RSV is the leading cause of hospitalizations in all infants. Know the signs and symptoms that may indicate worsening illness and when to contact your child’s healthcare provider.

When you're expecting a baby, it's natural to consult recent parents to learn their stories and learn helpful tips. You may be told about a disease called respiratory syncytial virus, or RSV. This virus is so common that nearly 100% of children catch it before the age of two. In addition to poor appetite, the initial symptoms of RSV are similar to those of a common cold: runny nose, fever, and cough.

Very young babies may be fussy, tired, and have trouble breathing. Symptoms usually go away on their own within a week, but it's important to stay in close contact with your baby's healthcare provider and know what to do. The diagnosis of RSV is based on your child's medical history, the time of year, and a physical exam. You may order a white blood cell count and virus screening test to confirm the diagnosis. All babies can experience severe RSV with short, shallow, rapid breathing. Their chest may sink between the ribs and below the ribs; this is known as chest wall retractions. Nasal flaring occurs. The mouth, lips, and nails may take on a bluish color from lack of oxygen. Each year, about 58,000 children age five and younger are hospitalized due to RSV. RSV is highly contagious and spreads from person to person through close contact with secretions from coughs and sneezes or by touching objects where the virus is present.

To help protect your newborn baby, take these steps:

  • Avoid close contact with people who have respiratory infections.
  • Do not share cups, bottles, or toys that may be contaminated by the virus.
  • Wash your hands with soap and water after coming into contact with a person who has a respiratory infection.

Learn more about RSV at Lung.org/rsv.


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

You should call your doctor if you or your child is having trouble breathing, has poor appetite or decreased activity levels, cold symptoms that become severe, a shallow cough that continues throughout the day and night.

Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.

Page last updated: June 14, 2022

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