Can Adults Get RSV? What to Know About Your Risk

Most of the time, an RSV infection is merely uncomfortable, but in some cases it can be life-threatening. Among adults, the infection is riskiest for older adults with weakened immune systems or chronic (long-term) conditions such as heart or lung disease.

Symptoms of RSV in Adults

For most healthy adults who get RSV, the virus causes symptoms that resemble those of a cold or the flu:

• Runny nose
• Nasal congestion
• Sore throat
• Coughing
• Fatigue
• Fever

Having a barking or wheezing cough, however, may be a reason to worry about RSV. It may signal that the infection is becoming worse and has spread to your lower respiratory tract, causing bronchiolitis (an inflammation of the small airways in your lung) or pneumonia (an infection of your lungs).

How Do Adults Get RSV?

Like other respiratory infections, RSV is highly contagious and spreads via sneezing, coughing, and even kissing.

Peak season for RSV infection in the United States includes fall, winter, and spring. But some doctors have been seeing infections in warmer months as well.

Who Is Most at Risk From RSV as an Adult?

• Are ages 75 and over
• Live with chronic heart or lung disease
• Have weakened immune systems
• Have certain other underlying medical conditions
• Live in nursing homes

“This is due to older adults having a lower respiratory reserve and less lung capacity,” says Inessa Gendlina, MD, PhD, an infectious diseases physician at Montefiore Health System and an assistant professor of medicine at the Albert Einstein College of Medicine in New York City.

• Chronic cardiovascular disease (heart failure, coronary artery disease, congenital heart disease [excluding isolated hypertension])
• Chronic lung or respiratory disease (chronic obstructive pulmonary disease, emphysema, asthma, interstitial lung disease, cystic fibrosis)
• End-stage renal disease
• Diabetes with complications or requiring treatment with insulin or a sodium-glucose cotransporter-2 (SGLT2) inhibitor
• Neurologic or neuromuscular conditions causing impaired airway clearance or respiratory muscle weakness
• Chronic liver disease (cirrhosis)
• Chronic hematologic conditions (sickle cell disease, thalassemia)
• Severe obesity
• Other chronic health conditions identified by a healthcare provider

Living in a nursing home can raise the risk of severe RSV as well.

Severe disease from RSV infection can also worsen existing symptoms of heart disease, asthma, or chronic obstructive pulmonary disease (COPD). The virus, Dr. Gendlina says, is now known to have a high mortality rate for people with these conditions.

Testing for RSV

If you’re sick with a respiratory infection and you don’t know which kind, it’s best to get tested, says Adi S. Shah, MBBS, an infectious disease expert at Mayo Clinic in Rochester, Minnesota.

The symptoms of RSV can overlap with those of COVID-19 and the flu, but there are several lab tests available to help with diagnosis.

Your doctor can carry out an antigen or PCR (polymerase chain reaction) test to identify or rule out RSV as the cause of your symptoms.

If you can’t get to your doctor or another healthcare facility, you can get an FDA-authorized 3-in-1 home test by Labcorp to find out whether you have the flu, COVID-19, or an RSV infection. You swab your nose to collect a sample, then FedEx it to a lab for PCR testing.

You can purchase a kit without a prescription online or in stores. The test results will come back in around one to two days through an online portal. You can then follow up with a healthcare provider.

How to Treat RSV in Adults

There is no treatment for a mild or moderate RSV infection. In most cases, doctors simply recommend drinking plenty of fluids, taking over-the-counter pain or fever medication, and resting. Symptoms should go away on their own in a week or two.

Ribavirin, an FDA-approved antiviral drug that treats severe lung infections caused by RSV, is available. But it’s known to have multiple and potentially serious side effects.

Gendlina says that people who have severely weakened immune systems — a blood stem-cell transplant recipient, for example — may take oral or inhaled ribavirin to fight off the infection. They might need to take either form of the drug along with immunoglobulin (antibodies from healthy people) that’s given through a vein.

How to Prevent an RSV Infection

An infection from RSV isn’t completely avoidable, but there are a couple of ways to reduce your risk.

Vaccination

The FDA has approved three RSV vaccines:

• Arexvy, from GSK (GlaxoSmithKline)
• Abrysvo, from Pfizer
• mRESVIA, from Moderna

• All adults 75 and older
• Those ages 50 to 74 at increased risk of severe RSV disease
• Pregnant people

Practice Healthy Habits

• Wash your hands often. If soap and water aren’t available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.
• Avoid touching your eyes, nose, and mouth to prevent the spread of viruses from your hands.
• Cover your mouth and nose with a tissue when sneezing and coughing, or sneeze and cough into your elbow.
• Avoid close contact (within six feet) with others who have coughs, colds, or are sick with a known RSV infection.
• Stay home if you’re sick.
• Don’t share cups, bottles, or other objects. RSV can live on such surfaces for hours (and be spread to your hands).
• If you’re prone to sickness or have a weakened immune system, stay away from large crowds of people.
• Clean frequently used surfaces such as doorknobs and countertops with a virus-killing disinfectant.

The Takeaway

• Adults can get sick with RSV, and for some, infection can be risky.
• Mild RSV cases tend to get better on their own, but serious ones can send someone to the hospital for treatment.
• You can minimize the odds of getting RSV with simple steps, such as handwashing. Vaccination can help prevent an infection from become severe, especially if you’re 75 and older or have a condition that raises your risk of RSV complications.