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Respiratory Syncytial Virus (RSV)

Respiratory syncytial virus, or RSV, is a common respiratory virus that often causes mild, cold-like symptoms but may result in severe illness in some people.

RSV spreads through contact with droplets from the nose and throat of infected people when they cough and sneeze. RSV can also spread through dried mucus or saliva (spit) on bedding and similar items.

Like influenza (flu), RSV infections are most common in the fall and winter months.

Symptoms

Symptoms begin four to six days after exposure and develop slowly over several days. People are usually contagious for three to eight days and can be contagious before they have symptoms. Most people recover in one to two weeks. Symptoms, particularly cough, can last for a few days to several weeks.

Symptoms of RSV often include:

  • Runny nose
  • Sneezing
  • Cough
  • Congestion
  • Chills
  • Low fever
  • Loss of appetite

In very young infants with RSV, the only symptoms may be irritability, decreased activity, decreased appetite and breathing difficulties.

RSV infection can cause pneumonia, especially in the very young, the very old or those who have weakened immune systems.

People at Risk of Infection

Anyone can be infected and RSV can be serious, especially in infants and older adults. People at the highest risk of severe symptoms include:

  • Infants, especially those born premature and those six months and younger
  • Children younger than two years old with chronic lung disease or congenital (present from birth) heart disease
  • Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus
  • Adults 65 years and older
  • Adults with chronic heart or lung disease
  • People with weakened immune systems
  • People living in long-term care facilities

It is possible to get RSV again after recovering from an RSV infection.

Prevention

There are new vaccines and medicines to help prevent RSV in people ages 60 and older and to infants and young children.

Everyone can decrease the risk of getting and spreading RSV and other respiratory viruses:

  • Cover your coughs and sneezes with a tissue or your arm.
  • Wash your hands often. Use hand sanitizer when soap and water are not available. Remind and help children to wash their hands.
  • Stay home when sick and keep children who are sick home from school and day care. Avoid close contact with people at increased risk for severe infection when you are sick.
  • Clean frequently touched surfaces, especially if someone in the household is sick.
  • Avoid close contact with people who are sick, especially if you are at increased risk for severe infection.
  • Get tested for flu, COVID-19 and RSV, as appropriate.
  • Wear a face mask.
  • Get an annual flu shot and stay up to date with your COVID-19 vaccinations.

Parents of young children should be careful to wash their own hands and their children’s hands often and avoid close contact with people who are sick. Keep children who are sick home from school.

Adults 60 and Over

There are two new RSV vaccines available (Arexvy and Abrysvo) for adults ages 60 years and older. Talk to your health care provider about whether RSV vaccination is right for you.

Infants and Young Children

Two monoclonal antibody products are available to protect infants and young children from severe RSV infection.

  • Nirsevimab (Beyfortus) — a new product recommended for all infants less than 8 months old during their first RSV season. Nirsevimab is also recommended for infants 8-19 months old who are at increased risk of severe RSV infection and entering their second RSV season.
  • Palivizumab (Synagis) — available for infants and young children with certain underlying health conditions who are at high risk of severe RSV infection and who have not or cannot receive nirsevimab.

In addition, the new Abrysvo RSV vaccine is recommended for pregnant people during weeks 32 to 36 of pregnancy to protect the infant. If vaccine is not given during pregnancy, it is recommended that the newborn receive nirsevimab. In most cases, only one option (vaccination of the pregnant parent or nirsevimab given to the infant) is needed to protect the infant. Expecting parents should discuss with their provider which option is right for them.

Diagnosis

The symptoms of RSV can be similar to symptoms due to infections with other respiratory viruses, such as COVID-19, cold and flu, as well as some bacteria. Doctors may recommend RSV or other diagnostic tests.

Treatment

There is no specific treatment for RSV infection. If you or your child have severe symptoms that might be caused by RSV, seek medical attention. Health care providers can provide supportive care.

If you do not have a health care provider, call 311 or 844-NYC-4NYC (844-692-4692) to be connected to NYC Health + Hospitals. Care is available in NYC regardless of immigration status, insurance or ability to pay. If it is an emergency, call 911 or go to the hospital.

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