Quick answer: in most adults, respiratory syncytial virus (RSV) feels like a common cold: runny nose, congestion, sore throat, cough, and tiredness that clear in 1 to 2 weeks. It becomes a bigger concern for adults 75 and older and for people with chronic heart or lung disease or a weakened immune system. The CDC estimates that 110,000 to 180,000 adults ages 50 and older are hospitalized with RSV in the United States each year.
RSV symptoms in adults
Symptoms usually begin 4 to 6 days after exposure and tend to come on in stages rather than all at once:
- Runny or stuffy nose
- Sore throat
- Cough, which can be dry or produce mucus
- Sneezing
- Headache and tiredness
- Low fever, or no fever at all
- Reduced appetite
Signs that the infection has reached the lower airways include wheezing, shortness of breath, a cough that keeps getting worse, and chest tightness. These need an examination.
How long does RSV last, and how long is it contagious?
Most healthy adults recover in 1 to 2 weeks, although the cough can hang on longer. Adults with RSV are usually contagious for 3 to 8 days and can begin spreading the virus a day or two before symptoms appear. People with weakened immune systems can continue to spread it for 4 weeks or longer, even after they feel better.
RSV spreads through coughs and sneezes, through direct contact such as kissing a child's face, and from surfaces. This matters in households with a newborn or an older relative: an adult with a "mild cold" can pass RSV to someone for whom it is not mild.
Who is at risk of severe RSV?
- Adults 75 and older
- Adults with chronic lung disease such as COPD or asthma
- Adults with chronic heart disease, including heart failure
- People with a weakened immune system
- People with diabetes with complications, advanced kidney disease, liver disease, or severe obesity
- Residents of nursing homes
In these groups RSV can lead to pneumonia and can worsen asthma, COPD, and heart failure.
RSV, flu, COVID-19, or a cold?
You cannot reliably tell these apart by symptoms. As a rough guide, the flu starts abruptly with fever and body aches, RSV builds gradually and is more likely to cause wheezing, and COVID-19 can look like either one. If you are at higher risk, testing matters because the flu and COVID-19 both have antiviral treatments that work best when started early. We test for flu and COVID-19 on site, with results while you wait. See our guides to flu symptoms in 2026 and COVID symptoms in 2026.
How RSV is treated in adults
There is no routine antiviral medicine for RSV in otherwise healthy adults, and antibiotics do not treat it. Care is supportive:
- Fluids and rest
- Acetaminophen or ibuprofen for fever and aches, if those are safe for you
- Saline nasal spray and a humidifier for congestion
- Your usual inhalers on schedule if you have asthma or COPD, with a low threshold to be seen if you need them more often
At our clinic, a visit for a worsening respiratory illness includes listening to your lungs, checking your oxygen level, and testing for flu and COVID-19. When pneumonia is a concern we can take a chest X-ray on site, and we can give a breathing treatment for wheezing. Patients with asthma or COPD can read more about our asthma and lung disease care.
RSV vaccine guidance for adults
The CDC recommends a single dose of RSV vaccine for:
- Everyone 75 and older
- Adults 50 to 74 who are at increased risk of severe RSV
The RSV vaccine is not an annual shot. If you have already had one dose, you do not need another at this time. The best time to be vaccinated is late summer or early fall, before RSV begins to circulate, but eligible adults can be vaccinated at any time. A separate RSV vaccine is given during pregnancy to protect newborns. Ask your pharmacy or regular medical provider about availability.
When to come to urgent care, and when to go to the ER
Walk in to urgent care for:
- Wheezing or a cough that is getting worse rather than better
- A fever that lasts more than 3 days
- Symptoms that worsen after the first week
- A flare of asthma, COPD, or heart failure
- Any respiratory illness in an adult 75 or older who seems weaker, more short of breath, or is not eating or drinking
Call 911 or go to the emergency room for:
- Trouble breathing or shortness of breath at rest
- Bluish or gray lips or face
- Chest pain or pressure
- New confusion, or difficulty staying awake
Walk in today, no appointment needed
Advanced Urgent Care of Pasadena is at 797 S Arroyo Pkwy, Pasadena, next to Petco, with free on-site parking. We are open Monday through Friday 8 AM to 8 PM and Saturday and Sunday 9 AM to 5 PM, and we take our last patient 30 minutes before closing. We serve Pasadena, South Pasadena, Altadena, San Marino, Alhambra, and nearby communities. Questions? Call (626) 304-0404.
Sources
- CDC: RSV in Adults
- CDC: Symptoms and Care of RSV
- CDC: How RSV Spreads
- American Lung Association: RSV Vaccination to Protect Adults
This article is general health information and is not a substitute for an examination by a medical provider. If you think you are having a medical emergency, call 911.