Understanding RSV: Symptoms, Diagnosis, and Treatment

Illustration of RSV virus
Photo: Free Image

What is RSV?

Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States.

Respiratory Syncytial Virus (RSV) is an extremely common but contagious illness that infects the lungs and breathing passages and is the most common cause of bronchiolitis. It can spread through the air, contact with secretions (such as saliva, mucus, and tears), or contact with contaminated objects and surfaces. 

While many cases of RSV are mild and cause no more than a few days of coughing and a runny nose, some cases can be more severe and lead to serious complications, especially for children. It is important to understand the symptoms, diagnosis, and treatment of RSV to recognize the virus and get appropriate medical care.

How Serious is RSV?

Child with oxigen mask
A child with Respiratory Syncytial Virus with an inhaler. Children are most susceptible to RSV. Photo: iStock

If you are exposed to RSV as an adult, you might have a bout of coughing and a runny nose and feel like you have the flu.

Babies and young children could become ill to the point of hospitalization. 

RSV causes more deaths in children under one-year-old than any other type of infection.

Babies and young children are at risk for serious health problems and even death if they get infected. According to a recent study, one in every fifty children die from this disease in low-income and middle-income countries. At this age, the immune system is still developing, and babies are at greater risk for serious complications from the infection.


Symptoms usually appear about four to six days after acquiring the infection. If you are an adult you most likely will have just mild cold-like symptoms.

These symptoms may include:

      • A cough that may or may not produce sputum (phlegm) 
      • Runny nose 
      • Asthma or wheezing 
      • Shortness of breath 
      • Hard time sleeping
      • Fever 


If you have these symptoms or others, your doctor will likely ask about your medical history, but he/she will be unlikely to order any tests because there is no specific diagnosis for RSV.  

To rule out other conditions and determine the best course of treatment, your physician may order tests such as a blood test, chest X-ray, or sputum (phlegm) cultures. These tests are usually done only if you have a child that is younger than two months old or if you have a complicated or severe case of RSV. 


In severe cases, there may be a few complications that can occur. 

      • Breathing Problems – RSV can cause wheezing, a whistling sound in the lungs (stridor), rapid breathing, and slow or irregular heart rate. In severe cases of RSV, these breathing problems can require treatment in the hospital, including a breathing tube (intubation). 
      • Pneumonia – If you have significant difficulty breathing and have a high fever, you may have a bacterial infection in the lungs, which can develop as a complication of RSV. Bacterial pneumonia can be serious and needs to be treated with antibiotics. 
      • Swallowing Problems – Since the respiratory system and the digestive system are close together, RSV can also affect the esophagus, the tube that connects the throat to the stomach. If a baby or young child with RSV develops significant sputum in their throat, they may have trouble swallowing and aspiration (taking in) their saliva and mucus. Esophagitis can occur in both breastfeeding and non-breastfeeding infants. If it is recognized early and treated, most cases resolve without complication.

Treatment of RSV

Doctor taking child's temperature

There is no specific treatment. Instead, doctors support and treat the symptoms as they arise. If you have severe or life-threatening issues, you may need to be hospitalized to get more focused care. 

For milder symptoms, take the following steps to support your body and allow the virus to pass without complications: – Rest and rest as needed. If you are not breastfeeding, it is best to rest for a few days.

If you are breastfeeding, you may still want to rest as needed. – Drink plenty of fluids. You can take in fluids by drinking water, juice, or sports drinks. You may also want to take in electrolytes through gels or packs. Avoid drinking carbonated beverages as these can lead to increased vomiting. – Take a pain reliever as needed for any coughing or pain. – Ask for help with childcare and housekeeping.


Man washing his hands with sanitizer
Photo by Towfiqu barbhuiya on Unsplash

There is no way to prevent RSV completely. However, taking steps to prevent the transmission of the virus can help reduce the risk of getting infected. The list below has been stated previously in other articles on respiratory diseases, but it never hurts to reiterate!

      • Wash hands regularly with soap and warm water for at least 20 seconds. 
      • Avoid touching your face and then touching your baby. This includes coughing and sneezing into your elbow, not your hands.
      • Avoid close contact with infants who have RSV.
      • Avoid crowds, especially if you are breastfeeding. 
      • Avoid places with poor air quality.

RSV in Infants and Young Children

For infants and young children, RSV can cause serious illness and even death. Babies under two months of age are at the highest risk for complications from RSV, including death.

The following signs may indicate that your child has RSV and should be checked by a doctor: 

      • Increased breathing rate or difficulty breathing 
      • Coughing that produces thick or colored sputum 
      • Poor feeding (e.g., appearing lethargic or sleepy, not feeding well, looking irritated or stressed when feeding)
      • Blue or purple coloring of hands and feet
      • Poor weight gain. If your child has any of these symptoms, you should contact your doctor right away to discuss their illness and get medical advice 

When to Seek Medical Care 

If you have any symptoms of RSV, particularly if you are breastfeeding and have an infant, it is important to contact your doctor. If your child has severe symptoms, you should seek medical care. If your child is less than two months old and has any of the following symptoms, they should be seen by a doctor: – Breathing difficulty – High fever – Poor weight gain.


Most people with RSV recover without any complications. It is important to rest and drink plenty of fluids to reduce the severity and duration of symptoms.

In some cases, people with RSV can develop pneumonia. If someone develops pneumonia, they may need antibiotics. If the infection spreads to the bloodstream, some people will need to be hospitalized and may need antibiotics to treat it. 

If your child has RSV, it is best to rest and take care of yourself as well. Taking good care of your health can help you take better care of your child.

If you were born between 1947 and 1957, you may have been exposed to a different type of RSV as a child. The infection was less common and often more severe, with a higher risk of complications and death. While you will have immunity to the type of RSV that is more common today, you may be at risk for a severe infection if exposed to the older type.


What is a Virus?

Coronaviurs rendering
Rendering of the coronavirus with spike proteins showing. Photo by CDC from Pexels

At this point, why should we discuss the coronavirus if we don’t know what it is or more generally, what a virus is, so let’s dive right in and get the answer to this!

What is a Virus?

A virus is not a cell. Cells refer to living organisms, but viruses are not alive. And since they are not living entities, they are parasites that must live within a host to perform their functions. So when we refer to these entities, we will always refer to them as a virus and not as a cell. Now, let’s break down the structure of a virus.

A virus contains a genetic code, called RNA (Ribonucleic acid). RNA is similar to DNA but it contains only one single strand, and it is this code that contains the message to produce proteins that creates the virus. These proteins are called nucleoproteins, which give the virus their structure as well as enable them to replicate.

The RNA contains a blueprint for developing nucleoproteins. When it attacks a healthy cell, it will send in information to that cell to mutate it.

Surrounding the virus is the viral envelope. It protects the genetic code that is within the virus and sets an anchor for its proteins to infect the healthy cells.

Specifics of the COVID-19 Virus

For the coronavirus, spike proteins protrude out from the envelope’s anchor and act as grappling hooks that grab onto the healthy cells and inject the virus’s proteins. The spikes closely resemble a crown, which gives the virus its name “corona” and means “crown” in Latin. 

Illustration of a spike proteinGiven the insights so far, researchers have identified hundreds of coronaviruses. However, only seven of them can infect humans and cause disease. 

For decades, coronaviruses have continued to infect humans, such as SARS, and MERS, which infect and damage the lungs. On the other hand, there are four coronaviruses that remain highly contagious -causing infections that lead to common cold symptoms and worse. 

The seventh coronavirus SARS-CoV-2 that causes the COVID-19 disease is slightly different as it contains the features of all six coronaviruses. It is highly contagious, fast-spreading, and causes symptoms like the common cold; however, this same virus can infect and damage the lungs. Hence, the seventh coronavirus that has infected humans is of the utmost concern to researchers and healthcare practitioners worldwide. 

Given its nature and that the viruses are constantly changing, the mutations in SARS-CoV-2 are critical to researchers. Here we take a closer look at how and why viruses mutate and why the mutation of SARS-CoV-2 is a major concern for global authorities. 

The Evolution of Viruses 

As a rule, viruses are constantly changing. They replicate and evolve within the host. However, it is important to understand how RNA viruses behave for a better understanding of how viral mutations work.

How do RNA Viruses Behave?

There are two types of viruses: 

      • RNA viruses, and 
      • DNA viruses. 

RNA viruses tend to be smaller and have fewer genes, making it easier for them to affect several hosts and replicate quickly within their host. On the other hand, DNA viruses are larger than RNA viruses and have a complicated replication mechanism. At the same time, RNA viruses can replicate easily and quickly. Given its speed and nature of replication, when RNA viruses replicate, there is always a potential mistake that can cause changes in the structure of the virus. These mistakes, also known as mutations, lead to variations in the structure and features of the virus compared to the original virus. 

Many of these mutations may not affect the properties, structures, and features of the virus, while many mutations can be harmful to the virus. However, a few mutations may make the virus better suited for certain environments, including a new host species. Hence, when an RNA virus enters a new host species and replicates itself, it is more likely to have more mutations to make the virus stronger. It is precisely due to this feature that epidemics like SARS and MERS and pandemics like COVID-19 resulted when the RNA coronavirus spread from animals to humans.

However, the process of mutation doesn’t stop here. Since RNA viruses continue to replicate within humans, they make a variation. While these variations are not robust enough to create a completely new virus, they are certainly strong enough to create new variations, also known as strains. Given these variations during the replication process, we have four variants of concern for COVID-19.

The coronavirus is an RNA virus. However, it is different from other RNA viruses due to its size. It is larger than most of the other RNA viruses, which creates more opportunities for dangerous mutations and the creation of new variations. 

Why is Coronavirus Mutation a Concern?

Photo by Fusion Medical Animation on Unsplash

The mutation of SARS-CoV-2 is a concern for global authorities as the persistent changes in the virus are leading to the emergence of new variants. So far, the world has witnessed the emergence of new variants, including Alpha, Beta, Delta, and now Omicron, some of which lead to more severe infections and a higher need for hospitalization. Given the virus’s changes in structure and features, some of these variants have been more successful in transmitting the disease and replicating within the host than the original virus strain.

While words such as mutation can seem terrifying and make you believe that something dramatically different will happen with the emergence of the new variant, that’s not always the case. In most cases, mutations of the RNA virus have little or no immediate effect on its ability to cause disease or more severe disease. However, certain mutations that are strong enough to create new variations can be a threat primarily because the mutations in the virus can make it less recognizable for our immune system. As a result, it is more difficult to fight off the infection. 

Another concerning aspect of mutations is that the new variants can make anti-viral drugs and vaccines less effective, leaving individuals more prone to the virus and more severe diseases. After all, vaccines and anti-viral drugs are specifically tailored to target the specific virus. Due to this reason, we need a flu vaccine each year that targets its mutations. 

However, compared to the influenza virus mutation, the SARS-CoV-2 mutates relatively slowly, which is a positive aspect for researchers and vaccine developers. The slower rate of mutation may allow vaccines and anti-viral drugs to remain effective in controlling the severity of infection even with the emergence of new variants. 

Still, we are not sure how long our bodies will remain immune to coronaviruses or vaccines. While scientists and researchers are closely studying the coronaviruses, their mutation, and the emergence of new variants, we must continue to follow COVID-19 safety protocols. Continue to wear a face mask and maintain social distance till researchers are confident that the seventh coronavirus is no longer dangerous for humanity.