Respiratory Syncytial Virus (RSV)

What are RSV signs and symptoms?

Most people show RSV symptoms about 4 to 6 days after exposure to the virus. In toddlers, older children and adults, symptoms are often similar to symptoms of the common cold, including:

• Congestion
• Coughing and sneezing
• Headaches
• Low fever
• Runny nose
• Sore throat

RSV symptoms in infants

Infants with RSV may also have cold-like symptoms but RSV in babies may cause other symptoms, including:

• Breathing pauses lasting more than 10 seconds
• Decreased appetite
• Irritability or fussiness
• Reduced activity

Seek immediate medical care if your infant starts showing any signs of a severe RSV infection, which includes:

• Cyanosis (bluish skin tint)
• Difficulty breathing
• Extreme fatigue (tiredness)
• Poor feeding
• Rapid or shallow breathing
• Wheezing

What tests are used to diagnose RSV?

A primary care doctor can diagnose RSV by evaluating your child’s symptoms. They may look in your child’s nose and throat or listen to their lungs with a stethoscope. However, because RSV can lead to more serious complications if left untreated, it’s important to see a doctor if symptoms last longer than 1 to 2 weeks.

RSV testing is available as part of a panel of tests that look for RSV as well as COVID, influenza and other respiratory viruses.

What can I expect from RSV testing?

Most RSV tests are noninvasive and quick and include:

• Cheek or nose swab: The doctor inserts a small cotton swab into your child’s nose or mouth and brushes it back and forth to collect a sample. Results usually come back in 1 to 2 days.
• Pulse oximetry testing: Your child’s doctor uses a small monitor placed on the finger that tests for the oxygen level in their blood. The results appear immediately on the monitor.
• Chest X-ray: Your child may need a chest X-ray from our Radiology Department to check for lung inflammation or infection. A technician uses an X-ray machine to take pictures of the organs inside your child’s chest, including their heart and lungs. Your child will need to stay still for several seconds during each image.

How is RSV treated?

Most children recover from RSV with at-home and over-the-counter remedies that relieve symptoms in 1 to 2 weeks. You may help make your child more comfortable by giving them:

• Fever-reducing medicine such as acetaminophen (Tylenol)
• Nasal suctioning or saline drops to help a stuffy nose
• Plenty of fluids so they stay hydrated

In some cases, your child’s doctor may give antibiotics to treat complications of RSV, such as bacterial pneumonia. But antibiotics don’t work to treat RSV itself because it’s a virus.

In rare cases, RSV may require a hospital stay. Infants younger than 6 months and adults over 65 years are more likely to need hospitalization for RSV. They may stay in the hospital for several days to get treatments such as fluids through an IV or oxygen. In cases of severe respiratory trouble, they may also be connected to a breathing machine.

Should my baby or toddler get the RSV shot? 

In the summer of 2023, the FDA approved two new shots to help prevent babies and high-risk toddlers from getting infected with RSV. The first, Beyfortus (nirsevimab), is a monoclonal antibody injection that can be given to all babies during their first cold and flu season, as well as high-risk toddlers. The second, Abrysvo, is a vaccine that can be administered during the third trimester of pregnancy to protect infants against RSV for up to six months.  

Previously, the only shot that prevented RSV infection in kids was palivizumab, which was approved only for high-risk babies under 2 years old. This monoclonal antibody shot has to be given once a month during cold and flu season, while Beyfortus and Abrysvo require only a single dose.  

Supplies of these new preventative medications are currently limited, but they represent a promising step in preventing RSV infections in babies and toddlers. For more information, contact your healthcare provider. 

Why choose us for RSV treatment?

At Children’s Hospital Colorado, our focus is providing care for kids. If your child needs treatment for RSV, you can feel confident that our team will provide the best care possible. And since we treat more kids than most hospitals, we have more experience in identifying the differences between RSV and other respiratory conditions that have similar symptoms. At Children’s Colorado, you’ll find: 

• Expertise and experience: Our Department of Pediatric Otolaryngology has one of the largest fellowship-trained pediatric ear, nose and throat (ENT) teams in the country. Each year, we treat more than 18,000 children for a range of conditions, from common illnesses such as RSV to complex illnesses. Children who experience breathing complications of RSV or bronchiolitis can also receive treatment from our nationally recognized pulmonary specialists at our Breathing Institute.
• Multidisciplinary care: Our doctors work together and this can include ear, nose and throat physicians, infectious disease physicians, pulmonologists, allergists and immunologists to ensure your child receives the best comprehensive care. We also have multiple specialists at one location to make your appointments as easy and efficient as possible.

Access to treatment: With multiple locations throughout Colorado, we make it easy for your child to get the care they need. We also offer telehealth appointments so your child can access high-quality care from the comfort and convenience of home.

Helpful resources

• The American Lung Association offers RSV education, including a resource library with handouts, videos and stories.
• The Centers for Disease Control and Prevention provides additional details about RSV, including how the virus affects infants and children.
• The National Foundation for Infectious Diseases provides further information on RSV, including updates on new vaccines and treatments.

What can I do to prevent RSV infection?

You can lower the risk of you or your child getting an RSV infection by:

• Avoiding sharing cups, bottles or toys with children who have symptoms
• Cleaning high-touch surfaces such as doorknobs and tables often
• Limiting or avoiding contact with someone who has the virus
• Reducing how often you touch your eyes, nose or mouth

Washing your hands thoroughly and frequently, especially after using the bathroom, coughing or sneezing