Department Resources

Respiratory Syncytial Virus (RSV)

Help protect yourself and your loved ones from RSV infection.

Two smiling grandparents hold a young grandchild 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.

RSV is very contagious, virtually all children get an RSV infection by the time they are 2 years old.

Most people who get an RSV infection will have mild illness and will recover in a week or two. However, some groups are more likely to get serious complications if they get sick with RSV. These include:

Premature infants
Very young infants (6 months and younger)
Young children with congenital (from birth) heart or chronic lung disease
Young children with weakened immune systems due to a medical condition or medical treatment
Adults with compromised immune systems
Older adults (65 years and older)

Situation Summary: December 2023

There are new tools available to protect those most vulnerable to RSV. The CDC recommends and the the Health Department encourages RSV immunization to protect babies and older adults.

See What to Know About the New RSV Immunizations to learn more and talk to your health care provider about what is right for you and your baby.
See and share the Protecting Infants from RSV fact sheet: English | Amharic / አማርኛ | Arabic / العربية | Chinese / 中文 | Farsi / فارسی | Korean / 한국어 | Spanish / Español | Urdu / اردو | Vietnamese / Tiếng Việt

Limited Availability of Nirsevimab

Because RSV immunizations are new, it may take time for Nirsevimab, a monoclonal antibody immunization recommended for infants under 8 months, to become widely available at health care providers' officers.

We are aware that parents have found it challenging to find appointments. We also understand that not all pediatricians or medical providers plan to carry this immunization. We continue to encourage providers, through our partnerships with the Northern Virginia Chapter of the American Academy of Pediatricians and other medical provider groups, to consider offering these immunizations to those whom it is recommended.

The Health Department generally provides immunizations for individuals who are uninsured, underinsured, or children who are enrolled in the Vaccine for Children (VFC) program. We are planning to have a supply of RSV immunizations for clients under 8 months of age in early December.

As RSV vaccine supplies, and a demand for it, continue to grow, we encourage parents and guardians to remain in touch with their health care providers.

Actions Everyone Can Take

While immunizations will not stop RSV from spreading in our community, they will protect those people most vulnerable to severe illness. Everyone can continue to help limit the spread of RSV, and other respiratory illnesses, by practicing healthy habits, including washing hands, covering coughs and sneezes, cleaning frequently touched surfaces, and staying home when sick.

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.

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.

RSV Immunization

There are new tools to help protect against RSV. Visit the CDC RSV Prevention website to learn more. Additional details about RSV immunizations, recommendations, and how to pay for them is also available, see the:

RSV vaccine for older adults

Learn more about RSV Prevention.

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.

Most RSV infections go away on their own in a week or two. There are steps you can take to relieve symptoms, including:

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.

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.

The CDC recommends immunization to prevent severe RSV in all infants and young children during RSV season.

There are two options to protect babies from RSV: vaccination during pregnancy or antibody immunization for infants. Most babies only need one.

What	Who	When	Why
Vaccine During Pregnancy (Abrysvo)	Pregnant Parent	At 32–36 weeks of pregnancy Usually September–January	Passes protection from severe RSV to baby during pregnancy that will last through first months of life.
RSV monoclonal antibody immunization (Nirsevimab)	Infants	Infants younger than 8 months born during – or entering – their first RSV season (fall through spring) Children 8 to 19 months who are at increased risk of severe RSV disease	Protects infants and young children from severe RSV for months following immunization.

A dose of RSV antibody is also recommended for the following children between the ages of 8 through 19 months entering their second RSV season:

Children who were born prematurely and have chronic lung disease requiring medical support .
Children with severe immunocompromise.
Children with cystic fibrosis who have severe disease.
American Indian and Alaska Native children.

Because RSV immunizations are new, it may take time for the monoclonal antibody immunization Nirsevimab to become widely available. Talk to your health care provider about what is best for you and your baby.

Additional Information

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.

CDC Fact Sheet: Older Adults are at High Risk for Severe RSV Infection | Spanish

RSV vaccines are now available to help protect adults 60 years and older from severe RSV illness.

Older adults are at greater risk than young adults for serious complications from RSV because immune systems weaken with age. In addition, certain underlying medical conditions may increase the risk of getting very sick from RSV. Older adults with certain conditions may especially benefit from getting RSV vaccine.

If you are 60 years and older, talk to your healthcare provider to see if RSV vaccination is right for you.

Additional Information

RSV Vaccination for Older Adults 60 Years of Age and Over

#FFXHealthFacts about RSV to share

RSV is a common respiratory virus that usually causes mild, cold-like symptoms, but can be serious for infants and older adults.
RSV infections can be dangerous for older adults, adults with chronic heart or lung disease, and adults with weakened immune systems.
RSV infections can be dangerous for premature infants, very young infants, children younger than 2 years of age with chronic lung or heart conditions, and children with weakened immune systems.
Help prevent the spread of RSV: stay home when you are sick and practice good hand and respiratory hygiene.
If you have cold-like symptoms, avoid contact and refrain from kissing children at high risk for severe RSV disease.
New RSV immunizations are available to protect babies and older adults.

protect infants and young children from RSV — Download image

Protect adults from RSV — Download image

Information for Healthcare Providers

On October 23, 2023, CDC released a health advisory notice to communicate interim recommendations regarding the limited supply of nirsevimab, the new preventive antibody to protect infants against severe RSV.

As we enter the time when RSV typically spreads, we encourage providers to

Consider carrying and providing these immunizations to those whom it is recommended
Consider RSV in patients with respiratory illness, particularly during the RSV season.

See information from the CDC:

Health Department

Health Department Alert:

Department Resources

Respiratory Syncytial Virus (RSV)