by John Avery Go, MD
Respiratory Syncytial Virus (RSV) is a highly contagious virus that affects the respiratory system, including the nose, throat, and lungs.
Although it often causes mild, cold-like symptoms, it can lead to serious illness in infants, older adults, and individuals with underlying health conditions.
RSV is extremely common.
Most children are infected by RSV at least once by the age of two, and it is the leading cause of hospitalization among infants under one year old.
RSV in babies typically starts with cold-like symptoms: runny nose, coughing, sneezing, and fever.
These symptoms may develop into more severe coughing and wheezing. In adults, especially those over 65 or with chronic conditions such as heart or lung disease, the virus can also cause severe respiratory illness and hospitalization.
RSV spreads through respiratory droplets when an infected person coughs or sneezes. It can also spread through direct contact or by touching contaminated surfaces and then touching the face.
Because RSV can survive on surfaces for several hours and may be transmitted before symptoms appear, it spreads easily in households, schools, and community settings. Symptoms usually develop within three to six days after exposure.
In many cases in adults, RSV presents like a common cold, with a runny nose, cough, sneezing, and mild fever. However, more severe symptoms like wheezing, difficulty breathing, and decreased appetite may develop, especially in high-risk individuals.
In serious cases, RSV can lead to complications such as pneumonia or inflammation of the small airways in the lungs.
RSV activity typically increases during the fall and winter months in much of the United States. However, in Hawaii, the virus may circulate all throughout the year.
Because RSV symptoms are similar to those of the flu and COVID-19, it can be difficult to distinguish between these illnesses without testing. RSV treatment is mainly supportive, focusing on rest, hydration, and symptom relief.
Most individuals recover within one to two weeks. Public health experts emphasize prevention as the most effective way to reduce the spread of RSV.
Recommended measures include frequent handwashing, cleaning commonly touched surfaces, avoiding close contact with sick individuals, and staying home when experiencing symptoms.
In Hawaii, health officials note that RSV does not always follow the same seasonal patterns seen on the mainland.
Cases can occur year-round due to the state’s tropical climate and consistent travel between islands and international destinations. This increases the risk of continuous community spread, especially in densely populated areas.
As a result, the Hawaiʻi Department of Health emphasizes maintaining preventive habits such as hand hygiene and staying home when sick at all times of the year, rather than only during a specific “RSV season.”
Infants should receive a medication (RSV monoclonal antibodies) if they are younger than 8 months old and their mother was not vaccinated during that pregnancy.
Pregnant individuals are also advised to receive the vaccine during weeks 32 to 36 of pregnancy to help protect newborns after birth.
Health authorities recommend a single dose of the RSV vaccine for adults aged 75 and older, as well as for adults aged 60 to 74 with certain medical conditions that increase their risk of severe disease.
For immunocompromised individuals, the RSV virus can lead to serious health complications. Continued awareness, preventive practices, and appropriate use of vaccines are essential in reducing its impact on public health.
DR. JON AVERY GO is a board-certified Internal Medicine physician. He practices as a primary care doctor at Primary Care Clinic of Hawaii.
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