Respiratory syncytial virus (RSV) isn’t just a childhood illness; adults can and do get infected, and for some, the consequences can be severe. While most people experience mild, cold-like symptoms, certain populations face a heightened risk of hospitalization and even death. This is due to waning immunity, underlying health conditions, and the virus’s ability to exacerbate existing respiratory issues.
What is RSV?
RSV is a common, highly contagious virus that infects the lungs and breathing passages. Most people have been exposed at least once by age two, but immunity diminishes over time. Recent surges in cases, even outside the typical fall and winter seasons, have brought renewed attention to the virus’s potential impact on adults.
Symptoms in Adults: More Than Just a Cold
For healthy adults, RSV often presents as a typical upper respiratory infection:
- Runny nose
- Nasal congestion
- Sore throat
- Coughing
- Fatigue
- Mild fever
However, a barking or wheezing cough should raise concern, as it may indicate the infection has spread to the lower respiratory tract, causing bronchiolitis or pneumonia. These complications are more common in high-risk individuals.
Who is Most Vulnerable?
Certain groups are at significantly higher risk of severe RSV disease:
- Adults aged 75 and older
- People with chronic heart or lung disease (COPD, asthma, heart failure)
- Individuals with weakened immune systems
- Those with chronic conditions like diabetes, kidney disease, or obesity
- Residents of nursing homes
Each year, an estimated 160,000 older Americans are hospitalized with RSV, with up to 10,000 dying from complications. This is because older adults have reduced lung capacity and diminished respiratory reserves, making them more susceptible to severe illness. The virus can also worsen existing heart and lung conditions, leading to a higher mortality rate.
How Does RSV Spread?
RSV spreads like other respiratory viruses: through sneezing, coughing, and close contact. The virus can survive on surfaces for hours, and people remain contagious for three to eight days, though some immunocompromised individuals may spread the virus for up to four weeks.
Diagnosis and Testing
If you suspect RSV, a medical test can help confirm the diagnosis. Doctors can perform rapid antigen or PCR tests to differentiate RSV from COVID-19 or the flu. Home testing kits are also available, allowing you to collect a nasal swab and mail it to a lab for PCR analysis.
Prevention: Vaccination and Hygiene
The FDA has approved three RSV vaccines specifically for adults: Arexvy, Abrysvo, and mRESVIA. The CDC recommends vaccination for all adults aged 75 and older, as well as those aged 50-74 with increased risk factors. These vaccines have been shown to be highly effective in preventing severe illness.
Beyond vaccination, practicing good hygiene is crucial:
- Wash your hands frequently with soap and water.
- Avoid touching your face.
- Cover coughs and sneezes.
- Stay home when sick.
- Disinfect frequently touched surfaces.
The Bottom Line
RSV can affect adults, and while most cases are mild, severe illness is possible, especially among older and immunocompromised individuals. Vaccination, combined with basic hygiene practices, can significantly reduce the risk of infection and complications. Staying informed about symptoms and seeking medical attention when necessary is essential for protecting your health.
