for more information.
RSV in Older Adults and Adults with Chronic Medical Conditions
When an adult gets RSV infection, they typically have mild cold-like symptoms. RSV infections can be dangerous for certain adults, including:
- Older adults, especially those 65 years and older
- Adults with chronic heart or lung disease
- Adults with weakened immune systems
Older adults are at greater risk than young adults for serious complications from RSV because our immune systems weaken when we are older.
Severe Illness
RSV can sometimes lead to serious conditions such as:
- Pneumonia (infection of the lungs)
- More severe symptoms for people with asthma
- More severe symptoms for people with chronic obstructive pulmonary disease (COPD) (a chronic disease of the lungs that makes it hard to breathe)
- Congestive heart failure (when the heart can’t pump blood and oxygen to the body’s tissues)
Older adults who get very sick from RSV may need to be hospitalized. Some may even die.
What you should do if you or a loved one is at high risk for severe RSV disease
If you are at high risk for severe RSV infection, or if you interact with an older adult, you should take extra care to keep them healthy. See the Prevention section on this page.
Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus, a virus that affects the lungs and breathing passages. It usually causes mild, cold-like symptoms.
