Respiratory syncytial virus infection (RSV) is an illness that affects the lungs and breathing passages. It typically resolves without medication. However, if the condition is severe, medications such as Ribavirin and Palivizumab may help.

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Respiratory syncytial virus infection (RSV) is a common respiratory illness that most people contract by the time they are toddlers. It typically causes mild symptoms like coughing, runny nose, and fever. However, in some individuals, RSV can quickly turn severe and lead to trouble breathing and even death.

RSV is a viral infection. This means it spreads from person to person through direct contact with substances containing the virus, like saliva droplets or nasal mucus.

It can be serious in infants, children with chronic conditions, and older adults. In babies 12 months old and younger, RSV is the leading cause of potentially life threatening conditions like bronchiolitis and pneumonia.

In severe cases, a doctor may suggest hospitalization so healthcare professionals can closely monitor the person with RSV. Doctors may also give medications such as ribavirin and palivizumab.

For most people, RSV resolves on its own without prescription medication within 1–2 weeks. During the illness, a doctor or healthcare professional may suggest using over-the-counter (OTC) drugs and other home remedies to manage your symptoms.

These may include:

  • taking pain relievers and fever reducers, like acetaminophen and ibuprofen
  • taking nonprescription cold medications (for adults, not children)
  • drinking plenty of water and other fluids to stay hydrated
  • getting enough quality rest to help your body recover

Ribavirin

Currently, the only FDA-approved drug for the treatment of active RSV infection is ribavirin. This medication is used only for people hospitalized with severe lower respiratory RSV infections.

Ribavirin is available as a capsule and also an inhalant. The inhaled form is only approved for use in children.

However, researchers suggest there isn’t much evidence that this medication actually improves a person’s outcome. This drug is also potentially toxic and expensive, so it’s primarily used in very specific circumstances when individuals have conditions that compromise their immune systems.

The American Academy of Pediatrics (AAP) no longer recommends this drug for RSV treatment due to the above considerations.

4’-fluorouridine

Researchers are also looking into antivirals — similar to Paxlovid for COVID-19 — that could lessen the severity and shorten the duration of RSV.

One candidate is 4’-fluorouridine, a broad-spectrum antiviral that may be able to treat both RSV and COVID-19 when given once per day as an oral pill. Early studies in mice show that it works by stopping the proteins that allow these viruses to copy themselves inside the body.

RSV can cause severe illness in infants and children under 5 years old. The Centers for Disease Control and Prevention (CDC) estimates that 58,000–80,000 children are hospitalized each year as a result of RSV infection.

If a child has severe symptoms of RSV, such as difficulty breathing, a doctor may suggest hospitalization so healthcare professionals can closely monitor them and administer any treatment they need.

The American Academy of Pediatrics (AAP) typically recommends the following two medications:

Nirsevimab

Nirsevimab is a new preventive medication given by injection. It works by strengthening the immune system to protect against severe illness caused by RSV.

It was approved by the Food and Drug Administration (FDA) in 2023 under the brand name Beyfortus.

The AAP recommends nirsevimab for:

  • most infants under the age of 8 months who are entering or in their first RSV season
  • infants and children ages 8–19 months who have a heightened risk of severe RSV and who are entering their second RSV season

Palivizumab

Palivizumab (or Synagis) is an FDA-approved medication doctors prescribe to premature babies and children with certain types of heart and lung disease. This medication is made from monoclonal antibodies and given monthly as a series of injections (shots) during the 5 months of RSV season.

This medication may help:

  • prevent severe RSV if a child is exposed
  • reduce the number of days a child spends hospitalized
  • reduce the number of days a child has wheezing

It’s important to understand that this medication is not used to treat active RSV infection. Instead, it is used to help prevent severe disease in children who are most likely to experience complications or hospitalization.

There have been several RSV vaccines approved by the Food and Drug Administration (FDA) for high risk groups: infants and young children, older adults, and pregnant people. Speak with a healthcare professional about whether vaccines are right for you or your child.

Doctors also suggest keeping up with your annual flu shot and COVID-19 vaccine to help strengthen your respiratory and immune systems and keep them functioning at their best.

The following hygiene practices may also help:

  • washing hands frequently with soap and water for at least 20 seconds
  • cleaning high touch surfaces often, such as doorknobs, tables, and utensils
  • coughing or sneezing into your elbow or a tissue
  • isolating sick family members, especially babies, young children, and people with chronic health issues or weakened immune systems
  • keeping air flowing in indoor spaces, including opening a window for better circulation when possible
  • masking in social settings or when around people who may have RSV

You should speak with a doctor or get emergency help if you or your child:

Some people may need to be hospitalized for a few days to receive intravenous (IV) fluids, oxygen, or, in severe cases, mechanical ventilation.

If you or your child receives an RSV diagnosis, you’ll probably have some questions. Consider writing down your questions before heading to a doctor’s appointment.

Helpful questions might include:

  • How does RSV differ from a common cold?
  • How long do symptoms typically last?
  • What symptoms indicate I should get emergency help?
  • What medications are available (prescription or OTC) to help?
  • Is my child eligible for Palivizumab injections?
  • How can I prevent the rest of my family from getting sick?
  • How long should I stay home from work/school?
  • What happens if someone is hospitalized with RSV?

How long is someone with RSV contagious?

People with RSV are contagious in the 1–2 days before symptoms start. They remain contagious for between 3 and 8 days after illness onset.

Who is at the highest risk of complications from RSV?

Children who are most likely to experience complications include premature babies and young children with chronic health issues or weakened immune systems. Adults at highest risk include those with compromised immune systems, heart disease, or lung disease and adults over age 65 years.

What time of year is RSV most prevalent?

RSV tends to start in the fall and peak in the winter months. That said, timing and severity can change from year to year, depending on where you’re located.

Most people contract RSV by the time they are toddlers. While the virus is common, it can significantly increase the risk of adverse effects in young children, older adults, and people with certain heart and lung conditions.

Doctors typically recommend preventive medications such as nirsevimab for those who are vulnerable to severe symptoms of RSV. These medications work by strengthening the immune system to protect against serious illness caused by RSV.

Researchers are continually looking into antiviral drugs that may advance available treatment options for RSV in the future.