We're all familiar with headlines about COVID-19 and the flu, but there's a third, lesser-known virus sharing the spotlight, and it's especially tough on young children. RSV, short for respiratory syncytial (sin-SISH-uhl) virus, is an illness that usually causes cold-like symptoms, but can become severe depending on your age and the strength of your immune system.

In a typical year, RSV cases follow the same timeline as the flu — beginning in the fall and hanging around during the colder months when we're often indoors together. But recently it's made an unusual appearance in the early summer, puzzling the medical community. This unseasonable rise has left many parents with more questions than answers: What is this virus, and is my child at risk?

Below, we provide an overview on RSV — including symptoms, treatment, when to seek medical care, comparisons to other viruses and more.

What is respiratory syncytial virus (RSV)?

RSV is a common virus that affects the lungs and respiratory tract. Most people experience minor, cold-like symptoms and recover on their own with rest and self-care remedies, but it can be more serious for certain groups of people.

Why has RSV been on the rise?

RSV usually appears in the fall and winter months, so the medical community across the country was stumped to see a spike in the early summer last year. Experts suspect that relaxed COVID-19 precautions in the spring led to people having more in-person gatherings and practicing less caution about preventing illness.

Who typically gets it?

RSV commonly affects infants and young children, which is why it's often known as a childhood illness. In fact, nearly all children will have RSV by their second birthday.

However, anyone can contract the virus — so adults should do their best to stay healthy and take precautions to avoid spreading it to others.

Those at greatest risk for a severe infection include:

  • Babies born prematurely
  • Babies under 6 months old
  • Young children
  • Adults over 65
  • People with weakened immune systems
  • Those with heart or lung conditions (RSV can also worsen existing heart and lung conditions)

What causes RSV and is it contagious?

RSV is very contagious, especially during the week or so that someone is showing symptoms. And some babies and older adults can remain contagious for up to four weeks.

RSV is spread through contact with someone who is infected. When the sick person coughs or sneezes, tiny particles of the virus become airborne and can enter your body through your mouth, nose or eyes. It can also live on hard surfaces for hours, so you can get it by touching an object that has virus particles on it.

Unfortunately, there is no vaccine that can help prevent RSV yet, but scientists are working to develop one.

Is there a vaccine for RSV?

Unfortunately, there is no vaccine that can help prevent RSV yet, but scientists are working to develop one.

How long does RSV last?

Symptoms typically last less than a week, and most people are fully recovered within a week or two. However, those with more serious cases can take longer to recover and may require hospitalization for trouble breathing or dehydration.

RSV symptoms

RSV symptoms can start anywhere from 2-8 days after exposure to a sick person. One way to differentiate it from other cold and flu-like conditions is that RSV symptoms often come in phases, rather than appearing all at once.

Symptoms can include:

  • Sore throat
  • Cough
  • Runny nose
  • Headache
  • Fever
  • Fatigue
  • Wheezing
  • Sneezing
  • Decrease in appetite

Symptoms of severe RSV

Serious cases of RSV can lead to more dangerous conditions, including bronchiolitis (inflammation of the small airways in the lungs) and pneumonia (infection of the lungs). Symptoms of severe RSV include:

  • Severe cough
  • Difficulty breathing
  • Rapid breathing
  • Wheezing
  • Bluish color to the skin (from lack of oxygen)

Signs of RSV in babies

In addition to the symptoms listed above, specific signs of RSV in babies include increased irritability, unusual fatigue, decreased appetite, fever and pauses in breathing.

Because babies' immune systems are so new, they haven't developed the strength or immunity to fight off many illnesses. For that reason, infants under 6 months old are at a much higher risk for experiencing a more severe case of RSV.

An added challenge is that babies can't tell us how they're feeling. That's why it's important to watch our littlest ones closely and recognize the signs of illness.

What should I do if my child has symptoms of severe RSV?

According to the Centers for Disease Control and Prevention (CDC), RSV is the number one cause of bronchiolitis and pneumonia in children under the age of one in the United States.

Be vigilant in watching for these signs of severe RSV and contact a doctor right away if you notice the following worsening symptoms:

  • Difficulty breathing — short, shallow or rapid breaths (also look for chest muscles and skin pulling inward with each breath)
  • Nostrils flaring with each breath
  • Bluish coloring of the skin, lips or fingernails
  • Wheezing (a high-pitched sound during inhales can be a sign of bronchiolitis or pneumonia)
  • Decreased activity or alertness
  • Severe cough

Your child's care team can guide you toward the best next steps based on your child's unique symptoms. If you call during business hours, they may advise you to make a same-day appointment or visit your local urgent care. If it's after business hours and your child is having trouble breathing, take them to your chosen emergency room for immediate care.

You can also talk directly with one of our nurses 24/7, 365 days a year, free of charge. They can help you decide if it's time to see a doctor, as well as provide helpful home remedy advice. Call the HealthPartners CareLine℠ at 800-551-0859 or the Park Nicollet Nurse Line at 952-993-4665.

RSV in adults

Older children and adults can also get RSV. Fortunately, their symptoms tend to be milder. Signs of RSV in adults usually include the typical cough, runny nose, sore throat, fatigue and sometimes fever.

Adults over the age of 65 or those with health complications are at higher risk for developing more severe RSV. Serious cases can cause trouble breathing or dehydration and may lead to a hospital stay. RSV usually goes away on its own in a week or two, but if you’re sick longer, or your symptoms are getting worse instead of better, call your primary care doctor right away.

How is RSV different from other viruses?

RSV, COVID-19 and influenza are all respiratory viruses with overlapping symptoms. It can be tricky to tell the three apart, so we've created this table to help.

RSV vs. COVID-19

RSV and COVID-19 can be hard to distinguish because they have several respiratory symptoms in common, including cough, shortness of breath, sore throat, fever, headache, fatigue and runny nose.

But people with RSV don't typically experience a sudden loss of taste or smell, or the gastrointestinal symptoms of diarrhea, nausea or vomiting that can occur (especially among children) with COVID-19.

If you or your child are experiencing symptoms of COVID-19 (with or without known exposure), your doctor may recommend getting tested to rule it out.

RSV vs. influenza

RSV and influenza also share overlapping symptoms — including cough, sore throat, fever, headache, fatigue and runny nose — making it hard to know what you're dealing with.

One key difference between the two is that symptoms of influenza often appear suddenly, whereas RSV symptoms happen more gradually — and often in phases. Also, like COVID-19, it's common for some people with influenza to have gastrointestinal discomfort, like diarrhea, nausea or vomiting. Those symptoms aren't often seen in adults or children with RSV.

If your symptoms overlap with those of the flu, your doctor may recommend that you or your child get tested for influenza. If you do have the flu, your care team may be able to begin treating you with antiviral medications to help you recover more quickly.

Treatment for RSV

While there isn't a particular treatment for RSV yet, most people recover on their own within a week or two. Here are some home care remedies that can help relieve symptoms and get you on the road to recovery.

  • Drink lots of fluids to prevent dehydration.
  • Prioritize rest — try to get extra sleep at night and reduce your daily activities until you're feeling better.
  • Take over-the-counter medications for pain relief and to reduce fevers as needed. (Note: Follow your doctor's or your child's pediatrician's guidance on taking over-the-counter medicines. And never give aspirin to children, as it can lead to a disease called Reye's Syndrome.)
  • Use saline nasal drops or spray to help loosen a stuffy nose (consult your pediatrician on when this is safe for younger children).
  • To help babies breathe easier, use a bulb syringe to remove mucus from their nose.
  • Try using steam to improve breathing. To ease dry or stuffy breathing passages, your child's doctor may recommend using a cool mist humidifier in their bedroom at night. If you don't have a humidifier, you can turn on a hot shower with the bathroom door closed to create a steam room effect that can make breathing easier and more comfortable.

For severe cases of RSV that require hospitalization, doctors can provide oxygen and IV fluids, as well as medications or procedures to help open the airways.

How to prevent getting (or spreading) RSV

To avoid getting or spreading RSV, you can practice the same methods that are recommended to prevent other seasonal illnesses.

  • Wash your hands frequently — Wash for at least 20 seconds with warm water and soap. If you can't wash your hands, use an alcohol-based hand sanitizer that contains at least 60% alcohol, especially after being in public spaces.
  • Avoid touching your eyes, nose and mouth with your hands — Even when you think your hands are fairly clean, try to avoid touching your face, which is a common way for viruses to spread.
  • Cover coughs and sneezes — Cough or sneeze into a tissue or the inside of your elbow. (As a fun way to help your child remember to use their elbow, you can encourage them to use their “chicken wing” when coughing or sneezing.)
  • Disinfect surfaces — Wipe down commonly used surfaces in your home regularly with a virus-killing disinfectant. It's also a good idea to wipe down cart handles and similar surfaces when you're out shopping.
  • Stay home if you're not feeling well (especially if you have a fever) — It's recommended that you stay home if you have a fever, and for at least 24 hours after your fever goes away (without the help of over-the-counter medications).
  • Keep a healthy social distance — Stay six feet apart from people in public, or from those you know are sick.
  • Avoid touching or kissing babies — It may be tempting to reach out for those tiny fingers, but it's important for babies to stay at a healthy distance from those outside of their immediate family.

Our family medicine and pediatric care experts are experienced in diagnosing and treating RSV, along with many other illnesses.