What You Need to Know About RSV and Pneumonia
Respiratory syncytial virus (RSV) causes mild illness in most children and adults. However, pneumonia can be serious, requiring treatment and sometimes hospitalization. Rarely, for people at high risk, pneumonia can be fatal.
RSV causes a viral infection that most people come in contact with before age 2 . For some infants, older adults, and people with certain health conditions, an RSV infection can become severe and lead to other health conditions, like bronchiolitis and pneumonia.
Here’s what you need to know about pneumonia caused by RSV, who’s at risk, and what treatments may help.
RSV pneumonia is pneumonia that results from an RSV infection.
RSV is a respiratory virus. It typically stays confined to the upper airways. In certain situations, though, it can move into the lungs. While rare , this is when RSV-related pneumonia may develop.
Pneumonia is a lung infection. When a person has pneumonia, the air sacs in their lungs fill with fluid and pus. This extra strain can make breathing difficult and lead to other symptoms.
RSV is the leading cause of pneumonia in children under age 1 in the United States.
Symptoms of RSV may be as mild as a runny nose and sore throat. When pneumonia develops, you may notice symptoms that happen slowly or suddenly.
Symptoms may include:
- cough with yellow, green, or bloody sputum
- fever, chills
- shallow or rapid breathing patterns
- rapid pulse rate
- chest pain with deep breaths or coughing
- fatigue
- low appetite
Newborns may not show obvious signs of pneumonia. Young children may experience nausea and vomiting with pneumonia, while older adults may feel confused or have trouble thinking.
Research suggests that having a severe form of RSV may make certain people vulnerable to a secondary bacterial infection.
One of the earliest symptoms of serious illness with RSV is a barking cough or wheezing. When this happens, it means that the infection has moved to the lungs.
When infection and inflammation take hold in the small airways into the lungs, it can result in bacterial pneumonia.
Diagnosis of RSV pneumonia starts with a physical exam. Your doctor will ask about your symptoms and how long you have had them.
Tests to diagnose RSV pneumonia include the following:
- Chest X-ray:Chest X-rays allow doctors to see any inflammation in the lungs.
- Blood tests: A complete blood count can help your doctor see if your body is dealing with an infection.
- Pulse oximetry:Pulse oximetry measures the level of oxygen in your blood. It’s a small sensor that attaches to either your ear or finger.
There are various other tests your doctor may perform depending on the severity of your symptoms and your medical history.
- blood gas test
- sputum Gram’s stain
- blood culture
- bronchoscopy
- CT scan of the chest
- pleural fluid culture
RSV itself is a virus. It tends to clear up for most people within 1 to 2 weeks with no specific treatment. Since RSV-related pneumonia is usually bacterial pneumonia, it can be treated with antibiotics that your doctor prescribes.
Other treatments may include:
- taking over-the-counter pain relievers and fever reducers
- staying hydrated by drinking water and other fluids
- resting to allow the body to heal
- using comfort measures, like adding moisture to the air with a humidifier to help open your airways
Some people may need care in a hospital setting. For example, this is the case for 1 to 2 out of every 100 children under 6 months old.
Hospitalization may include:
- oxygen therapy
- breathing treatments
- IV fluids
- intubation
- mechanical ventilation
People at the highest risk for serious illness, like pneumonia, related to RSV include:
- premature infants
- children 6 months old and younger
- children under 2 years old with congenital heart disease or lung disease
- children with compromised immune systems
- children with neuromuscular disorders
- adults over age 65
- adults with chronic heart and lung issues
- adults with compromised immune systems
The outlook for somebody with RSV pneumonia depends on a number of factors. In severe cases, a person may need to be hospitalized for specialized care. Even if a person is hospitalized, it’s usually only for a few days .
Some people recover from pneumonia quickly — in as little as a week. For others, it may take a couple of months until they feel back to their typical health.
Complications of pneumonia include:
- respiratory failure
- sepsis
- acute respiratory distress syndrome
- lung abscess
Is there a vaccine for RSV?
No. Researchers are working on a vaccine. Right now, the only preventive measure is a drug called palivizumab (Synagis). It is only available to babies and young children at the highest risk.
How often does RSV result in hospitalization?
According to the Centers for Disease Control and Prevention (CDC) , 58,000 to 80,000 children under age 5 and 60,000 to 160,000 adults over age 65 are hospitalized with severe RSV each year.
When is RSV season?
The exact season is different each year. The usual onset of RSV season is between mid-September and mid-November. It typically lasts until between mid-April and mid-May.
Make an appointment with your doctor if you have concerns about a respiratory illness. It can be difficult to tell if RSV has moved to the lungs by symptoms alone. Your doctor can perform the necessary tests to diagnose pneumonia and prescribe medications and other treatments so you’ll feel better.
If you have any of the following symptoms, like trouble breathing, nasal flaring, or blue-tinted lips or fingertips, contact your doctor or head to the emergency room. Pay close attention to your symptoms, especially if you have risk factors for severe infection.
Last medically reviewed on March 29, 2023
How we reviewed this article:
Austra Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- Bianchini S, et al. (2020). Role of respiratory syncytial virus in pediatric pneumonia.
ncbi.nlm.nih.gov/pmc/articles/PMC7766387/ - Cai W, et al. (2020). Risk factors for hospitalized respiratory syncytial virus disease and its severe outcomes.
ncbi.nlm.nih.gov/pmc/articles/PMC7578333/ - Jain H, et al. (2022). Respiratory syncytial virus infection.
ncbi.nlm.nih.gov/books/NBK459215/ - Pneumonia diagnosis. (2022).
nhlbi.nih.gov/health/pneumonia/diagnosis - Respiratory syncytial virus infection (RSV). (2022).
cdc.gov/rsv/index.html - RSV symptoms and diagnosis. (2023).
lung.org/lung-health-diseases/lung-disease-lookup/rsv/symptoms-diagnosis - Shibata T, et al. (2020). Respiratory syncytial virus infection exacerbates pneumococcal pneumonia via Gas6/Axl-mediated macrophage polarization.
jci.org/articles/view/125505
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.