Respiratory syncytial virus, or RSV

May 22, 2024

Primary Care
Mid adult mother calls doctor because baby has fever

Monitoring by the Centers for Disease Control and Prevention (CDC) and reports from U.S. hospitals are showing a spike in cases of respiratory syncytial virus (RSV) nationwide. Diagnoses of RSV and associated emergency department visits and hospitalizations are driving hospitals in many regions to capacity, particularly for pediatric cases. It is important to know the symptoms, when to seek treatment, and how to distinguish between RSV and COVID-19 explains  Meredith R. Good, D.O., a hospitalist at Riverside Walter Reed Hospital.

 What is RSV?

Respiratory syncytial virus (RSV) is a common virus that affects the human respiratory system.

Who is most at risk? 

While anyone can contract RSV, the most vulnerable populations are infants and toddlers, people with compromised immune systems and older adults says Dr. Good. 

Symptoms of RSV 

RSV generally causes mild, cold-like symptoms, such as a runny nose, sneezing, coughing, loss of appetite and fever. Particularly in vulnerable populations, RSV can cause more acute symptoms, such as wheezing and difficulty breathing. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States. Most individuals with mild cases recover in a week or two and do not require medical intervention. However, serious cases may require hospitalization.

Transmission of RSV 

RSV can spread when an infected person coughs or sneezes; the eyes, nose, or mouth come into contact with virus droplets from a cough or sneeze; a person has direct contact with the virus, such as through kissing the face of a person with RSV; or through touching a surface that has the virus on it, like a doorknob, and then touching your face before washing your hands explains Dr. Good.

People infected with RSV are usually contagious for three to eight days and may become contagious a day or two before they start showing signs of illness. 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 four weeks.

As with the “common cold,” influenza, and COVID-19, individuals with RSV should take measures to prevent spreading the virus. These steps include staying home when ill, avoiding contact with others, particularly those who are most at risk, wearing masks, and washing hands often.

Treatments for RSV 

The most medically fragile infants may benefit from Palivizumab, a humanized monoclonal antibody. However, this is the only licensed agent for prevention of severe RSV infection, specifically for use with high-risk infants. Palivizumab is administered intramuscularly, every month during the RSV season, usually five doses are required.

However, for most infants, children and adults, there is no specific treatment for RSV infection, though researchers are working to develop vaccines and antivirals (medicines that fight viruses). Antibiotics, staples for treatment of bacterial infections, are useless against a viral infection such as RSV.  When antibiotics are given for a viral illness, not only are they ineffective, but inappropriate prescribing of antibiotics promotes bacterial resistance, leading to the creation of bacterial “super-bugs” for which we may not have treatment. 

Steps to relieve symptoms include using over-the-counter fever reducers and pain relievers such as acetaminophen or ibuprofen. Talk to your healthcare provider before giving a child nonprescription cold medicine to make sure the product is safe, and never give aspirin to children. American Academy of Pediatrics (AAP) recommendation is against the use of OTC cold preparations for children under six years of age. There has never been evidence they are effective in this age group. There are potential toxicities and risk of miss-dosing. They should also be avoided along with aspirin. Also, it is important to drink plenty of fluids to prevent dehydration adds Dr. Good.

RSV vs. COVID-19 

Both RSV and COVID-19 can cause symptoms such as cough, fever, stuffy/runny nose, and shortness of breath. COVID-19 can also cause body aches, chills, sore throat, diarrhea, nausea/vomiting, and loss of smell/taste. The best way to be sure is to get a COVID-19 test.  

Time from exposure to infection for RSV is 1 to 4 days, while for COVID-19 it’s 2 to 14 days.

More Information

While there is no vaccine currently available for respiratory syncytial virus (RSV), Riverside encourages every eligible person to receive vaccinations for both COVID-19 and the flu. For more information on receiving one or both of these vaccinations from Riverside, please visit

You can also schedule an e-visit through MyChart. This is a quick, confidential, easy process. For those concerned about a COVID-19 infection, Riverside provides an assessment for you to complete and submit. Your primary care provider will evaluate and prepare a treatment plan, and when appropriate, order tests and write prescriptions. 

Another option is to call Riverside Nurse 24/7 at 800-675-6368. Our nurses are trained in telephone triage, and they can provide information on what to do next. 


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