Respiratory Syncytial Virus (RSV) is a highly contagious respiratory pathogen recognized as a significant cause of illness in adults, especially those aged 65 and older. While often associated with severe disease in infants, RSV poses a substantial risk to older adults due to age-related changes in the immune system and chronic health conditions. Each year, this virus leads to an estimated 110,000 to 180,000 hospitalizations and up to 10,000 deaths in this age group. Understanding how the virus manifests and its typical duration is important for older adults and their caregivers.
Unique Presentation of RSV in Older Adults
The symptoms of RSV in older adults often present differently than the familiar cold-like symptoms seen in younger individuals. Older patients may not exhibit typical signs of a respiratory infection, such as a high fever or pronounced wheezing, leading to the illness being mistaken for a common cold.
Instead of classic respiratory distress, the infection frequently appears as subtle and non-specific changes. These atypical symptoms include a decrease in appetite, profound fatigue, and a drop in functional capacity. An older adult may seem simply “off,” unusually tired, or less engaged in daily activities.
The virus may also lead to acute cognitive decline or a worsening of existing chronic conditions, such as chronic obstructive pulmonary disease (COPD) or congestive heart failure. Recognizing these diminished states is important for timely medical intervention.
The Typical Course and Duration of RSV Symptoms
For an older adult who does not experience severe complications, an uncomplicated RSV infection generally spans one to two weeks. Symptoms usually appear four to six days after exposure, starting with mild upper respiratory signs like a runny nose, congestion, and a cough.
The most intense symptoms, including a low-grade fever and increased respiratory discomfort, generally peak and begin to improve within three to five days. However, the resolution of the illness can be slow for older adults.
The characteristic cough and lingering fatigue often persist for a week or two after the initial symptoms have cleared. While the acute viral phase is short, the residual effects, such as post-viral fatigue, can significantly impact an older person’s quality of life and mobility. The overall duration is dependent on the individual’s underlying health and immune status.
When RSV Becomes Severe and Requires Medical Attention
RSV becomes a serious concern when it progresses from a mild upper respiratory infection to a lower respiratory tract disease. This progression can lead to severe complications such as pneumonia or bronchiolitis (inflammation of the small airways). These severe outcomes are a major reason for the high rates of hospitalization in older adults.
A severe RSV infection often exacerbates pre-existing chronic illnesses, particularly heart failure or COPD, leading to acute worsening of these conditions. This worsening can involve fluid buildup in the lungs or a reduction in lung function.
Specific red flags signaling severe infection requiring immediate medical attention include difficulty breathing, a rapid increase in the breathing rate, or sustained high fever. A bluish or grayish tint to the lips or nail beds, known as cyanosis, indicates dangerously low oxygen levels and is a medical emergency. Confusion or disorientation are warning signs that should prompt an immediate call to a healthcare professional.
Managing Symptoms and Preventing Future Infection
Managing an uncomplicated RSV infection focuses primarily on supportive care to ease symptoms and assist recovery. Staying well-hydrated and ensuring adequate rest are important actions during the illness. Over-the-counter medications can manage fever, aches, and general discomfort, but existing prescribed medications for chronic conditions, such as inhalers for COPD, should be continued as directed.
Proactive measures are the most effective way to reduce the risk of severe RSV disease. The Centers for Disease Control and Prevention (CDC) recommends that all adults aged 75 and older receive the RSV vaccine.
The vaccine is also recommended for adults aged 60 to 74 who have underlying medical conditions that increase their risk of severe illness. The approved RSV vaccines have demonstrated high efficacy in preventing lower respiratory tract disease and severe outcomes. Standard infection control practices, such as diligent hand hygiene and avoiding close contact with sick individuals, remain important to minimize infection chances.