Young children, older adults, and people with certain health conditions may be at higher risk for complications from RSV. Understanding your risk can help you make informed decisions about your health and the health of your family.

Respiratory syncytial virus (RSV) is a common cause of respiratory illnesses. In most people, RSV infection causes mild cold-like symptoms that get better within 1 to 2 weeks.

In some cases, though, RSV infection can cause severe complications that require hospitalization, such as bronchiolitis or pneumonia. People who are hospitalized with RSV may receive oxygen, intravenous (IV) fluids, and IV medication.

In this article, you’ll find answers to commonly asked questions about who’s at risk for severe illness from RSV.

RSV infections are very common in young kids. Experts estimate that 90% of children will experience an RSV infection by their second birthday.

Research on the frequency of RSV infection in adults is limited, but some studies suggest that RSV is the cause of 7% to 20% of upper respiratory infections in adults.

People of all ages contract RSV, even if they have had it before. The immune system does not develop complete immunity to the virus, so people can get RSV multiple times, sometimes within the same season.

Tracking RSV infections can be challenging because people may not always get tested for the virus. In most cases, people who have an RSV infection experience mild, cold-like symptoms that are similar to those of other respiratory illnesses.

People can usually manage the symptoms of RSV at home. But even if someone goes to the doctor, they may not be tested unless they’re likely to have serious complications.

Anyone can develop severe complications from RSV, but the virus tends to cause more severe illness in children and older adults.

Children under age 4 are the most likely age group to be hospitalized for RSV infection. According to data from the Centers for Disease Control and Prevention (CDC), the monthly hospitalization rate for children ages 0 to 4 years was 241 per 100,000 at its highest point during the 2022 to 2023 RSV season.

Although RSV infections are generally mild in adults, people ages 65 and older are also at risk for severe RSV infection. As a comparison, the monthly hospitalization rate for this age group was 20 per 100,000 at its highest point during the 2022 to 2023 RSV season.

Most cases of RSV are not severe, but it can be hard to estimate of how often RSV causes severe complications because people do not usually get tested for the virus.

One study published in 2022 estimated that RSV infections are responsible for more than 10% of hospitalizations due to respiratory illness in children less than 1 year old. Another 2022 study suggests that the proportion of RSV-related hospitalizations in this age group is closer to 45%.

The CDC estimates that, in a typical season, RSV leads to:

  • 58,000 to 80,000 hospitalizations and 100 to 300 deaths in children under age 5
  • 60,000 to 160,000 hospitalizations and 6,000 to 10,000 deaths in adults ages 65 and older

Adults under 65 can experience severe complications from RSV infection, but severe complications are much more common in young children and older adults.

According to the American Lung Association, adults with certain health conditions are more likely to develop severe illness as a result of RSV.

An analysis of several studies found that, among adults under 65 who have an RSV infection, those with a chronic medical condition are up to 28 times more likely to develop severe illness than those without such a condition.

Q: What health conditions put you at risk for severe RSV infection?

Anonymous

A:

For infants and young children, risk factors for severe RSV infection include prematurity, congenital heart disease, lung disease, and some neuromuscular disorders that can affect breathing. As a result, it may be beneficial to give RSV prophylaxis (palivizumab) to those who meet certain criteria in order to prevent severe disease.

For adults, those at higher risk for severe disease include people above 65 years of age and those who have conditions including chronic lung diseases, such as COPD or asthma, or heart disease.

People who have weak immune systems, particularly those who have undergone bone marrow transplant, are also at a very high risk of developing severe RSV.

Megan Soliman, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Although most cases of RSV are mild, young children and older adults are more likely to develop severe complications that require hospitalization. Adults under 65 have an increased risk for severe illness from RSV if they have other health conditions that affect their lungs, heart, or immune system.

If you or someone in your life is at risk for severe illness due to RSV infection, you can help prevent infection by washing your hands often, avoiding close contact with others (especially those who may be sick), and cleaning frequently touched surfaces often.

If you develop cold-like symptoms and you’re at higher risk for severe RSV infection, connecting with a healthcare professional early can help you get on track to recovery.