RSV Timeline of Symptoms and Contagion

Medically Reviewed by Neha Pathak, MD on May 15, 2024
9 min read

Respiratory syncytial virus (RSV) is a common respiratory virus. Most people have it before age 2, but older kids and adults also get it. 

There’s a good chance you’ve had it without even knowing. That’s because the symptoms look a lot like those of a cold in most people. 

Most of the time when you have RSV, you’ll be contagious for 3 to 8 days. You could spread it before you know you’re sick. But babies and people with weak immune systems can carry RSV for a lot longer. It also can cause severe illness in some cases.

RSV timeline in adults vs. young children

RSV symptoms in adults usually go away in about a week or two at most. It’s possible you could be sick longer if you end up with pneumonia or some other complication. 

RSV can be worse and sometimes even dangerous for babies and very young children. But most kids get it early, and it usually looks like a cold and gets better. Some kids can get sick for longer and can spend time in the hospital. It’s also possible for infants to spread RSV for up to 4 weeks, even after they don’t seem sick anymore.

The incubation period for any virus is the time it takes from when you first get infected until you will have symptoms. RSV symptoms usually start 4 to 6 days after you got exposed. 

Your symptoms, including a runny nose, sneezing, fever, and wheezing, may show up slowly for several days. But it’s possible to have and spread RSV with only symptoms that are mild. You might not even notice that you’re sick. Because symptoms look a lot like those of a cold, there’s a good chance you’ve had RSV infections without knowing it.

What to do when RSV symptoms emerge

Unless you get an RSV test, you won’t know that you have RSV vs. some other respiratory virus or a cold. Most of the time, RSV symptoms aren’t bad. It will look like you have a regular cold. Usually you’ll get better in a week or possibly two. You can take care of yourself at home by:

  • Taking medicine for pain and fever
  • Drinking plenty of water
  • Taking cold medicines may help, but check with a doctor before giving them to children.

It’s possible an RSV infection could make people really sick. That's more likely if your baby or young child has it, or if you have it and you also have a weak immune system. You could have trouble breathing or get dehydrated. If you have RSV or think you may have RSV and are having trouble breathing or other worrying symptoms, see a doctor right away. You could need to stay in the hospital, but even then, most people will get better in a few days.

RSV can spread easily from one person to the next. You can get it when someone with an RSV infection sneezes or coughs on or near you. You can get it if the virus, or droplets containing the virus, end up in your nose, mouth, or eyes.

You also could get RSV from direct contact, such as kissing someone who has it. If you touch a surface with RSV on it and then touch your nose, eyes, or mouth, you can get it that way, too. Sometimes, people can spread RSV even when they don’t have symptoms yet or after symptoms go away.

How long does RSV live on surfaces?

When RSV gets on hard surfaces, such as counters or tables, it can take hours for it to lose its ability to make other people sick. It usually won’t stay contagious for as long when it’s on something soft, such as fabric or tissues. You can protect yourself from getting it from someone close to you by washing your hands often, cleaning surfaces, and bringing fresh air in from outside.

The CDC tracks patterns in the spread of RSV and other viruses. They’ve been looking at how it spreads since the 1980s. They gather information from RSV test results from labs around the country that show how many people tested positive each week.

What are RSV seasonal patterns?

In most of the U.S., RSV season usually starts in the fall. In a typical year, most people get it in the winter along with other common respiratory viruses. Some places can show different patterns. For instance, the seasonal pattern has looked different in Florida and Hawaii, compared to other parts of the U.S.

It’s common to see the number of positive RSV tests go up around the middle of September into the middle of November. The number of cases per week usually reaches its highest point, or peak, in late December to the middle of February before dropping back off in the middle of April to the middle of May.

How have seasonal patterns changed?

The normal seasonal trends in RSV infection aren’t as clear as they used to be. The reason is that the COVID-19 pandemic got in the way of normal patterns of spread for RSV and other common viruses. People took extra precautions that kept them from getting sick or spreading infections, including RSV, to other people as much. 

In 2021, RSV cases rose in the South in the spring and peaked in July. No one knows when RSV infections will settle back into their usual seasonal pattern.

It’s usually contagious for 3 to 8 days. It can be contagious even before you know you have it. Some people with a weak immune system, including babies, can spread it for up to a month. 

Do I need to wear a mask while I have RSV?

It’s not required. But wearing a mask is a way you can protect yourself and others from RSV infection and other respiratory infections.

RSV quarantine

There’s no rule about quarantining yourself when you have RSV. Most of the time, you won’t even get tested and won’t know for sure you have RSV vs. some other infection. But it’s always a good idea to stay home when you’re sick. You can take steps to keep others in your family from getting it, too, including staying in your own space as much as you can and keeping things clean.

RSV droplet precautions

You can make it less likely RSV will spread through the air by covering your nose and mouth when you cough or sneeze. It can take hours for RSV droplets that land on hard surfaces to lose their ability to make other people sick. To protect against this, wash your hands often and keep surfaces clean.

RSV transmission in infants

Infants and other children often get exposed to RSV in day care or at school. Babies also may spread the virus to other people for a longer period. If you have a young child in your home, there’s a good chance they will get RSV and spread it to other people in the family. Most people get RSV before age 2.

RSV transmission in immunocompromised or older people

Adults with weak immune systems also can carry and spread the virus for longer periods. If you have a weak immune system and are worried about RSV, ask your doctor about how you can protect yourself. RSV usually causes mild symptoms similar to those of a cold. But it can lead to pneumonia or make other heart or lung conditions worse.

Your risk of getting severely ill with RSV will go up if you:

  • Are older
  • Have chronic heart or lung disease
  • Have a weak immune system
  • Have other health problems
  • Live in a nursing home or long-term care facility

Is there a vaccine for RSV?

Yes. You can get a vaccine for RSV. They're recommended for:

  • Pregnant people

  • Everyone 75 years and older

  • Adults 60 to 74 years old and up who are at high risk for severe RSV disease

When you’re pregnant, getting the vaccine will give protection to your baby early in life. 

Kids can’t get vaccinated for RSV. But there’s a preventive antibody shot that can protect some babies and young children. Ask your doctor if you should consider getting vaccinated to make a severe RSV infection less likely. It’s recommended during RSV season for babies under 8 months old. Babies up to 19 months also might get it if they’re at greater risk of having a severe infection.

If you got vaccinated for RSV when you were pregnant, your baby won’t need it. Ask your doctor if you should think about a vaccine or antibody protection and when it’s the right time.

RSV is usually mild, but it can turn into a serious illness in some people. You’re likely to recover in a week or two, but it could take longer, especially in infants or if your immune system is weak.

How long do RSV symptoms last?

You’ll likely get symptoms in stages instead of having them all at the same time. You’re likely to feel better within a week or possibly two.

RSV recovery after hospitalization

If you or a loved one ends up in the hospital with RSV, usually it only lasts for a few days. You could have more lasting effects of RSV if you have:

  • Asthma
  • Congestive heart failure
  • Chronic obstructive pulmonary disease (COPD)

RSV recovery time in infants

Infants usually will get better pretty quickly. But sometimes, an RSV infection can cause inflammation in small airways (bronchiolitis). If this happens, you may hear wheezing. Your child might need to stay in the hospital to make sure they can breathe and are getting enough fluids.

Most infants and kids get better after a few days. But they might cough or wheeze for more than a week. It could cause more lasting problems in kids who:

  • Are very young
  • Were born prematurely
  • Have lung or heart disease
  • Have a weak immune system

RSV infection usually is mild and similar to a cold. But it can cause more serious illness in older people, infants, and people with a weak immune system or other conditions that affect the lungs or heart. You can take steps to protect yourself from getting it or make it less likely you’ll give it to other people. Ask your doctor if you should take any special precautions, and see a doctor if you or your child has signs of a more severe RSV infection, including trouble breathing.

How long does it take for RSV to run its course?

Most people get better in a week or two, but it can have more lasting effects in some cases.

What is the timeline of RSV infection?

You’ll likely notice symptoms 4 to 6 days after exposure, and they’ll last 2 to 8 days but sometimes longer. RSV is usually contagious for 3 to 8 days, but some people may carry and spread it for weeks.

On which day of infection does RSV get worse in babies?

Everyone is different, but RSV symptoms are most often worst on days 3 to 5.

When is RSV no longer contagious?

It’s hard to know for sure. Some people can spread it even before or after they have symptoms. But it usually stops being contagious after 8 days.

When is RSV at its peak?

RSV usually follows a seasonal pattern like colds and the flu, with a peak in winter. But the pattern can vary, depending on the year and where you live. Since the COVID-19 pandemic, RSV hasn’t shown the seasonal pattern it normally does. You could get RSV at any time of the year.