The virus is found in discharges from the nose and throat of an infected person. People can get RSV infection by breathing in droplets after an infected person has coughed; by hand-to-mouth contact after touching an infected person; and by hand-to-mouth after touching a surface that an infected person has touched or coughed on. The time period from exposure to illness is usually 4 to 6 days. After an infection, a person may be contagious for 3 to 8 days. However, some infants and people with weakened immune systems can spread the virus for up to 4 weeks. 

Infection can also result from direct and indirect contact with nasal or oral secretions from infected persons, such as kissing an infected child’s face or touching a common surface (e.g., a doorknob) on which viruses have been deposited. People infected with RSV can spread the virus for 3 to 8 days. However, some infants and people with weakened immune systems can spread the virus for up to 4 weeks. RSV infections occur all over the world, most often in outbreaks that can last up to 5 months, from late fall through early spring. RSV epidemics spread easily in households, daycare centers, and schools.

Most children are infected at least once by age 2 and continue to be reinfected throughout life. RSV is the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age. The majority of children hospitalized for an RSV infection are under the age of six months. The elderly (those 65 years of age and older), premature infants, persons with chronic lung or heart problems, or persons with weak immune systems are at higher risk for developing serious illness. Those who are exposed to tobacco smoke, attend daycare, live in crowded conditions, or have school-aged siblings could also be at higher risk. 

If you think someone in your family has RSV, consult with your healthcare provider. Any breathing difficulties in an infant should be considered an emergency, so seek immediate help.

RSV and Traveling

RSV is common worldwide, but no additional precautions are needed when traveling. The number of infections usually peaks in the late fall, winter, and early spring in the United States and Europe. In tropical climates, epidemics occur during the rainy season. 

Symptoms of RSV are similar to other respiratory infections. Illness begins 4 to 6 days after being exposed to the virus. In adults and older children, typical RSV symptoms include a low-grade fever, congested or runny nose, cough, sore throat, headache, fatigue, and occasionally wheezing. In children younger than age 2, RSV can cause a lower respiratory tract illness such as bronchiolitis or pneumonia; more severe cases can result in respiratory failure. For people with severe illness, symptoms may include a worsening croupy cough, unusually rapid breathing, difficulty breathing, and a bluish color of the lips or fingernails caused by low levels of oxygen in the blood. RSV can cause middle ear infections (otitis media) in preschool children.

The majority of children hospitalized for an RSV infection are under the age of six months. The elderly (those 65 years of age and older), premature infants, persons with chronic lung or heart problems, and persons with weak immune systems are at higher risk for developing serious illness. Those who are exposed to tobacco smoke, attend daycare, live in crowded conditions, or have school-aged siblings could also be at higher risk.  

Individual cases of RSV are not reportable by law in Texas.

There are steps that you can take to prevent the spread of RSV. If you have cold-like symptoms:

• Cover your cough and sneezes with a tissue, sleeve, or elbow.
• Wash your hands often and correctly (with soap and water for 20 seconds).
• Avoid sharing cups and utensils with other people.
• Do not kiss other people.
• Clean contaminated surfaces such as doorknobs and countertops with a disinfectant.

Other steps that may be taken to the prevent the spread of RSV are:

• Stay home when you are sick. 
• Avoid exposure to sick persons, especially those that have cold-like symptoms. If possible, parents with high-risk young infants should avoid crowds.
• Limit the time that high-risk children spend at their school or child-care center during the RSV season.

Vaccines are available to protect older adults from severe RSV. Vaccines for pregnant women or monoclonal antibody products are available to protect infants and young children from severe RSV. Vaccines are available to protect older adults from severe RSV. Vaccines for pregnant women or monoclonal antibody products are available to protect infants and young children from severe RSV. Nirsevimab is an injectable monoclonal antibody that prevents severe RSV disease in infants and young children.  Monoclonal antibodies do not activate the immune system, as would occur with infection or vaccination (active immunization). Rather, the antibodies themselves protect against disease (i.e., passive immunization). Because nirsevimab does not activate the immune system, protection is likely most effective the weeks after nirsevimab is given and wanes over time. Nirsevimab does not provide long-term immunity to RSV disease but provides protection to infants when they are most at risk of getting severe RSV disease. As children get older, they are less likely to get severe symptoms from RSV infection.

The Advisory Committee on Immunization Practices (ACIP) recommends adults 50–59 years of age who are at increased risk of severe RSV disease receive a single dose of RSV vaccine. At this time, RSV vaccination is recommended as a single dose only. Persons who have already received RSV vaccination are not recommended to receive another dose. RSV vaccines can be administered with any product licensed in this age group, including Moderna’s mResvia, GSK's Arexvy and Pfizer's Abrysvo. There is no preferential recommendation for any licensed product over another. 

There are steps that can be taken to help prevent the spread of RSV. Covering coughs and sneezes, practicing frequent hand washing, refraining from kissing other people, and disinfecting surfaces may help stop the spread of RSV. Persons with RSV illness should not share cups or eating utensils with others, and persons with cold-like symptoms should not interact with high-risk children. When possible, limiting the time that high-risk children spend in child-care centers or other potentially contagious settings may help prevent infection and spread of the virus during the RSV season. 

A drug called palivizumab is available to prevent severe RSV illness in certain infants and children who are at high risk. The drug can help prevent development of serious RSV disease, but it cannot prevent infection with RSV or help cure or treat children already suffering from serious RSV disease. 

Children with a fever should be kept out of school or childcare until they are fever free for 24 hours without the use of fever suppressing medications. Rules for exclusion of sick children from school and childcare are outlined in the Texas Administrative Code, specifically Rule 97.7 for schools and Rule 746.3603 for childcare.  

RSV activity typically begins to increase in Texas in September or October and peaks in December or January. The timing of the RSV season and the seasonal peaks can vary by region in Texas. For surveillance reports, see the Data link.