What Are the Symptoms of RSV?
Initial signs of RSV are similar to mild cold symptoms, including congestion, runny nose, fever, cough and sore throat. Very young infants may be irritable, fatigued and have breathing difficulties. Normally these symptoms will clear up on their own in a few days.
A barking or wheezing cough can be one of the first signs of a more serious illness. In these instances, the virus has spread to the lower respiratory tract, causing inflammation of the small airways entering the lungs. This can lead to pneumonia or bronchiolitis.
Infants with severe RSV will have short, shallow and rapid breathing. This can be identified by "caving-in" of the chest in between the ribs and under the ribs (chest wall retractions), "spreading-out" of the nostrils with every breath (nasal flaring), and abnormally fast breathing. In addition, their mouth, lips and fingernails may turn a bluish color due to lack of oxygen.
How RSV Is Diagnosed
Because mild RSV symptoms are similar to the common cold, testing usually isn't required to diagnose the infection. However, your doctor may suspect RSV based on your medical history, time of year and a physical exam. In this case, they may want to run lab tests to confirm the diagnosis. The most common is a mouth swab or a blood test to check white blood cell counts and look for viruses.
In severe RSV cases that require hospitalization, additional testing may be needed. Imaging tests, such as a chest X-ray or CT scan can check for lung complications. Blood and urine cultures may be necessary when infants are very sick, as RSV-related bronchiolitis can occur with a urinary tract infection in newborns.
When to See Your Doctor
Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.
Page last updated: October 24, 2020