RSV (Respiratory Syncytial Virus)

A mother holding her baby

RSV is a common virus similar to a cold. It usually causes mild symptoms.

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. 

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.

RSV symptoms

RSV symptoms show up four to six days after someone gets infected. 

Cold symptoms usually appear first. They include:

  • Cough
  • Fever
  • Runny or stuffy nose
  • Sneezing
  • 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
    • Grunting
    • Wheezing
    • Ribs pulling in with each breath

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 a bluish tint
  • 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.

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 a bluish or gray tint (depending on skin color).
  • Their symptoms don't improve after a couple of weeks.

Preventing RSV

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?

Adults 60 and over and pregnant people

Abrysvo is an RSV vaccine for pregnant people and adults 60 and over.

Pregnant people: Abrysvo is approved for use between 32 and 36 weeks of pregnancy. It protects the infant from RSV for several months after delivery. 

Adults 60 and over: In healthy adults, RSV is similar to a cold. But RSV can move into the lungs and cause pneumonia in adults who:

  • Have heart or lung conditions.
  • Have weakened immune systems (immunocompromised).

OHSU offers Abrysvo. Find an OHSU pharmacy near you.

Learn more:  RSV vaccination for adults 60 years of age and over, CDC

Newborns, babies and at-risk children up to 2 years old

RSV immunization is recommended for:

  • Babies 8 months and under entering their first RSV season
  • Babies and children 8 to 19 months who are at high risk of severe RSV and entering their second RSV season

Talk to your provider if your baby or toddler is eligible this season.

Learn more: RSV immunization for babies and pregnant people, CDC

Who’s most at risk for RSV?

Health officials are most concerned about:

  • Children 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

Learn more