7 Common Symptoms of RSV in Older Adults

Plus, how to recognize if a mild infection is turning severe

Rachel Nania,

AARP

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Published September 27, 2024

an illustration of lungs filled with RSV virus on a blue background

AARP (Source: Adobe Stock(2))

It’s the time of year when COVID-19 and flu are top-of-mind for many. But there’s another highly contagious respiratory virus that spreads in the fall and winter months, and similar to the coronavirus and influenza, this bug can be downright dangerous for older adults.

It’s called RSV, short for respiratory syncytial virus. And while it’s commonly thought of as an illness that affects babies and young children, RSV sends as many as 160,000 U.S. adults ages 60-plus to the hospital each year, and kills as many as 10,000 older Americans annually, according to data from the Centers for Disease Control and Prevention (CDC).

Doctors and public health experts are hopeful that a suite of new RSV vaccines can help keep these numbers down this year. Health officials recommend that everyone 75 and older get an RSV vaccine if they didn’t get one when the shots first became available in 2023. The vaccine is also recommended for people 60 to 74 who have underlying health conditions, like chronic heart and lung disease.

What are the symptoms of RSV?

A mild infection

RSV can be tricky to identify, since its symptoms tend to mirror those of other respiratory illnesses, including flu and COVID, says William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine.

While infants and babies with RSV tend to display signs of lethargy, apnea (pauses in breathing) and loss of appetite, the infection in older adults can come with a runny nose, congestion, cough, fatigue, a mild headache and fever. Adults can also have a stuffy nose, sore throat and aches and pains, Schaffner says.

7 Common RSV symptoms in older adults

Congestion
Cough
Fever
Lack of energy
Mild headache
Runny nose
Sore throat

Source: Cleveland Clinic

When RSV turns severe

While symptoms are usually mild in most, RSV can make some adults really sick, and older adults are at higher risk for complications from a respiratory virus, like RSV. So are individuals with heart and lung disease or a compromised immune system.

RSV can cause lower respiratory infections like pneumonia and bronchitis, and it can worsen existing health conditions like asthma, COPD (chronic obstructive pulmonary disease) and heart failure.

According to Cleveland Clinic, some symptoms that signal an RSV infection is taking a turn for the worse include:

Extreme tiredness or weakness
Low appetite
Persistent cough
Wheezing
Shortness of breath
Bluish skin, lips or nails
Sudden change in mental state

Another clue is if your temperature continues to climb, Schaffner says, or if your cough starts to produce sputum (phlegm or mucus), which could indicate that “you’ve developed a complicating pneumonia.” If you notice any of these more serious symptoms, seek medical attention.

Treating RSV symptoms

Both flu and COVID-19 have prescription antiviral treatments that can help keep a mild infection from turning severe, but no such treatment exists for RSV, which is why Schaffer says prevention with the vaccine is crucial.

If you have a mild infection, you can get relief from symptoms with over-the-counter medications. Ann Philbrick, a pharmacist and associate professor and director of community engagement in the University of Minnesota College of Pharmacy, suggests a pain reliever such as acetaminophen (Tylenol) to curb any aches and pains from the illness, though it’s always important to check with a doctor or pharmacist first to see which type is best for your needs.

For the cough, she recommends guaifenesin (Mucinex) to help “loosen up the mucus.”

Guaifenesin can appear in combination products with dextromethorphan, a cough suppressant, but Philbrick generally recommends steering clear of the latter ingredient. “Because typically when we have an infection, a cough is good to loosen things up and get things flowing through the body,” she says. “Where I do recommend dextromethorphan is if that cough is just keeping you up at night and you absolutely cannot sleep.” Again, before using be sure to check with your doctor or pharmacist.

Pseudoephedrine can help with congestion, but the medication can also affect blood pressure. “So for patients that have blood pressure issues already, that’s something that I would certainly limit or just kind of stay away from,” Philbrick says. And don’t forget fluids, she adds; staying hydrated is key.

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