Can Adults Get RSV? What to Know About Respiratory Syncytial Virus

RSV is a respiratory virus with a widespread impact during peak fall and winter months. While it’s often considered a childhood illness, RSV in adults can lead to serious, even life-threatening, symptoms for individuals and age groups who are at high-risk.  

The Centers for Disease Control estimates up to 160,000 older adults in the U.S. are hospitalized each year because of RSV. One study says that among those hospitalized in the 2022-2023 season, 17 percent were admitted to the ICU and 5 percent required ventilator support.

Because of these risks, knowing how to prevent, diagnose, and treat RSV can help you protect yourself and others from severe illness this season. 

What is RSV? 

Respiratory syncytial virus (RSV) infects the lungs and respiratory tract. While the timing and severity of the illness varies each year, the season typically begins in the fall and peaks during the winter months. RSV presents a greater risk to infants and older adults, especially those with compromised immune systems.

“It’s important to watch for lower respiratory symptoms such as wheezing and shortness of breath,” said Robert Wilson, MD, a family medicine physician with Covenant Medical Group.  “High-risk individuals should be evaluated if these conditions linger or worsen.” 

Is RSV Contagious? 

RSV spreads easily from person to person. When an infected person coughs or sneezes, virus droplets settle on nearby surfaces and often live there for several hours. If you touch a contaminated surface and then touch your face before washing your hands, the virus can enter your eyes, nose or mouth. Airborne transmission is also possible but occurs less often in RSV than with COVID or flu. 

Symptoms of RSV in Adults 

RSV symptoms often mimic those of other common viral and bacterial infections – you may contract the illness and not know it. In most healthy adults, mild cold-like symptoms include runny nose, sneezing, cough, sore throat, congestion, fever and body aches. These symptoms sometimes lead to a secondary lung infection or pneumonia. RSV in high-risk adults can worsen serious underlying health conditions like asthma, chronic lung disease and congestive heart failure.

It’s especially important to know when to see a physician or seek emergency care. Contact your provider if you experience these symptoms:  

• Difficulty breathing 
• High fever 
• A bluish tint to your skin 
• Wheezing 
• Dehydration 
• Other worsening issues 

If you’re admitted to the hospital, treatment may include IV fluids for dehydration and supplemental oxygen to improve oxygen saturation. A nebulizer may be used to treat wheezing. This device converts liquid medicine to an inhalable mist that’s delivered directly to your lungs. 

Who is at Highest Risk for Severe RSV Illness? 

Those at highest risk for severe RSV illness include adults who have chronic cardiovascular and lung disease and weakened immune systems. Adults 75 or older and those with certain conditions like severe obesity or diabetes are also at greater risk. 

How Long Do RSV Symptoms Last in Adults? 

The duration of the RSV illness depends on factors including your age, overall health and the severity of your symptoms. You may become contagious a day or two before showing signs of illness and remain contagious for three to eight days. 

The older you are, the longer it may take to recover, because your body loses some of its disease-fighting abilities with age. “Humoral immunity describes the body’s ability to produce antibodies for protection against invading pathogens,” said Dr. Wilson. “In older adults, immune cells are less effective in producing these antibodies. This lowers their humoral immune response.” 

You are less contagious when your symptoms have improved, and you’ve been fever-free for at least 24 hours. Use precautions for several days to reduce the risk of spreading the illness as your body fully sheds the virus. 

RSV Diagnosis and Treatment 

If you suspect an RSV infection, your physician can test for the virus using a fluid sample from your nose. Samples are collected using a nasal swab or aspirate, which involves inserting saline solution into your nose and removing it with a gentle suction. A rapid test of the sample takes around 10 minutes and can confirm infection. 

There’s no specific treatment for RSV illness – most infections go away on their own in a week or two. To relieve mild symptoms, be sure to rest and drink plenty of fluids to prevent dehydration. You can manage fever and pain using over-the-counter medicines such as acetaminophen or ibuprofen. A saline solution may also be helpful to clear mucus from the nose. 

Anti-viral treatments are not usually administered to treat RSV but may be prescribed for high-risk adults with immune deficiencies. If you have COPD or asthma, stay on top of your prescribed medications to reduce breathing difficulties. Talk with your physician if you need to adjust medications or if you experience severe or worsening symptoms. 

If you become seriously ill, are hospitalized or are at increased risk for complications, your provider may order a respiratory pathogen panel. This molecular test finds common pathogens and determines whether an illness is caused by a virus or by bacteria that can be treated with medication. 

How to Prevent RSV Infection 

You can help prevent the spread of RSV and other respiratory illnesses by practicing good hygiene and staying away from others when you are sick. Cover your coughs and sneezes, wash or sanitize your hands regularly and clean frequently touched surfaces. 

“Because viruses spread easily from your hands to your eyes, nose, and mouth, frequent handwashing is key to prevention,” said Dr. Wilson. “If soap and water are unavailable, you can use a hand sanitizer with at least 60 percent alcohol to kill germs on your hands.” 

For those 60 and older, vaccination is one of the best tools to boost immunity and prevent serious RSV illness. Immunizations are available for older adults at increased risk, with three RSV vaccines now licensed by the FDA for use. The CDC recommends the RSV vaccine for all adults ages 75 and older and for those ages 60-74 who are at increased risk for severe RSV illness. The RSV vaccine is also recommended for adults living in nursing homes or long-term care facilities, or who work in daycare centers and schools. 

The RSV vaccine is given as a single dose and protects from the virus for at least two winter seasons. “Vaccines are well-studied and are shown to be safe and effective in preventing severe RSV,” said Dr. Wilson. “Studies show they prevent severe illness and the need to seek medical care by up to 80 percent. They also decrease the risk of bronchitis and pneumonia by up to 75 percent.” 

The RSV vaccine is also approved for pregnant women between 32-36 weeks of pregnancy. By transmitting their immunity, mothers can better protect infants from RSV and reduce the risk of hospitalization if they are exposed to the virus. Talk with your OB-GYN for more information about vaccines during pregnancy. 

“Vaccine side effects are similar to those of other immunizations. They include slight pain at the injection site and the potential for fever, weakness, and muscle aches,” said Dr. Wilson. “These are indications of the immune system ramping up, not of virus infection.” 

Where to Get the RSV Vaccination

RSV vaccines are available through your primary care provider. The primary care providers at Covenant Medical Group have served families in the Knoxville, Tennessee, area for more than 60 years and are led by board-certified internal and family medicine physicians. To find a location near you, visit Covenant Health Primary Care Services.

“Consider scheduling your vaccine in early fall to give your immunity time to build before peak season,” said Dr. Wilson. “This is especially important as we approach holiday gatherings and an increased potential for exposure.” 

Out-of-pocket costs for the RSV vaccine vary. Based on recommendations from the Advisory Committee on Immunization Practices, Medicare Part D typically covers the RSV vaccine without any out-of-pocket cost. Private insurance plans may also cover the cost of the vaccine. Check with your insurance provider for your coverage details. 

Talk with your doctor about steps you can take to prevent RSV, especially if you are at high risk for severe illness. Visit our website to find a primary care provider in your area.