GoodRx Guide
Childhood RSV: Your GoodRx Guide
Comprehensive information for you or a loved one — including treatment options and discounts on popular medications.
Definition
Respiratory syncytial virus (RSV) is a common cold virus that’s usually active during the winter months.
RSV typically causes common cold symptoms. Most people get an upper respiratory tract infection and mild symptoms like a runny nose and cough. In fact, older children and healthy adults generally don’t need to see a healthcare professional if they catch RSV.
But some children are at risk for developing lower respiratory tract infections like bronchiolitis and pneumonia. These types of infections cause more severe symptoms like wheezing and trouble breathing. Children are more likely to develop serious RSV illness if they are younger than 12 months or if they:
Were born prematurely
Were born with a heart condition
Have a lung condition like asthma
Have a weakened immune system
Causes
RSV illness is caused by respiratory syncytial virus. RSV illness can include upper respiratory tract infections, like the common cold and lower respiratory tract infections, like bronchiolitis.
RSV is very contagious. It spreads from person to person through respiratory droplets (similar to the way coronavirus and influenza spread).
Respiratory droplets are tiny sprays of water that come from your nose or mouth when you sneeze, cough, talk, sing, or shout. These droplets might be too small to see, but they carry the RSV virus through the air.
If you breathe air containing these droplets, you can catch RSV.
RSV spreads very quickly among children. Young children aren’t very good at covering their coughs and sneezes. They are often grouped together in day care and schools. And since young children usually aren’t immune to RSV, they pass it around very quickly.
Like other common cold viruses, RSV will go away as your immune system fights it off. It usually takes about 7 to 10 days for this to happen. In some children it can take longer, especially if they have certain medical conditions.
After the illness, children develop immunity to RSV. But this immunity doesn’t last very long. So children can get RSV more than once.
Symptoms
Most toddlers and young children with RSV have mild symptoms. These can include:
Coughing
Sneezing
A stuffy nose
Eating less
Fussy or irritable behavior
A fever
But RSV in babies can cause more serious symptoms, especially in babies younger than 6 months. These symptoms include:
Fever
Severe congestion and runny nose
Rapid breathing
Trouble breathing
Inability to eat/drink
Dehydration
Toddlers and young children with certain medical conditions might also have more serious symptoms from RSV. But in general, as a child gets older, they are less likely to get severely ill.
Related Health Conditions
Diagnosis
A nasal swab test can be used to detect RSV. This is the same type of test used to check for influenza and COVID-19. Sometimes, all three viruses are checked with the same swab.
Your child’s healthcare professional may be able to do a rapid test in their office. You’ll get the results within a few minutes. Otherwise, they’ll send your child’s nasal swab to the lab and you’ll get the results back at a later time.
Many times, a nasal swab isn’t necessary to diagnose RSV. Your child can receive a diagnosis of bronchiolitis based on their symptoms and their physical exam.
Treatments
There’s no cure for RSV illness. RSV is a virus, which means antibiotics can’t stop it. Children with mild RSV illness will get better on their own as their immune system fights off the virus.
Children with mild illness can be treated at home with remedies like:
Fluids to stay hydrated
Steam (such as from a shower or bath) to open up a stuffy nose
Hot tea or hot water with lemon to soothe a sore throat for older children
Honey as a natural cough suppressant for children older than 1 year
Over-the-counter (OTC) cold medications or acetaminophen (Tylenol) to help with fever and discomfort
Babies and children with severe RSV illness may need care in the hospital. This is so healthcare professionals can keep a close eye on how they’re doing, and give treatments quickly if they’re needed.
Prevention
Handwashing, physical distancing, wearing face masks, and avoiding crowded areas can all help prevent the spread of RSV.
There’s also an FDA-approved monoclonal antibody against RSV for babies and toddlers called Beyfortus. Beyfortus works like a vaccine — it’s given as an injection and keeps kids from getting sick with RSV. But the protection doesn’t last very long.
The CDC recommends that infants younger than 8 months get Beyfortus at the start of their first RSV season. They recommend a dose for children between 9 and 18 months old who are at higher risk for severe RSV illness. This may include children who were born prematurely, have a heart or lung condition, or have a weakened immune system.
Unlike the flu shot, Beyfortus is not a yearly vaccine. In fact, most children only need one dose. This protects them during their first RSV season — when they’re most vulnerable to severe illness.
The medication palivizumab (Synagis) can protect some babies at high risk for RSV. This medication is given as a shot. It contains antibodies (that is, ready-made immune system particles) that lower the baby’s risk of severe disease if they catch RSV. Babies might be eligible for palivizumab if they are:
Less than 7 months old and were born prematurely (born before 35 weeks gestation)
Less than 25 months old and have bronchopulmonary dysplasia (BPD)
Less than 25 months old and have a particular congenital heart condition
Unlike Beyfortus, which is given as a one-time dose, babies who take palivizumab need to get it once a month during RSV season.
Frequently asked questions
Yes, adults can pick up the RSV virus from kids. Adults can get RSV infections, too. Most adults will only get mild cold symptoms when they’re sick with RSV. But older adults and those with a weakened immune system are at risk of developing serious RSV illness.
Children are contagious for about 1 week when they have RSV. Some children stop being contagious within a couple of days, but others can take up to 4 weeks. It’s best to keep your child home from school or day care until they’re fever-free and their symptoms are getting better. This will keep the virus from spreading to others.
RSV is worse in children than adults for a couple of reasons. First, infants and young children have smaller airways that lead to the lungs, called bronchioles. RSV causes inflammation, swelling, and mucus buildup in the bronchioles. Smaller bronchioles will clog up faster than large ones, leading to trouble breathing (respiratory distress). Adult airways have stronger cartilage around them, which helps keep them open even when they’re inflamed. But children’s airways have softer cartilage so they’re more likely to collapse.
Children are also more likely to get dehydrated when they’re sick with RSV. RSV illness leads to mucus-clogged noses, which makes it difficult to breathe. Babies have to be able to breathe through their nose in order to feed. When babies can’t feed, they get dehydrated, which stresses the body and makes it harder to recover from an illness.
References
Caserta, M., et al. (2024). RSV: When it's more than just a cold. HealthyChildren.org.
Centers for Disease Control and Prevention. (2023). CDC recommends a powerful new tool to protect infants from the leading cause of hospitalization.
Centers for Disease Control and Prevention. (2024). Clinical overview of RSV.
Centers for Disease Control and Prevention. (2024). How RSV spreads.
Centers for Disease Control and Prevention. (2024). RSV in infants and young children.
MedlinePlus. (2022). Respiratory syncytial virus (RSV) tests.
U.S. Food and Drug Administration. (2023). FDA approves new drug to prevent RSV in babies and toddlers.
