Respiratory syncytial virus (RSV) in children isn’t limited to infants. Learn how RSV affects toddlers and school-age kids, red flag symptoms and how to protect your child.

Published: September 15, 2025

Estimated reading time: 4 minutes

When most parents hear “RSV,” they usually think of sick infants and babies. While respiratory syncytial virus (RSV) is most serious for infants (children ages 12 months and under), many families are surprised to learn that RSV in children — including toddlers and preschoolers — sometimes can cause more severe symptoms than expected.

“Parents often assume their 3-year-old just has a regular cold, but RSV can affect children of all ages,” said Patrick K. Hynes, M.D., pediatrician with Norton Children’s Medical Group. “Understanding the warning signs of RSV can help families know when to seek care.”

Can children get RSV?

Children of all ages can get RSV. While RSV is considered most dangerous for babies, toddlers and young children still can contract the virus. As children grow they typically have stronger immune systems and larger airways, which typically results in less severe illness than in infants.

While RSV might cause a baby to be hospitalized, the virus usually causes cold-like symptoms in older kids (ages 2 and up) that can be managed at home with proper care.

How RSV differs in children versus infants

RSV symptoms in infants are typically more severe than RSV in older children. Here is how symptoms may vary among age groups:

Infants (12 months and under):

• Difficulty feeding and breathing
• Severe bronchiolitis (inflammation of small airways)
• Higher risk of hospitalization
• May have very subtle early symptoms

Children (ages 2 and up):

• Symptoms similar to a common cold
• Runny nose, cough, low-grade fever
• Less likely to develop severe breathing issues
• May complain of sore throat or headache
• Generally recover faster than infants

However, some children with certain conditions are at higher risk of developing severe illness. Children with asthma, heart conditions or weakened immune systems can develop serious RSV complications that require medical attention.

Difference between RSV and common cold

Knowing the difference between RSV in children versus a common cold can be challenging, since many symptoms overlap. Both can cause runny or stuffy nose, cough, mild fever, fatigue and general fussiness.

Signs that suggest RSV instead of a common cold may include:

• Persistent, worsening cough that sounds “wet” or produces mucus
• Wheezing or whistling sounds when breathing
• Decreased appetite lasting several days
• Symptoms that seem to worsen after initially improving

How long is RSV contagious?

Children with RSV are typically most contagious during the first few days of illness when symptoms are developing. However, kids can typically spread the virus for up to a week.

Your child can return to day care or school when they’ve been fever-free for 24 hours and are feeling well enough to participate in normal activities. Keep in mind that they may still have a lingering cough for weeks after the infection clears.

Treatment options for RSV in children

Most children recover from RSV within seven to 10 days. Ensure your child receives plenty of rest and hydration. Nasal saline drops can help clear congestion, while a cool mist humidifier can help relieve breathing and cough symptoms. Consult your child’s pediatrician for proper dosage of acetaminophen or ibuprofen based on your child’s age.

RSV prevention strategies

While you can’t completely prevent RSV, you can help reduce your child’s risk with the following:

• Beyfortus vaccine in infants (or Abrysvo vaccine in pregnant mothers)
• Frequent hand-washing for the whole family
• Avoiding close contact with sick people
• Cleaning and disinfecting surfaces regularly
• Teaching children proper hygiene
• Keeping up with routine vaccinations

When to seek emergency care

The following RSV symptoms are emergencies that require immediate medical care:

Breathing issues:

• Fast or labored breathing
• Wheezing or whistling sounds
• Chest pulling in with each breath
• Bluish color around lips or fingernails

Dehydration signs:

• Refusing to drink fluids for several hours
• No wet diapers for six-plus hours (or no urination in older kids)
• Dry mouth, no tears when crying
• Extreme fussiness or unusual sleepiness

Severe illness symptoms:

• High fever (over 101 F in children under 3 months, over 103 F in older children)
• Unconsciousness (Child cannot be stirred awake.)

If you’re concerned about RSV symptoms in your child, don’t hesitate to consult with a pediatrician. Early evaluation can provide peace of mind and ensure your child receives proper care.