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4 Things Older Adults Need to Know About RSV as Cases Surge

Little ones aren’t the only ones in danger from this common respiratory virus

Shot of a man coughing while recovering from an illness on the sofa at home
Charday Penn

It’s often thought of as a risk to young kids, but respiratory syncytial virus (or RSV for short) can be downright dangerous for older adults too.

More than 177,000 older Americans wind up in the hospital each year because of RSV — well within the range of the flu’s annual impact — and roughly 14,000 die from it. And right now, cases of RSV are surging in many areas of the country. Data from the Centers for Disease Control and Prevention (CDC) show that nationwide infection rates have skyrocketed in the past few weeks, and older adults are being hospitalized at higher rates than previous years.

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That’s bad news ahead of what many experts say could be a stormy season for flu and COVID-19. All three illnesses — RSV, influenza and COVID-19 — share a similar list of symptoms. And all three cause complications in adults with certain chronic health conditions and in those who are 65 and older. 

“I think RSV is a virus that’s been a little bit under the radar screen, but it’s responsible for a significant number of infections,” says Marshall Glesby, M.D., associate chief of the Division of Infectious Diseases at Weill Cornell Medicine in New York. “So it is something to be aware of.”

Here’s what you need to know about RSV, including how to help prevent an infection and how to spot warning signs if you do get sick.

1. Symptoms are hard to separate from other common illnesses 

What makes the increase of RSV cases so tricky, especially this time of year and given the pandemic, is that many of its common symptoms overlap with those of the common cold, flu and COVID-19.

A cough, a fever and a runny nose often accompany an RSV infection, the CDC says. Same with wheezing, sneezing and a decrease in appetite. You may even notice a “pinkeye-type of manifestation” or sinus-like issues, Glesby adds. It’s typical for these symptoms to appear in stages, not all at once.

Most adults who get RSV will experience a mild course of these ailments. But in some adults — especially older adults who have weaker immune systems — the illness can turn serious and lead to pneumonia or congestive heart failure. People with asthma and chronic lung disease may also suffer with more severe symptoms that make it difficult to breathe.

2. Shortness of breath is a warning sign you need medical attention

If you find yourself battling a bad case of RSV, you may need to be hospitalized.

Shortness of breath is one warning sign that you should seek immediate medical attention. “If you find yourself having coughing spasms or fits where it’s hard to catch your breath, that’s not normal,” says Patricia A. Stinchfield, a pediatric nurse practitioner and president of the National Foundation for Infectious Diseases (NFID). The same goes if you get out of breath while doing routine chores.

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“That means that your lungs and your heart and your circulatory system are sort of overworking,” Stinchfield says. (Likewise, struggling to catch a breath or taking short and shallow, rapid breaths are red flags for severe RSV in babies.) 

You should check in with a doctor if you have significant weakness or your symptoms get worse and won’t go away, Glesby says.

Are you at high risk?

  • Adults at highest risk for severe RSV infection include:
  • Older adults, especially those 65 and older
  • Adults with chronic heart or lung disease
  • Adults with weakened immune systems

Source: Centers for Disease Control and Prevention

“The main thing for older adults and parents of young children is to listen to your gut. If your gut is saying, ‘I don't think this is normal, and I’m scared,’ that's when it’s time to call [the doctor],” Stinchfield says.

An NFID report found that although adults with RSV and influenza report similar symptoms, RSV patients don’t seek medical attention as quickly as flu patients.

3. There is no specific treatment for RSV 

Unlike with the flu or COVID-19, there isn’t an antiviral treatment available for the majority of adults that can knock out RSV, nor is there a vaccine that can help prevent it, though researchers are working to develop both.

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There also isn’t an easy at-home test that can tell you if your illness is due to RSV. If you go to your doctor’s office with symptoms, they’ll probably test you for multiple viruses to rule out different treatment options.

If you’re positive for RSV, over-the-counter pain relievers can help to manage fevers and general discomfort. Fluids can help keep you hydrated and your immune system functioning at its best, Stinchfield says. If you need to be hospitalized, you may receive oxygen support and fluids through an IV.

4. RSV is very contagious 

You can catch RSV just like you might catch the flu and other respiratory bugs. Virus droplets can fly through the air when an infected person coughs or sneezes and land in your eyes, nose or mouth. RSV can survive for several hours on hard surfaces, the CDC says, so be sure to wipe down high-touch areas (think doorknobs, light switches and TV remotes) if you or someone you live with is sick.

You can also get RSV from direct contact with the virus, say by kissing an infected grandchild on the face. Once you have it, you’re usually contagious “for quite a while,” Stinchfield says — up to eight days. Some infants and people with weakened immune systems can spread the virus for as long as four weeks, according to the CDC. 

To that point, if you have a grandchild or another little one you plan to be around who is battling a runny nose and cough, it’s best to wait until symptoms subside before visiting, Stinchfield says.

As RSV rages, it’s important to wash your hands often (and correctly, which means with soap and water for 20 seconds), wipe down frequently touched surfaces and avoid touching your eyes, nose and mouth — all familiar precautions from the coronavirus pandemic, Glesby says. Finally, if you can, stay home when you are sick.

Editor's note: This article, originally published Oct. 26, 2022, has been updated to include new information.