An infection from a respiratory syncytial virus (RSV), a cold-like virus, can include a cough. It may clear in a few weeks but can be a concern in young children, older adults, and those with chronic respiratory conditions. Treatments include medications, humidifiers, and more.

person in bed with an RSV coughShare on Pinterest
Lambert And Young/Getty Images

According to the Centers for Disease Control and Prevention, each year in the United States, there are 58,000 – 80,000 hospitalizations of children under 5 years old and 60,000 to 160,000 hospitalizations of adults 65 years or older due to RSV.

A common virus that typically resembles a cold, experts consider RSV particularly serious for young children and older adults. RSV symptoms often include a cough that can range in severity. If you or someone you care for has this cough, you may be able to let it run its course naturally, but you may also need to contact a doctor if the cough negatively affects breathing.

An RSV cough can sound wet from mucus. The cough often involves wheezing or labored breathing in individuals with serious infections.

In one 2020 study, researchers looked at the accuracy of nurses and doctors in identifying RSV based on the sound of the cough in infants under 1 year old.

They found that it took 3.5 years of work experience before medical staff could diagnose RSV based on the cough alone. It may be more difficult to recognize RSV as the likely cause of a cough in older children and adults.

They also found that while senior staff and nurses could correctly identify RSV 76.2% and 73.1% of the time, a nasal swab sample was still the gold standard for diagnosis.

RSV symptoms typically present 4–6 days after infection and usually last one to two weeks. However, symptoms may persist past this point, and additional complications are possible.

RSV coughs can range in seriousness. It’s typical to have a mild cough linger after other symptoms clear up. However, if an individual’s cough sounds bark-like and labored, it can be a sign of bronchiolitis or pneumonia.

In infants, short, shallow, and rapid breathing is a sign of serious RSV. It’s important for caregivers to look for a “caving-in” of the chest in between and under the ribs, nostrils flaring with every breath, and atypically fast breathing.

When to get emergency care

It’s important to call 911 or get emergency care if you or your child is having trouble breathing, not getting enough liquids, or if symptoms are worsening.

Also, notify your child’s doctor if:

  • symptoms do not improve in 7 days
  • an infant under 12 weeks has a fever with a rectal temperature of 100.4°F (38°C) or higher
  • a child of any age has a fever that repeatedly goes above 104°F (40°C)
  • chest pain or signs of an ear infection develop

RSV (and RSV cough) typically goes away within 2 weeks or so.

Nasal saline and gentle sucking to clear out the nose can be especially useful in young children and infants. A cool mist humidifier can also help break up mucus and make breathing easier. Acetaminophen or ibuprofen can help relieve fevers in individuals older than 6 months.

It is advisable for caregivers to always check with their child’s doctor before offering cold medications, since many contain ingredients that can be harmful to children’s health.

It’s important to drink plenty of liquids. In more severe RSV cases, doctors can offer oxygen and intravenous fluids at the hospital to help with breathing and staying hydrated.

There have been several RSV vaccines approved by the Food and Drug Administration (FDA) for adults and children. Speak with a healthcare professional about whether vaccines are right for you or your child.

Not sure where to start the conversation with your child’s doctor? Here are some questions you can ask:

  • What would you suggest I do to make my child more comfortable?
  • When should I take my child to urgent care or the emergency room?
  • Are there any medications that might help relieve my child’s symptoms?
  • How long should I wait before bringing my child in again if symptoms don’t improve?

Some other symptoms of RSV include:

Below are frequently asked questions relating to RSV coughs.

Can I get RSV from my child?

RSV is contagious, and individuals can pass it on to each other regardless of age. To help prevent transmission, you can wash hands and surfaces regularly and teach your child to cough into their elbow.

How do you know it’s RSV causing cold symptoms?

Your doctor may perform a nasal swab to confirm that your child has RSV. This can also help rule out other viral infections.

How can you prevent RSV cough?

Immunization during pregnancy and immunization of infants in the first year can help prevent RSV coughs.

Other methods to reduce the risk of infection include washing hands regularly and disinfecting surfaces and toys. You may also wish to avoid crowded places where germs can pass easily between people. When appropriate, nursing may also provide antibodies that can help.

RSV often appears like a cold, with symptoms that resolve naturally in a few days. But for some individuals, it can become more severe. It can be especially serious for individuals with chronic conditions that affect their respiratory systems, infants, and older adults.

It’s important to get medical assistance if you have a cough that worsens and negatively affects breathing. Also, notify a doctor if your symptoms don’t improve after a week or two.