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RSV (Respiratory Syncytial Virus)

A very common respiratory virus that looks like a cold in most people but can cause serious breathing trouble in babies, older adults and people with heart, lung or immune problems. There is no specific treatment, but there are vaccines, infant antibody shots and everyday habits that lower the risk of severe illness.

Call 911 — or have someone call for you — if a baby, a child or an adult with a cold-like illness has any of these emergency signs:

Get medical help urgently, the same day, if a child is getting worse, is feeding or eating much less than normal, has had a dry diaper for 12 hours or more or shows other signs of dehydration, is very tired or irritable, or has a high temperature — the NHS gives 38°C (100.4°F) for a baby under 3 months and 39°C (102.2°F) or higher for an older baby. The NHS gives the same advice to anyone with difficulty breathing and to anyone with a long-term heart or lung condition or a weakened immune system who gets cold symptoms (NHS, NHS, bronchiolitis). CDC says to call a health care professional about difficulty breathing, not drinking enough fluids or worsening symptoms (CDC).

Signs of dehydration in infants and young children include crying without tears, no wet diapers for 3 hours or more, a dry mouth and tongue, sunken eyes, a high fever, and being unusually sleepy or irritable. Get medical help right away if dehydration comes with confusion, fainting, no urination, a rapid heartbeat or rapid breathing (MedlinePlus). In older adults, confusion is listed among the signs that RSV has caused a more serious infection such as pneumonia (NHS).

Do not drive yourself to the emergency room if you are unwell, and trust your instincts if a child seems seriously ill (NHS). The NHS is the UK’s health service, so in the U.S. call 911 where its pages say 999. No herb, supplement, adjustment or massage treats these emergencies.

What is RSV?

Respiratory syncytial virus (RSV) is a common respiratory virus that infects the nose, throat, airways and lungs (CDC). It usually causes mild, cold-like symptoms, but it can cause serious lung infections, especially in infants, older adults and people with serious medical problems (MedlinePlus). Nearly all children are infected by age 2 (MedlinePlus, NHS). RSV does not usually cause severe illness in healthy adults and children, but CDC calls it the most common cause of bronchiolitis and pneumonia in children younger than 1 year and the leading cause of infant hospitalization in the U.S. (CDC). CDC estimated that 58,000 to 80,000 children younger than 5 were hospitalized with RSV each year before RSV immunizations were introduced (CDC).

Because the symptoms are not specific, RSV is hard to tell apart from a cold, flu or COVID-19 (CDC); see our Colds and Flu guides. Bronchiolitis is inflammation of the small airways in the lung, and pneumonia is an infection of the lungs; RSV can cause both (MedlinePlus). Bronchiolitis is different from bronchitis, which affects people of all ages (NHS, bronchiolitis); see our Bronchitis guide.

How it spreads, and the RSV season

  • How: through droplets when an infected person coughs or sneezes near you; through direct contact, such as kissing the face of a child with RSV; and by touching a surface with the virus on it, such as a doorknob, then touching your face before washing your hands (CDC, MedlinePlus).
  • On surfaces: RSV can survive for many hours on hard surfaces such as tables and crib rails (CDC).
  • How long people are contagious: usually 3 to 8 days, and sometimes a day or two before symptoms start. Some infants and people with weakened immune systems can keep spreading the virus for 4 weeks or longer (CDC).
  • Season: in the U.S., RSV spreads in the fall and winter along with other respiratory viruses and usually peaks in December and January (CDC); MedlinePlus describes the season as usually fall through spring (MedlinePlus). The nirsevimab label tells parents that their health care provider can say when RSV season starts in their area (DailyMed, nirsevimab label).

Who is at higher risk of severe illness?

  • Infants, especially those younger than 6 months (CDC, NHS).
  • Babies and young children who were born prematurely, have chronic lung disease or congenital heart disease, have a weakened immune system, have severe cystic fibrosis, or have neuromuscular disorders (especially with trouble swallowing or clearing mucus); CDC also lists American Indian and Alaska Native children (CDC).
  • Older adults. Sources draw the age line differently: MedlinePlus says especially ages 65 and older, and the NHS names adults over 75 (MedlinePlus, NHS).
  • Adults with certain conditions. CDC’s clinical page lists chronic cardiovascular disease, chronic lung disease, end-stage kidney disease or dialysis, diabetes with complications or treated with insulin or SGLT2 inhibitors, neurologic or neuromuscular conditions that impair airway clearance, chronic liver disease, chronic blood conditions, severe obesity (BMI of 40 or more), moderate or severe immune compromise, and living in a nursing home (CDC). See our Heart, Emphysema & COPD, Asthma, Diabetes, Kidney, Dialysis and HIV/AIDS guides.
  • People who smoke, and babies exposed to tobacco smoke (NHS).

Symptoms

Symptoms usually start about 4 to 6 days after infection and tend to appear in stages rather than all at once. They include a runny nose, decreased appetite, cough, sneezing, fever and wheezing (CDC, MedlinePlus). CDC’s clinical page describes a runny nose and reduced appetite first, with cough following about 1 to 3 days later (CDC). Most infections go away on their own in a week or two (CDC).

  • Very young infants may show only irritability, decreased activity and breathing difficulties (CDC). Babies may also be irritable and feed less than usual (NHS).
  • Adults 50 and older mostly have mild or no symptoms similar to an upper respiratory infection; milder illness typically resolves in 1 to 2 weeks (CDC).
  • When RSV turns serious (pneumonia or bronchiolitis), the NHS lists a cough that gets worse, shortness of breath, faster breathing or long gaps between breaths, difficulty feeding in babies, loss of appetite, wheezing, and confusion in older adults (NHS). For bronchiolitis, symptoms are usually worst between days 3 and 5, and the cough usually gets better in 3 weeks (NHS, bronchiolitis).
  • RSV can worsen underlying lung conditions such as COPD or asthma, and people with these conditions may need treatment for asthma attacks or COPD flare-ups (CDC). CDC’s clinical page also lists worsening heart failure (CDC).

How it’s diagnosed

A provider may use a medical history, a physical exam and a lab test of nasal fluid or another respiratory sample to check for RSV, which is usually done for people with severe infection. For severe infection, tests may also include a chest X-ray and blood and urine tests (MedlinePlus).

We plan separate Babies and Children guides that will cover the early years in more depth.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) No medicine cures or specifically treats RSV. Care is supportive: fluids, rest and comfort at home, and for severe cases hospital oxygen, IV fluids and sometimes breathing support. Prevention is the strongest tool: vaccines for older adults and in pregnancy, antibody shots for infants, and good hygiene. Cost estimate being researched. Most infections go away on their own in a week or two. Most hospital stays for severe RSV last only a few days. Vaccines and antibody shots lower the chance of severe illness but do not guarantee protection.
Chiropractic No established role in preventing or treating RSV. Spinal adjustment does not treat a viral lung infection. About $90–$200 for a first visit and $55–$100 for follow-ups (self-pay estimates). We found little research. One review of manual therapies for children with respiratory diseases did not study RSV specifically. Never a substitute for medical care for a baby or older adult with breathing trouble.
Acupuncture No established role. One small retrospective hospital study from China looked at needle therapy as an add-on to standard care in young children with RSV. About $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. That study reported slightly faster relief of wheezing and cough, but it was retrospective and cannot show cause and effect. Not a treatment for RSV on its own.
Herbal medicine No herb or supplement has been shown to treat or prevent RSV in people. Studies of integrated traditional Chinese medicine for infant bronchiolitis exist, but they are limited. Cost estimate being researched. A 2022 review of Chinese trials reported benefits when traditional Chinese medicine was added to standard care for infant bronchiolitis, but we read only the abstract. Talk to your pharmacist before giving anything to a baby.
Massage therapy Not a treatment for RSV. Airway-clearance (chest physiotherapy) is a different, clinical therapy. About $70–$90 a month at one national chain (Massage Envy) for one 60-minute session a month on a 12-month membership; rates vary by location. A Cochrane review found that standard chest percussion and vibration did not help babies with bronchiolitis, and forced techniques could cause serious harm. Relaxation massage is comfort care at most.
MBHA Wellness Coach Hygiene habits, a household plan for RSV season, tracking feeding and wet diapers, protecting babies and older relatives, vaccine and antibody timing questions for your provider, and knowing when to call or go to the ER. Cost estimate being researched. Good habits lower the chance of catching or spreading RSV and help you spot trouble early, but never replace medical care.

Approach 1 of 6

Conventional medicine (AMA)

There is no specific treatment for RSV infection, and most infections go away on their own in a week or two (MedlinePlus, NHS). That makes prevention and supportive care the heart of conventional medicine for RSV. No doses are given here; your provider or the product label sets them.

1. Care at home

2. Hospital care

In the most severe cases people may need extra oxygen, IV fluids, or a breathing tube with a ventilator, and most of these hospital stays last only a few days (CDC, MedlinePlus). Most otherwise healthy infants and young children do not need to be hospitalized (CDC). We read the abstracts of two Cochrane reviews on bronchiolitis in infants:

  • Heated, humidified high-flow nasal cannula (an oxygen delivery method). A 2024 review of 16 trials (2,813 infants) found that compared with low-flow oxygen it may modestly shorten hospital stay (by about 0.65 days) and oxygen treatment, with low-certainty evidence for those outcomes, and probably lowers the risk that treatment has to be stepped up (moderate certainty). It found no difference in adverse events (Cochrane review, 2024).
  • Nebulised hypertonic (salt-water) saline. A 2023 review of 34 trials (5,205 infants) found it may modestly shorten hospital stays (by about 0.4 days) and may reduce the risk of hospital admission for infants seen as outpatients or in the emergency department, but the certainty of the evidence was low to very low (Cochrane review, 2023). This is a hospital treatment chosen by the care team.

3. Vaccines and antibody shots

Recommendations change, so confirm what is current with CDC and your provider (CDC).

Adults. CDC recommends an RSV vaccine for all adults 75 and older and for adults 50 through 74 who are at increased risk of severe RSV. CDC lists age 75 and older, chronic heart or lung disease, a weakened immune system, certain other underlying conditions and living in a nursing home as risk factors. It is given as a single shot and is not currently an annual vaccine; if you have had one, you should not get another at this time. Late summer and early fall, August through October in most of the continental U.S., is the best time, though it can be given any time of year. If you have a moderate or severe illness, wait until you recover; a minor illness such as a cold is not a reason to wait. Common side effects, usually mild, include pain, redness and swelling where you got the shot, fatigue, fever, headache, nausea, diarrhea and muscle or joint pain. Do not get it if you have had a severe allergic reaction to any of its components (CDC).

  • What the labels say. FDA lists three vaccines for adults: Abrysvo and Arexvy, indicated for ages 60 and older and for younger adults at increased risk, and Mresvia, indicated for 60 and older and for 18 through 59 at increased risk. The FDA labels cover more people than CDC’s recommendation does (FDA, Abrysvo, FDA, Arexvy, FDA, Mresvia).
  • What the trials found. In a trial of about 34,000 adults 60 and older, one vaccine was 66.7% effective against RSV lower respiratory illness with at least two symptoms and 85.7% effective with at least three symptoms at an interim analysis (trial, New England Journal of Medicine). In a trial of about 25,000 adults 60 and older, a different vaccine was 82.6% effective against confirmed lower respiratory disease over a median of 6.7 months of follow-up (trial, New England Journal of Medicine). Both trials were funded by the manufacturers. We read only the abstracts, and results from one season do not tell us how long protection lasts.
  • Guillain-Barré warning. In January 2025 FDA required a warning on Abrysvo and Arexvy. A study in Medicare beneficiaries 65 and older suggested an increased risk of Guillain-Barré syndrome (GBS) in the 42 days after vaccination, with an estimated 9 extra cases per million Abrysvo doses and 7 extra per million Arexvy doses. FDA said the evidence is insufficient to establish that the vaccines cause it, and that the benefits continue to outweigh the risks (FDA safety communication). GBS is a rare disorder in which the immune system damages nerve cells, causing muscle weakness and sometimes paralysis; see our Guillain-Barré guide. Tell your provider about any history of GBS.

Pregnancy. CDC recommends one of two options to protect infants from severe RSV, and most babies do not need both. One is the Pfizer RSV vaccine (Abrysvo) given to the mother at 32 through 36 weeks of pregnancy, from September through January in most of the U.S.; it takes about 2 weeks to protect, and antibodies last about 6 months after birth. A mother who had the vaccine in an earlier pregnancy should not get another dose; her baby should get the antibody instead. CDC lists headache, nausea and pain at the injection site as common effects, and notes that hypertensive disorders of pregnancy, including pre-eclampsia, are possible risks still under study (CDC). The Abrysvo label limits use to 32 through 36 weeks because of a possible risk of preterm birth before 32 weeks; in clinical studies there was a numerical imbalance in preterm births, and the label says the data are insufficient to establish or exclude a causal relationship (DailyMed, Abrysvo label). In a trial of about 7,400 pregnant women, the vaccine was 81.8% effective against severe RSV lower respiratory illness in infants within 90 days of birth and 69.4% within 180 days; it did not meet the study’s success criterion for the broader measure of medically attended RSV illness at 90 days, and no safety signals were detected (trial, New England Journal of Medicine). See our Pregnancy guide.

Infant antibody shots. The other option is an RSV antibody given to the baby (nirsevimab or clesrovimab), with protection starting right away and lasting at least 5 months. CDC recommends it for all babies younger than 8 months whose mothers did not get the pregnancy vaccine, given shortly before RSV season or within a week of birth for babies born October through March in most of the U.S. Some children 8 to 19 months old at increased risk may get nirsevimab before their second season: those born prematurely with chronic lung disease, with severe immune compromise, with severe cystic fibrosis, or who are American Indian or Alaska Native (CDC). These medicines can help prevent severe RSV illness, but they cannot cure or treat children who already have RSV and cannot prevent every infection (MedlinePlus). The nirsevimab label says a child may still get RSV disease after receiving it; its common side effects are rash and pain, swelling or hardness where the shot was given, and serious allergic reactions have been reported (DailyMed, nirsevimab label). The clesrovimab label lists injection-site redness and swelling and rash as the most common reactions and carries the same allergy caution (DailyMed, clesrovimab label). In a trial of 1,490 late-preterm and term infants, a single nirsevimab injection cut medically attended RSV lower respiratory infection from 5.0% to 1.2% (74.5% efficacy); the difference in hospitalizations was not statistically significant in that trial (trial, New England Journal of Medicine).

4. Everyday prevention

MedlinePlus and CDC advise washing hands often with soap and water for at least 20 seconds, avoiding touching your face with unwashed hands, avoiding close contact such as kissing and sharing cups with people who are sick, cleaning and disinfecting frequently touched surfaces, covering coughs and sneezes, and staying home when sick (MedlinePlus, CDC). CDC adds improving indoor air by bringing in fresh air, using air purifiers or meeting outdoors (CDC). The NHS advises keeping newborns away from anyone with a cold or the flu, especially if premature or with serious health conditions (NHS).

What it costs

  • RSV vaccines, antibody shots, doctor visits, tests and hospital care: MBHA cost estimate being researched. Ask your insurer or plan before getting a vaccine.

Find a medical doctor in our directory

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Chiropractic

Chiropractic care has no established role in preventing or treating RSV. RSV is a viral infection of the airways and lungs; spinal adjustments do not treat a virus, and nothing here should delay medical care for a baby or older adult with breathing trouble.

What the research says

We found little research. The closest is a 2013 systematic review of manual therapy for children and adolescents with respiratory diseases, which included 8 studies — 5 in children with asthma and the rest in conditions including cystic fibrosis, bronchiolitis and recurrent respiratory infections. Six reported some benefit (for example in spirometry, immune tests, anxiety scores or stress-hormone levels) and two did not; the authors concluded manual techniques seemed beneficial but called for more standardized studies. Chiropractic, osteopathic medicine and massage were the most common interventions (systematic review, 2013). We read only the abstract. The review was not about RSV, mixed several different conditions and therapies, and its outcomes (such as lung function numbers or anxiety) are not the same as preventing or shortening an RSV infection, so we cannot say chiropractic care helps RSV.

Safety

Mild side effects such as increased pain, stiffness or headache often occur after spinal manipulation; serious problems have been reported but are very rare, and the likelihood may be greater in people with underlying health problems (NCCIH). If you or your baby is sick with breathing symptoms, see a medical provider first.

What it costs

Self-pay estimates are about $90–$200 for a first appointment and about $55–$100 for follow-up visits (The Pricer).

Find a chiropractor in our directory

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Acupuncture

Acupuncture is not a treatment for RSV and does not replace vaccines, hydration or hospital care. Research is very limited.

What the research says

One 2025 retrospective cohort study from a hospital in China reviewed the medical records of 83 hospitalized children under 5 with RSV lower respiratory infections. Forty-two received press needle therapy along with Western medicine and 41 received Western medicine only. The authors reported that wheezing, shortness of breath and cough eased about 0.4 days sooner, and that some airway function measures were better, in the needle group (retrospective study, Medicine). Because it looked back at records rather than randomly assigning children to treatments, it cannot show that the needle therapy caused the difference, and it was small and from one hospital. We read only the abstract. Beyond this, we found little research on acupuncture for RSV.

Safety

Relatively few complications have been reported, but nonsterile needles and improper delivery have caused problems; U.S. needles must be sterile and single-use. Don’t use acupuncture to postpone seeing a health care provider (NCCIH). Tell any practitioner about your or your child’s RSV symptoms, and never delay care for breathing trouble.

What it costs

Private sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer).

Find an acupuncturist in our directory

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Herbal medicine

No herb or supplement has been shown to prevent or treat RSV in people, and none replaces vaccines, fluids, oxygen or other medical care. We do not suggest any herb or supplement for RSV, and we list no doses. “Natural” does not mean risk-free: NCCIH’s digest on herb–drug interactions describes possible interactions with prescription medicines for several popular herbs (NCCIH). Talk to your doctor or pharmacist before giving anything to a baby or young child, or if you are an older adult taking other medicines.

Traditional Chinese medicine for infant bronchiolitis

A 2022 systematic review pooled 46 trials (6,427 children) of integrated traditional Chinese medicine and Western medicine for infant bronchiolitis, which is most often caused by RSV (NHS, bronchiolitis). The reviewers reported better clinical efficacy, about 2.1 days shorter hospital time and a lower recurrence rate than Western medicine alone, with no increase in adverse reactions (meta-analysis, Medicine). We read only the abstract. The review searched English- and Chinese-language trials, the treatments varied, and the abstract does not say which products or herbs were used, so we cannot tell what, if anything, would be safe or helpful for a particular child. The reviewers themselves said further studies are needed to set specific protocols. These trials were not limited to RSV, and are not a reason to give a baby herbs on your own.

Laboratory research

Our PubMed search for herbal products and RSV also returned many laboratory studies. We did not review them; studies in cells or animals cannot show whether something helps people.

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Massage therapy

Massage is not a treatment for RSV. Gentle touch may comfort someone who is unwell, but it does not treat the virus. It helps to know the difference between massage and chest physiotherapy (airway clearance), a clinical therapy delivered in the hospital.

Chest physiotherapy is different

A 2023 Cochrane review of 17 trials (1,679 infants under 24 months) of chest physiotherapy for acute bronchiolitis found, with high certainty, that conventional techniques (percussion and vibration with postural drainage) and forced expiratory techniques made no difference to bronchiolitis severity or other outcomes, and that forced expiratory techniques in infants with severe bronchiolitis do not improve their health and can cause severe adverse effects. Gentler passive slow expiratory techniques may mildly to moderately improve severity scores, but that was low-certainty evidence (Cochrane review, 2023). We read only the abstract. Do not attempt chest percussion or similar techniques on a baby at home; ask the hospital care team.

Massage research

The 2013 review of manual therapies for children with respiratory diseases listed massage among the most common interventions but was not about RSV (systematic review, 2013), and we found little research specific to massage and RSV.

Safety

The risk of harm from massage appears low, though rare serious problems such as blood clots, nerve injury or broken bones have been reported, some with vigorous massage or in people at higher risk, such as older adults. Don’t use massage to postpone seeing a health care provider (NCCIH).

What it costs

One national chain, Massage Envy, charges about $70–$90 a month for a membership that includes one 60-minute session a month, with a 12-month initial term; rates are set by each franchise location and vary (The Pricer).

Find a massage therapist in our directory

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MBHA Wellness Coach

An MBHA Wellness Coach is not a medical provider and cannot diagnose or treat RSV. A coach can help you build habits, make a plan for RSV season and know when to call for help.

Habits that lower the chance of catching or spreading RSV

Plan ahead for RSV season

  • RSV usually peaks in December and January (CDC). Put a reminder on the calendar in late summer.
  • Bring these questions to your provider: Am I (or my parent) due for an RSV vaccine? Should I get the pregnancy vaccine, or should my baby get the antibody shot? CDC’s timing is late summer and early fall for adults, September through January for the pregnancy vaccine, and shortly before the season, or within a week of birth for babies born October through March, for the antibody shot (CDC, adults, CDC, infants).
  • If you or a loved one has asthma, COPD or heart failure, ask your provider for a plan, since RSV can worsen these conditions (CDC, CDC).

If someone gets sick

  • Offer fluids often; for babies, smaller feeds more often (NHS). Keep a simple log of feeds and wet diapers, since fewer wet diapers, crying without tears and unusual sleepiness are dehydration signs (MedlinePlus).
  • Keep a child with bronchiolitis upright when awake, check on them during the night, and keep the home smoke-free (NHS, bronchiolitis).
  • Keep a written list of your medicines and your child’s medicines to share with the care team.

When to get help

  • Difficulty breathing, blue or grey lips or skin, pauses in breathing, or a floppy child who will not wake: call 911 (see the alert at the top of this page).
  • Not drinking, a dry diaper for 12 hours or more, a worsening illness, a high temperature or a very tired or irritable baby: get same-day medical help (NHS).
  • Worsening asthma or COPD symptoms during a cold-like illness: contact your provider (CDC).

Member stories

Living with RSV (Respiratory Syncytial Virus)? Share your experience

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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The Monterey Bay Holistic Alliance is a charitable, independent registered nonprofit 501(c)(3) organization and does not endorse any particular products or practices. Claims and statements herein are for informational purposes only and have not been evaluated by the Food and Drug Administration. We strongly recommend that you seek out your trusted medical doctor or practitioner for diagnosis and treatment of any existing health condition. MBHA provides administrative support, education and navigation — not medical, legal or tax advice — and cannot guarantee claim, billing or fundraising outcomes. MBHA is not an emergency service: in an emergency, call 911 or go to the nearest emergency room.