RSV symptoms in adults are more serious than many people realize. Respiratory Syncytial Virus (RSV) is commonly associated with infants and young children — but adults, especially those over 65 or with underlying health conditions, can become severely ill. Every year, RSV hospitalizes an estimated 177,000 adults aged 65 and older in the United States. If you or a loved one is experiencing RSV symptoms, understanding what to look for and when to seek care can make a critical difference.
What Are RSV Symptoms in Adults?
In healthy adults, RSV symptoms often look like a moderate cold. However, in older adults or those with weakened immune systems or chronic conditions, RSV can progress to lower respiratory tract illness — and that is when it becomes dangerous.
Common RSV symptoms in adults include:
- Runny or stuffy nose
- Sore throat
- Cough — often dry or mildly productive
- Low-grade fever (less common than in children)
- Headache
- Fatigue
- Decreased appetite
RSV symptoms that indicate lower respiratory involvement (more serious):
- Worsening cough becoming more productive or persistent
- Shortness of breath or difficulty breathing
- Wheezing
- Chest tightness or pain
- Rapid or labored breathing
- Worsening fatigue that limits daily activities
- Cyanosis — a bluish tint to the lips or fingertips (emergency sign)
RSV symptoms typically appear 4–6 days after exposure and last 1–2 weeks. However, in high-risk individuals, illness can last longer and become more severe.
RSV Symptoms in Adults vs. Children: Key Differences
RSV behaves very differently depending on the age and immune status of the person infected. Understanding these differences helps caregivers and patients respond appropriately.
In healthy adults: RSV typically causes upper respiratory symptoms only — similar to a mild to moderate cold. Most recover within 1–2 weeks without specific treatment.
In older adults (65+) or those with chronic conditions: RSV can move into the lower respiratory tract, causing bronchitis or pneumonia. It can worsen existing conditions like COPD, asthma, or heart failure — sometimes severely enough to require hospitalization.
In infants and young children: RSV is the leading cause of bronchiolitis (inflammation of the small airways) and pneumonia in children under 1 year. RSV symptoms in infants include fast breathing, flared nostrils, pulling-in of the chest, poor feeding, and grunting with each breath. Infants under 6 months with any signs of breathing difficulty need emergency evaluation.
In immunocompromised adults: RSV can cause severe pneumonia, respiratory failure, and may be life-threatening. These patients should seek care at the first sign of RSV symptoms.
Who Is at Highest Risk for Severe RSV?
The CDC identifies the following groups as being at highest risk for severe RSV illness:
- Adults 60 years and older — especially those in long-term care facilities
- Adults with chronic lung disease — COPD, asthma, cystic fibrosis
- Adults with chronic heart disease — congestive heart failure, congenital heart disease
- Immunocompromised individuals — including those with HIV, cancer patients on chemotherapy, organ transplant recipients, and those on immunosuppressive medications
- Adults with diabetes, kidney disease, or liver disease
- Premature infants and children under 2 with congenital heart or lung conditions
If you are in one of these groups and develop RSV symptoms, do not wait to be evaluated. Early care reduces the risk of serious complications.
RSV vs. Flu vs. COVID: How to Tell the Difference
RSV symptoms overlap significantly with influenza and COVID-19. Here is how they compare:
- RSV: Gradual onset, prominent nasal congestion and cough, less fever than flu, can cause wheezing — particularly in those with underlying lung disease.
- Flu: Sudden onset, prominent fever, severe body aches, fatigue — often feels more intense than RSV.
- COVID-19: Variable onset, loss of taste or smell is distinctive, more likely to cause gastrointestinal symptoms, and can cause post-COVID symptoms (long COVID).
All three can cause serious illness in vulnerable groups. Testing is the only reliable way to distinguish them. CityHealth offers rapid testing for flu, COVID, and can evaluate for RSV and other respiratory illnesses at all locations.
When to Go to Urgent Care for RSV Symptoms in Adults
For many adults with RSV, symptoms can be managed at home. However, visit CityHealth Urgent Care when:
- You are 60 or older and RSV symptoms are worsening
- You have asthma, COPD, heart disease, diabetes, or another chronic condition, and RSV symptoms are affecting your breathing
- You have a fever above 102°F that has lasted more than 3 days
- Your cough is worsening significantly after the first week
- You are too fatigued to maintain adequate food and fluid intake
- You are caregiving for a child or elderly person with RSV symptoms who is worsening
- You want testing to confirm RSV vs. flu vs. COVID and clarify treatment options
At CityHealth, we can assess your oxygen saturation, evaluate your lungs, perform diagnostic testing, prescribe supportive medications, and determine whether hospital-level care is needed.
When to Go to the ER for RSV Symptoms
Go to the emergency room immediately if you or a loved one with RSV symptoms has:
- Significant difficulty breathing or shortness of breath at rest
- Oxygen saturation below 94% (if you have a pulse oximeter at home)
- Blue or grayish color around the lips or fingernails
- Confusion, extreme lethargy, or inability to be aroused
- Chest pain with breathing
- Rapid deterioration in someone with COPD, heart failure, or an immune condition
- An infant who is struggling to breathe, is not feeding, or appears very ill
Treatment Options for RSV Symptoms in Adults
There is currently no specific antiviral treatment for RSV in otherwise healthy adults. Treatment focuses on relieving RSV symptoms and supporting recovery:
- Rest: Allow your body to focus energy on fighting the virus.
- Hydration: Stay well hydrated — fluids help thin mucus secretions.
- Fever and pain management: Ibuprofen or acetaminophen for fever and discomfort.
- Nasal decongestants and saline rinses: Help manage nasal symptoms.
- Bronchodilator inhalers: May be prescribed for patients with wheezing or underlying lung conditions.
- Supplemental oxygen: Required for patients with low oxygen saturation — provided at urgent care or hospital depending on severity.
- Hospitalization: Needed in severe cases for IV fluids, oxygen therapy, and close monitoring.
In immunocompromised patients, antiviral medications such as ribavirin may be used under specialist supervision, though evidence is limited.
RSV Prevention: What You Can Do
RSV spreads through respiratory droplets and contact with contaminated surfaces. Reduce your risk by:
- Washing hands frequently with soap and water for at least 20 seconds
- Avoiding close contact with people who have cold or respiratory symptoms
- Disinfecting high-touch surfaces in your home
- Avoiding touching your face — especially eyes, nose, and mouth
- Staying home when you are sick to avoid spreading RSV to vulnerable people
RSV vaccines: As of 2023–2024, RSV vaccines are now available for adults 60 and older. The CDC recommends that older adults discuss RSV vaccination with their healthcare provider, as it significantly reduces the risk of lower respiratory tract disease from RSV. CityHealth providers can advise you on whether the RSV vaccine is right for you.
How CityHealth Manages RSV Symptoms
At CityHealth Urgent Care in Oakland and San Leandro, we provide comprehensive respiratory illness evaluation. When you come in with RSV symptoms, we will:
- Assess your oxygen levels and respiratory status
- Perform a physical exam including lung auscultation
- Order diagnostic tests for flu, COVID, and other respiratory pathogens as indicated
- Prescribe supportive treatments — nebulizer treatments, inhalers, or other medications
- Arrange emergency transfer if your condition warrants hospital-level care
Walk in any day — no appointment is needed. RSV can escalate quickly in at-risk adults, and having a clinical evaluation early in your illness is always worthwhile.
Frequently Asked Questions About RSV Symptoms in Adults
How long do RSV symptoms last in adults?
In otherwise healthy adults, RSV symptoms typically resolve in 1–2 weeks. In older adults or those with chronic conditions, RSV may last longer and can lead to complications requiring several weeks to recover.
Can adults get RSV more than once?
Yes. RSV immunity is incomplete and short-lived. You can get RSV multiple times throughout your life. Prior infection provides only partial protection.
Is RSV contagious?
Highly. RSV spreads through respiratory droplets (coughing and sneezing) and by touching contaminated surfaces then touching your face. People with RSV are most contagious during the first 3–8 days of illness.
When should I be worried about my elderly parent with RSV symptoms?
Watch for breathing difficulty, rapid breathing, confusion, decreased urine output, fever that does not improve, or deterioration of a chronic condition like COPD or heart failure. These are signs that warrant immediate medical evaluation.
Do not dismiss RSV symptoms — especially if you or a loved one is in a high-risk group. Walk into CityHealth Urgent Care for a thorough evaluation and peace of mind.
