Respiratory syncytial virus infection (RSV) is a respiratory virus that affects most infants and toddlers by the time they turn 2 years old. It can also affect older children and adults.

RSV infections usually cause mild, cold-like symptoms that you can manage at home. In severe cases, RSV infections may cause inflammation of the airways (known as bronchiolitis) or lung infections (known as pneumonia).

Infants and young children have an increased risk of severe RSV infections, which may require hospitalization to treat.

Read on to learn when RSV infections require emergency treatment.

Each year in the United States, more than 2 million children under 5 years old visit a doctor for RSV. An estimated 58,000–80,000 children require hospitalization for RSV infection.

Children of Color may have an increased risk of developing RSV infection, including a severe infection.

According to the Centers for Disease Control and Prevention (CDC), the peak hospitalization rate for RSV in 2022–2023 was higher for American Indian/Alaskan Native, Hispanic, and Black people than non-Hispanic white people. Children under 6 months of age were most likely to be hospitalized.

A special note

Most of the research on RSV has limited or no participants from underserved populations, even though the CDC reports that Black mothers and infants have a higher mortality risk than other populations.

To understand better how RSV affects these communities, more racial diversity in clinical trials is needed.

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RSV infections may range from mild to severe.

Mild RSV infections cause cold-like symptoms, such as:

  • coughing
  • sneezing
  • runny nose
  • sore throat
  • irritability
  • fussiness
  • fatigue
  • fever
  • decreased appetite

Fever can but doesn’t always occur with RSV infections.

Severe RSV infections may lead to bronchiolitis, which may cause:

  • wheezing
  • flaring nostrils
  • rapid breathing
  • short, shallow breathing
  • rhythmic grunting while breathing
  • bobbing head while breathing
  • caving in of the chest, under and between the ribs
  • gray, blue, or purple tinge to their skin, mouth, or fingernails

These are signs that your child is having difficulty breathing.

Changes in the color of your child’s skin or fingernails may be harder to see if they have darker skin. Watch for a gray, blue, or purple tinge to their lips, tongue, gums, and around their eyes.

Contact a doctor right away or take your child to the emergency department if they develop signs or symptoms of bronchiolitis or you suspect they’re having trouble breathing or aren’t getting enough fluids to stay hydrated.

Most RSV infections go away on their own within a week or two.

If your child has mild cold-like symptoms, you may treat the infection at home.

Consider taking these steps to treat your child’s symptoms and support their recovery:

  • Encourage your child to drink plenty of fluids to stay well hydrated.
  • Install a cool-mist humidifier in your child’s room to help clear blocked airways.
  • If their nose is clogged, administer nasal saline drops and gently suction mucous from their nose. Try to clear their nose before feeding them.
  • If they have a fever, follow your doctor or pharmacist’s directions for administering over-the-counter fever medications, such as acetaminophen or ibuprofen. Ibuprofen should not be given to children under 6 months old. Additionally, giving aspirin to your child isn’t recommended.

Talk with a doctor or pharmacist before giving your child any cold medication. Some cold medications contain ingredients that aren’t safe for young children.

RSV infections can cause mild symptoms that become more severe over time in some cases.

Contact a doctor if your child’s symptoms don’t improve within a week or they get worse.

Severe RSV infections can cause potentially life-threatening breathing difficulties or dehydration that may require emergency treatment to manage.

Contact a doctor right away or take your child to the emergency department if they:

  • have pauses in their breathing or have difficulty breathing
  • develop a gray, blue, or purple tinge to their skin, mouth, or fingernails
  • develop other signs or symptoms of bronchiolitis, which are listed above
  • have fewer than one wet diaper every 8 hours, which is a sign of dehydration
  • become significantly less active or alert than usual

You should also contact a doctor if your child is under 12 weeks old and develops a fever of 100.4°F (38°C) or higher on a rectal thermometer. For older children, contact a doctor if their temperature repeatedly rises above 100.4°F (38°C).

Your child’s doctor may order tests to learn whether they have RSV or another infection.

If hospitalization is required, your child may receive supportive care, such as:

  • suctioning of mucus
  • supplemental oxygen
  • mechanical ventilation
  • intravenous (IV) fluids
  • tube feeding

Most children who receive supportive care in the hospital for RSV go home within a few days.

Mild RSV infections cause cold-like symptoms, which usually resolve without treatment within 1 to 2 weeks. You can typically manage a mild RSV infection at home.

Severe RSV infections may lead to bronchiolitis or pneumonia, which may require treatment in a hospital. Infants under 6 months of age have an increased risk of severe RSV infection.

Contact a doctor or take your child to the emergency department if you suspect they’re having difficulty breathing or they’re not drinking enough fluids to stay hydrated. Their doctor may prescribe supportive care to help them breathe and stay hydrated.

Most children who require hospitalization for RSV return home within a few days.