RSV Cough: Is It as Bad as It Sounds?

An infection from a respiratory syncytial virus (RSV), a cold-like virus, can include a cough. It may clear in a few weeks but can be a concern in young children, older adults, and those with chronic respiratory conditions. Treatments include medications, humidifiers, and more.

According to the Centers for Disease Control and Prevention , each year in the United States, there are 58,000 to 80,000 hospitalizations of children under 5 years old and 60,000 to 160,000 hospitalizations of adults 65 years or older due to RSV.

A common virus that typically resembles a cold, experts consider RSV particularly serious for young children and older adults. RSV symptoms often include a cough that can range in severity. If you or someone you care for has this cough, you may be able to let it run its course naturally, but you may also need to contact a doctor if the cough negatively affects breathing.

An RSV cough can sound wet from mucus. The cough often involves wheezing or labored breathing in individuals with serious infections.

In one 2020 study, researchers looked at the accuracy of nurses and doctors in identifying RSV based on the sound of the cough. They found that it took 3.5 years of work experience before medical staff could diagnose RSV based on the cough alone. They also found that while senior staff and nurses could correctly identify RSV 76.2% and 73.1% of the time, a nasal swab sample was still the gold standard for diagnosis.

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When to get emergency care

It’s important to call 911 or get emergency care if you or your child is having trouble breathing, not getting enough liquids, or if symptoms are worsening.

• symptoms do not improve in 7 days
• an infant under 12 weeks has a fever with a rectal temperature of 100.4°F (38°C) or higher
• a child of any age has a fever that repeatedly goes above 104°F (40°C)
• chest pain or signs of an ear infection develop

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RSV symptoms usually last 5 to 7 days and are typically their worst on days 3 to 5. But a mild cough can linger for several weeks after this.

RSV coughs can range in seriousness. It’s typical to have a mild cough linger after other symptoms clear up. However, if an individual’s cough sounds bark-like and labored, it can be a sign of bronchiolitis or pneumonia.

In infants, short, shallow, and rapid breathing is a sign of serious RSV. It’s important for parents to look for a “caving-in” of the chest in between and under the ribs, nostrils flaring with every breath, and atypically fast breathing.

RSV (and RSV cough) typically goes away on its own in a few weeks . Because there is currently no medical cure for RSV, doctors tend to focus on helping relieve some of the discomforts from symptoms.

Nasal saline and gentle sucking to clear out the nose can be especially useful in young children and infants. A cool mist humidifier can also help break up mucus and make breathing easier. Acetaminophen or ibuprofen can help relieve fevers in individuals older than 6 months.

It is advisable for parents to always check with their child’s doctor before offering cold medications, since many contain ingredients that can be harmful to children’s health.

It’s important to drink plenty of liquids. In more severe RSV cases, doctors can offer oxygen and intravenous fluids at the hospital to help with breathing and staying hydrated.

Not sure where to start the conversation with your child’s doctor? Here are some questions you can ask:

• What would you suggest I do to make my child more comfortable?
• When should I take my child to urgent care or the emergency room?
• Are there any medications that might help relieve my child’s symptoms?
• How long should I wait before bringing my child in again if symptoms don’t improve?

Some other symptoms of RSV include: