These Are the First Warning Signs of RSV, Doctors Say

This respiratory virus is on the rise among people of all ages.

As winter approaches, you may be worrying about the new COVID variant—but another illness is on the rise as well. Respiratory syncytial virus (RSV) rates are spiking, according to The New York Times—and may even be behind a new amoxicillin shortage that has many people concerned about whether they'll be able to access needed medication. (Although antibiotics can't combat viruses, they are frequently used to fight secondary bacterial infections that can occur.)

Knowing the early signs of RSV is important, so you can seek treatment before it becomes more serious. Read on to find out what to watch for.

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People of all ages can get RSV.

Mother and daughter in office speaking to doctor.

While RSV has long been known as a potentially dangerous virus that affects mostly infants and young children, Emily Martin, PhD, MPH, an associate professor of epidemiology at the University of Michigan School of Public Health told The New York Times that "Adults still get RSV fairly regularly and they can get reinfected multiple times throughout adulthood."

RSV may not be as well known as other seasonal illnesses, but cases of the virus are surging. "CDC surveillance has shown an increase in RSV detections and RSV-associated emergency department visits and hospitalizations in multiple U.S. regions, with some regions nearing seasonal peak levels," reports the Centers for Disease Control and Prevention (CDC). "Clinicians and public health professionals should be aware of increases in respiratory viruses, including RSV."

RSV can be mistaken for the common cold.

Woman coughing and covering her mouth.

In many adults and older children without preexisting health conditions, RSV symptoms "are mild and typically mimic the common cold," says The Mayo Clinic. However, "RSV can cause severe infection in some people, including babies 12 months and younger (infants), especially premature infants, older adults, people with heart and lung disease, or anyone with a weak immune system (immunocompromised)." According to the National Institute of Allergy and Infectious Diseases (NIAID), RSV causes 160,00 deaths each year worldwide.

The symptoms of RSV don't always happen all at once; frequently, they can occur in stages. "In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties," says the CDC.

Secondary infections caused by RSV can be serious.

Doctor looking at x-ray of lungs.
Wasan Tita/iStock

It's when severe cases of RSV cause problems like pneumonia and bronchiolitis that the condition can turn serious and even life-threatening, warns the Cleveland Clinic. Pneumonia occurs when there is an infection in the lungs, and bronchiolitis is an "inflammation of the small airways in the lungs," their experts explain.

The early warning signs of RSV can vary depending on the age of the patient, cautions the American Lung Association, which explains that the first signs can include congestion, runny nose, fever, coughing, and a sore throat. "Very young infants may be irritable, fatigued and have breathing difficulties," says the site. "Normally these symptoms will clear up on their own in a few days." But each year in the U.S., RSV results in 58,000-80,000 hospitalizations among children under five, and 60,000-120,000 hospitalizations among adults 65 years and older.

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These symptoms may be a sign of severe RSV.

Doctor with patient who is coughing.

When RSV causes a "barking or wheezing" cough, it can be an early indicator of something more serious, warns the American Lung Association: "In these instances, the virus has spread to the lower respiratory tract, causing inflammation of the small airways entering the lungs" which can then result in pneumonia or bronchiolitis. Other signs to watch out for include breathing that is rapid or labored, preferring to sit up rather than lie down, and a "bluish color of the skin due to lack of oxygen (cyanosis)," says the Mayo Clinic.

Infants with a severe case of RSV "will have short, shallow, and rapid breathing," the American Lung Association explains. This can be identified by "caving-in" of the chest between and under the ribs, nostrils that flare with every breath, and abnormally fast breathing. Cyanosis can also occur in infants, potentially manifesting in "skin, lips, and nail beds," notes the Boston Children's Hospital.

Luisa Colón
Luisa Colón is a writer, editor, and consultant based in New York City. Her work has appeared in The New York Times, USA Today, Latina, and many more. Read more
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