Respiratory syncytial virus, commonly known as RSV, is a contagious virus that infects the nose, throat and lungs.

For most people, RSV causes mild cold-like symptoms. However, it can cause more serious illness in babies, young children, older adults and people with certain health conditions.

RSV is a common cause of bronchiolitis and pneumonia in young children.

What Are the Symptoms of RSV?

Symptoms are often similar to those of a cold.

Common symptoms include:

• runny nose
• blocked nose
• cough
• sneezing
• fever
• wheezing
• reduced appetite
• tiredness

Symptoms usually develop several days after exposure to the virus.

Many people begin to improve within about a week, although coughing may last longer.

RSV Symptoms in Babies

Babies can develop more significant symptoms because their airways are small.

Signs may include:

• difficulty feeding
• feeding less than usual
• irritability
• unusual tiredness
• coughing
• wheezing
• rapid breathing
• working harder to breathe

Very young babies may not always develop an obvious fever.

Instead, the first signs may be poor feeding, reduced activity or changes in breathing.

Signs of Breathing Difficulty in a Baby

Seek medical advice promptly if your baby appears to be struggling to breathe.

Warning signs can include:

• rapid breathing
• flaring of the nostrils
• grunting
• the skin pulling in between or under the ribs
• pauses in breathing
• difficulty feeding because of breathlessness
• blue or grey colouring around the lips
• unusual drowsiness

Severe breathing difficulty requires urgent medical attention.

Who Is Most at Risk of Severe RSV?

Anyone can catch RSV, but some people have a higher risk of complications.

These include:

• babies under 12 months
• premature babies
• infants with heart or lung conditions
• children with weakened immune systems
• older adults
• people with chronic heart or lung disease
• people with weakened immune systems
• people with some other chronic medical conditions

RSV can also worsen existing respiratory conditions such as asthma.

For more information, see our Asthma guide.

How Does RSV Spread?

RSV spreads easily between people.

The virus can be transmitted through droplets and respiratory secretions when an infected person:

• coughs
• sneezes
• talks

It can also spread when someone touches a contaminated surface and then touches their:

• eyes
• nose
• mouth

The virus can remain on some surfaces for several hours, which is why hand hygiene and cleaning frequently touched surfaces are important.

How Contagious Is RSV?

RSV is highly contagious.

People are commonly infectious for several days after symptoms begin. Some babies and people with weakened immune systems may remain infectious for longer.

Because RSV can spread before symptoms become severe, outbreaks can occur quickly in households, childcare centres and other group settings.

Can You Get RSV More Than Once?

Yes.

Previous infection provides some immunity, but this protection does not last indefinitely.

As a result, people can catch RSV more than once throughout their lives.

Repeat infections are often milder in otherwise healthy adults, but they can still be serious in people at higher risk.

How Is RSV Diagnosed?

RSV may be diagnosed based on symptoms, age and medical history.

A doctor may also take a sample from the nose or throat to test for RSV and other respiratory viruses.

Testing may be more likely when:

• symptoms are severe
• a young baby is unwell
• hospital treatment is required
• the diagnosis is uncertain
• identifying the virus will affect medical management

Treatment for RSV

There is no routine antibiotic treatment for RSV because it is caused by a virus.

Most mild cases improve with supportive care at home.

This may include:

• rest
• drinking enough fluids
• frequent feeds for babies
• appropriate fever or pain relief
• monitoring breathing and hydration

Antibiotics will not treat RSV itself. However, they may occasionally be needed if a secondary bacterial infection develops.

Caring for a Baby With RSV

Babies with mild illness can often be cared for at home.

Helpful measures may include:

• offering smaller feeds more frequently
• continuing breastfeeding where possible
• keeping the baby comfortable
• clearing nasal mucus gently if it interferes with feeding
• monitoring wet nappies
• regularly checking breathing

Babies can become dehydrated if they are unable to feed properly.

Seek medical advice if your baby is feeding significantly less than usual or producing fewer wet nappies.

Fever and RSV

Fever can occur with RSV.

Age-appropriate paracetamol or ibuprofen may help relieve discomfort in some children.

Always use the correct dose for your child’s age and weight and follow the product instructions.

If your baby is under 3 months old and has a temperature of 38°C or higher, seek urgent medical assessment.

Your pharmacist can help you choose appropriate fever and pain relief.

Bronchiolitis and RSV

RSV is one of the most common causes of bronchiolitis in babies and young children.

Bronchiolitis occurs when the small airways in the lungs become inflamed and produce mucus.

Symptoms may include:

• coughing
• wheezing
• rapid breathing
• difficulty feeding
• breathing difficulty

Some children require hospital treatment for oxygen, hydration or help with breathing.

RSV and Pneumonia

RSV can also cause pneumonia, particularly in people at higher risk.

Possible signs include:

• worsening cough
• high fever
• rapid breathing
• shortness of breath
• chest discomfort
• significant weakness

Medical assessment is important if pneumonia is suspected.

RSV in Older Adults

RSV is often associated with babies, but it can also cause serious illness in older adults.

Symptoms may initially resemble a cold but can progress to:

• bronchitis
• pneumonia
• worsening asthma
• worsening chronic lung disease
• worsening heart disease

Older adults should seek medical advice if breathing symptoms become significant or if they feel increasingly unwell.

RSV and Asthma

RSV and other respiratory infections can trigger asthma symptoms.

People with asthma may experience:

• increased coughing
• wheezing
• chest tightness
• shortness of breath
• increased use of reliever medicine

Follow your asthma action plan and seek medical advice if symptoms are not responding to usual treatment.

RSV Prevention

Good hygiene can help reduce the spread of RSV.

Helpful measures include:

• washing hands regularly
• covering coughs and sneezes
• cleaning frequently touched surfaces
• avoiding sharing cups and utensils
• keeping babies away from people who are unwell where possible
• staying home when sick

People with respiratory symptoms should avoid close contact with newborn babies and other vulnerable people.

RSV Immunisation in Australia

Australia now has several ways to reduce the risk of severe RSV illness in people at higher risk.

These include:

• vaccination during pregnancy
• RSV vaccination for older adults
• long-acting monoclonal antibodies for eligible infants and young children

Eligibility and funded programs can change, so speak with your doctor, midwife, child health nurse or pharmacist about current recommendations.

RSV Vaccination During Pregnancy

RSV vaccination is recommended during pregnancy to help protect the baby during the first months of life.

In Australia, the maternal RSV vaccine Abrysvo can be given from around 28 weeks of pregnancy.

Protective antibodies produced by the mother can pass across the placenta to the baby.

This helps protect the infant during the period when severe RSV illness is most likely.

RSV Protection for Babies

Some babies may be eligible for a long-acting monoclonal antibody medicine such as nirsevimab.

This provides ready-made antibodies against RSV rather than stimulating the baby’s immune system in the same way as a vaccine.

Eligibility may depend on factors including:

• whether the mother received an RSV vaccine during pregnancy
• timing of maternal vaccination
• the baby’s age
• prematurity
• heart or lung conditions
• other risk factors

Programs vary between Australian states and territories.

RSV Vaccination for Older Adults

RSV vaccination is also recommended for some older adults.

Current Australian recommendations particularly prioritise:

• adults aged 75 years and older
• Aboriginal and Torres Strait Islander adults aged 60 years and older
• some adults aged 60 years and older with medical conditions that increase the risk of severe RSV

Other adults may also be eligible or may choose vaccination depending on their age and health.

Ask your pharmacist or doctor whether RSV vaccination is recommended for you.

RSV or a Cold?

RSV can be difficult to distinguish from a common cold based on symptoms alone.

Both can cause:

• runny nose
• coughing
• sneezing
• mild fever
• tiredness

RSV is more concerning when it causes:

• wheezing
• breathing difficulty
• poor feeding
• significant lethargy

Young babies and older adults are more likely to experience complications.

RSV or Influenza?

Influenza often causes more sudden symptoms such as:

• high fever
• headache
• significant body aches
• marked fatigue

RSV may be more likely to cause wheezing or bronchiolitis in young children.

However, symptoms overlap, and testing may sometimes be needed to identify the virus.

RSV and COVID-19

RSV, influenza and COVID-19 can all cause respiratory symptoms.

These may include:

• cough
• fever
• fatigue
• sore throat
• runny nose

It is possible to have more than one respiratory infection at the same time.

If you are at higher risk of serious illness, seek medical advice about testing and treatment options.

How Long Should Children Stay Home?

Children with RSV should stay home from childcare or school while they are unwell.

They can generally return when:

• their overall symptoms have improved
• they are feeling well enough to participate
• fever has resolved

A lingering mild cough may continue after the child otherwise feels well.

Follow any specific advice from your healthcare professional or childcare provider.

When Should You See a Doctor?

Seek medical advice if you or your child:

• has difficulty breathing
• is wheezing significantly
• has a worsening cough
• has a high or persistent fever
• is feeding poorly
• has fewer wet nappies
• is unusually sleepy
• appears increasingly unwell
• belongs to a group at higher risk of complications

Very young babies should generally be assessed earlier if there are concerns.

When Is RSV an Emergency?

Call 000 or seek urgent emergency care if a baby, child or adult:

• is struggling to breathe
• turns blue or grey around the lips
• has pauses in breathing
• is grunting with each breath
• is difficult to wake
• collapses
• appears severely dehydrated
• is rapidly becoming worse

Speak With Your Pharmacist

Your MediAdvice pharmacist can provide advice about managing mild RSV symptoms and reducing transmission.

They can also help with:

• fever and pain relief
• saline nasal products
• medicine dosing
• RSV vaccination information
• advice about when medical assessment is needed

Babies, older adults and people with significant breathing problems may require medical assessment rather than self-treatment.

General advice only: This information is not intended to replace advice from your healthcare professional. If breathing becomes difficult, a baby is feeding poorly or symptoms are severe or worsening, seek medical advice promptly.