Cold, Flu or RSV? How to Tell Which Virus You Might Have, From Testing to Symptoms

Most RSV infections, the agency said, “go away on their own in a week or two.”

So, if you’re an adult who’s not at higher risk for severe RSV, the CDC recommends managing fever and pain symptoms with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. It’s also important to drink fluids to prevent getting dehydrated.

Stay home as much as you can

Remember, the big difference between having “just” a cold and having RSV is that if you spread RSV, you’re potentially endangering infants and older people who are at much higher risk from it. The best thing to do is keep away from others as much as possible while you’re sick — especially infants and people aged 60 and older. And “definitely don’t go out if you have a fever,” Chin-Hong said — “that’s probably the highest risk.”

What if you really can’t stay indoors away from others? Then it’s time to wear a well-fitted face covering like an N95 or KN95 mask, Chin-Hong said. By masking, you’ll reduce the risks of spreading the virus to those around you.

Why are younger and older people more at risk from RSV?

Every year, as many as 80,000 children under 5 years old are hospitalized in the U.S. because of RSV, according to an estimate from the CDC. Children at the greatest risk from RSV include:

• Premature infants
• Infants up to 12 months, especially (6 months and younger)
• Children younger than 2 years with chronic lung disease or congenital (present from birth) heart disease
• Children with weakened immune systems
• Children with neuromuscular disorders.

Part of the danger of RSV is how it can bring on more severe infections, including:

• Bronchiolitis: when the small airways in the lungs are inflamed
• Pneumonia: when the lungs are infected.

The CDC said that RSV is “the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age.”

These statistics can seem scary — and RSV does undoubtedly pose a threat to many younger children. But for context, the CDC notes that “almost all children will have had an RSV infection by their second birthday.”

If an infant or young child gets infected with RSV, parents and caregivers can always call their provider’s advice line, added Chin-Hong, who said to watch for red flags, including when a young child is having difficulty feeding or breathing, or is wheezing and lethargic. “Infants with quote-unquote ‘colds’ who have any of those [symptoms] should be brought into the hospital or urgent care or the emergency room for advice,” he said.

People age 60 and older

RSV poses a particular risk to older people because of how our immune systems weaken with age. Every year, between 60,000 and 160,000 older adults in the U.S. are hospitalized with RSV, and as many as 10,000 die from it, The CDC estimates.

In addition to causing more severe infections like bronchiolitis and pneumonia, the virus can also exacerbate existing health conditions — including asthma, chronic obstructive pulmonary disease and congestive heart failure.

Some younger adults are also at higher risk from RSV. These groups include folks with chronic heart or lung disease, weakened immune systems or certain other underlying medical conditions.

When should older adults — or their caregivers — seek medical attention due to a potential RSV infection? Chin-Hong said that one of the main concerns for this age group is developing pneumonia, of which a new shortness of breath can be a symptom. Oxygen levels can also be monitored with an at-home pulse oximeter — if a person’s levels drop below 93%, Chin-Hong said that’s a sign to head to the emergency room.

When RSV means being hospitalized

What does hospitalization actually mean for infants and older adults with severe RSV?

Hospitalization often occurs if the patient is having trouble breathing or has become dehydrated — and once in the hospital, they may require extra oxygen or fluids given through an IV if they can’t eat or drink enough on their own.

A patient might also need to be intubated with a breathing tube inserted through the mouth, and be given mechanical ventilation to help them breathe again. While this sounds scary, hospitalization usually lasts for only a few days “in most of these cases,” according to the CDC.

Who can get the RSV vaccine?

In May, the U.S. Food and Drug Administration approved the first RSV vaccine for older adults, and, several months later, approved another one for pregnant people, as well as a separate preventative antibody treatment for infants.

RSV vaccines for these groups are available through health care providers and pharmacies, with the shots covered partly or fully by most health insurance plans.

Adults age 60 and older

The CDC recommends this group “should talk with their health care provider about whether RSV vaccination is right for them.” There is no upper age limit for getting an RSV vaccination, which is given as a single shot. Read more about older adults and the RSV vaccine, and about health insurance coverage for this vaccine.

People between 32 and 36 weeks of pregnancy

Vaccinations for pregnant people are one of two ways that infants can be immunized against RSV — in this case, to pass on the benefits to the fetus. The CDC said that a baby born to a mother who got the RSV vaccine “at least two weeks before delivery” will have protection — and “in most cases,” that baby then won’t require a later RSV immunization. Read more about pregnant people and the RSV vaccine, and about health insurance coverage for this maternal vaccine.

Infants

A preventive antibody — not a vaccine — can also be given directly to a baby after birth if a maternal vaccine isn’t an option. This form of immunization is recommended for children younger than 8 months of age during their first RSV season. In some cases, this immunization is extended to children under 24 months of age “with certain conditions that place them at increased risk for severe RSV disease,” the CDC said. Read more about RSV immunization for infants and young children and about health insurance coverage for this immunization.

KQED’s Sara Hossaini contributed reporting to this story.