We're all familiar with headlines about COVID-19 and the flu, but there's a third, lesser-known virus sharing the spotlight. 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 often spike during the respiratory illness season – beginning in the fall and hanging around during the colder months when we're often indoors together. RSV is considered a childhood illness because it commonly affects kids, but this often leaves parents and other adults wondering, “Are adults at risk?”
Below, we provide an overview on RSV in adults, 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, especially babies, young children and adults over 65.
RSV is less common in adults than in children
Although RSV most commonly affects children, adults can contract the virus as well, which means that you should do your best to stay healthy and take precautions to avoid spreading it to others.
Adults over the age of 65 or those with health complications (such as a weakened immune system or heart, lung or other conditions) are at higher risk for developing more severe RSV. Serious cases can cause trouble breathing or dehydration and may lead to a hospital stay.
What causes RSV to spread?
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.
RSV is very contagious, especially during the week or so that someone is showing symptoms. And it’s possible for some people to remain contagious for up to four weeks.
But if you’ve been fever-free for at least 24 hours without the help of fever-reducing medications like ibuprofen and acetaminophen, and if your overall symptoms have improved, it’s okay to return to regular activities – including going back to school or work. Wearing a mask for a few days to a week after returning can help prevent transmitting it to others.
How long does RSV last in adults?
Symptoms of RSV typically last less than a week, and most people are fully recovered within 1-2 weeks. However, those with more serious cases can take longer to recover and may require clinical treatment or hospitalization for trouble breathing or dehydration.
RSV symptoms adults should watch for
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:
- Cough
- Decreased appetite
- Fatigue
- Fever
- Headache
- Runny nose
- Sneezing
- Sore throat
- Wheezing
While RSV usually goes away on its own in a week or two, if you’re sick for longer, or your symptoms are getting worse instead of better, call your primary care doctor right away.
Symptoms of severe RSV in adults
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 in adults can include:
- Difficulty breathing
- Rapid breathing
- Severe cough
- Wheezing
- Bluish color to the skin (from lack of oxygen)
If you’re experiencing any of these more severe symptoms, seek medical care right away.
How RSV is different from other viruses
RSV, COVID-19 and influenza (the seasonal flu) 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’re 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 share several symptoms, including cough, sore throat, fever, headache, fatigue and runny nose. This makes it hard to know which virus you're dealing with.
One key difference between the two is that symptoms of influenza 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 children or adults 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.
RSV vaccines and other types of RSV protection
The U.S. Food and Drug Administration (FDA) has approved three forms of preventive treatment against severe RSV: a vaccine for older adults, a vaccine for pregnant women, and monoclonal antibody immunization for babies and young children. These immunizations can prevent severe RSV, but they may not protect against RSV entirely.
RSV vaccine for older adults
The Centers for Disease Control and Prevention (CDC) recommends that adults 75 and older, and those 60-74 years old with chronic health conditions like asthma, COPD or heart disease, get the RSV vaccine. Currently, just one dose of the vaccine is recommended, so you don’t need to get a dose every RSV season.
Where can adults get the RSV vaccine?
Depending on your age and risk factors, you may want to talk with your doctor or clinician before getting the RSV vaccine.
- If you’re 75 or older, you can receive your vaccine at a local pharmacy.
- If you’re 65-74 years old with a chronic health condition that makes you eligible for the vaccine, you can also visit a pharmacy to get vaccinated.
- If you’re 60-64 years old with a chronic health condition, contact your doctor to discuss whether the RSV vaccine is right for you.
Also, if you have Medicare Part D coverage, Medicare Part D now fully covers vaccines the CDC recommends for adults, if administered at a pharmacy, including the RSV vaccine.
The maternal RSV vaccine
The FDA has approved a maternal RSV vaccine for pregnant people. When you receive the RSV vaccine while you’re pregnant, your baby is better protected against the virus. That’s because the vaccine can help provide your baby with protection from the moment they’re born.
Where can pregnant people get the RSV vaccine?
Your OB-GYN, midwife or other prenatal care provider can discuss the vaccine with you at your prenatal visits, and the vaccine itself will be administered between week 32 and week 36 of pregnancy.
Home RSV treatments for adults
While there isn't a treatment for mild to moderate cases of 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 by trying to get extra sleep at night and reducing your daily activities until you're feeling better.
- Take over-the-counter medications for pain relief and to reduce fevers as needed. Follow the dosage instructions on the label or your doctor’s recommendations.
- Use saline nasal drops, nasal spray or a neti pot to help loosen a stuffy nose.
- Try using steam to make breathing easier. 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.
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 help avoid getting or spreading RSV, the CDC advises practicing the same methods that are recommended to prevent other seasonal illnesses.
- Get vaccinated if you’re eligible – If you’re pregnant or at least 60 years old, your doctor will likely suggest that you get vaccinated for RSV.
- Wash your hands frequently – Every time you wash your hands, do so 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.
- 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.