RSV (respiratory syncytial virus) spreads through respiratory droplets when an infected person coughs, sneezes, or talks. The virus can also survive on surfaces for hours, making indirect contact another common route. Nearly everyone catches RSV at least once by age two, and reinfection throughout life is normal because immunity fades over time.
How RSV Spreads From Person to Person
The primary way you catch RSV is by inhaling droplets from someone who is infected. These droplets land on your eyes, nose, or mouth, where the virus enters through the moist tissue lining those areas. Close contact like kissing a child’s face, sharing cups, or being near someone who is coughing all create opportunities for transmission.
What makes RSV especially tricky is the timing. An infected person can start spreading the virus a day or two before they show any symptoms. By the time someone realizes they have a cold, they may have already passed it to the people around them. Adults often experience RSV as a mild cold and may not think twice about being around a baby or an older relative while contagious.
How Long Someone Stays Contagious
Most people with RSV are contagious for 3 to 8 days. That window starts a day or two before symptoms appear and continues through the worst of the illness. For most healthy older children and adults, the risk of spreading the virus drops off within about a week.
Infants and people with weakened immune systems are the exception. They can continue shedding the virus for 4 weeks or longer, even after their symptoms have cleared. This prolonged contagious period is one reason RSV circulates so easily in daycare centers, hospitals, and nursing homes.
Surface Contact Is a Real Route
RSV does not need a cough or sneeze to reach you. The virus survives on hard, nonporous surfaces like countertops for up to 7 hours. On rubber gloves, it lasts about 5 hours. On fabric and clothing, roughly 2 hours. Even on bare skin, it can remain viable for about 20 minutes.
The practical scenario looks like this: a sick child wipes their nose, touches a toy or a table, and another child picks it up and then rubs their eyes. In a household or childcare setting, this kind of chain happens constantly. Stainless steel surfaces, like door handles and faucet knobs, can harbor infectious virus for several days under the right conditions.
The good news is that RSV is relatively easy to kill on surfaces. Alcohol-based disinfectants, hydrogen peroxide cleaners, and standard hand sanitizers all effectively destroy the virus. The WHO-recommended alcohol-based hand rub formulations completely eliminated infectious RSV in lab testing, as did solutions containing as little as 30% ethanol. Regular handwashing with soap and water works well too.
When RSV Season Peaks
In the United States, RSV follows a predictable seasonal pattern with increased activity from October through April. During the 2024-2025 season, the national epidemic began in early November 2024 and tapered off by the end of March 2025. The peak hit the week before Christmas, when 11% of RSV tests came back positive.
This timing is important if you are planning around a new baby or caring for an older adult. The highest risk months are November through January, when the virus is circulating most heavily. In southern states, the season can start a bit earlier, while northern regions sometimes see activity extend into spring.
Who Is Most Vulnerable
Anyone can catch RSV, but the virus hits hardest at the extremes of age and in people with certain underlying conditions.
Infants and Young Children
Babies born prematurely face the highest risk of severe RSV illness because their lungs and immune systems are still developing. Children with weakened immune systems, neuromuscular disorders that make it hard to cough up mucus, congenital heart or lung problems, and severe cystic fibrosis are also at elevated risk. For these children, RSV can move from the upper airways into the lungs, causing bronchiolitis or pneumonia that sometimes requires hospitalization.
Adults Over 50
The risk of severe RSV climbs again later in life, particularly for adults with chronic heart disease, lung conditions like COPD or emphysema, poorly controlled diabetes, kidney disease requiring dialysis, liver cirrhosis, sickle cell disease, or severe obesity (BMI of 40 or higher). People with moderate to severe immune suppression and those living in nursing homes are also at higher risk. Neurological conditions that weaken the muscles used for breathing or swallowing, such as ALS or muscular dystrophy, add further vulnerability because they make it harder to clear mucus from the airways.
Why You Can Get RSV More Than Once
Unlike some viruses that grant lasting immunity after a single infection, RSV does not produce strong, durable protection. Your body builds antibodies after each infection, but those antibodies wane over months to years. This is why adults catch RSV repeatedly throughout their lives, usually experiencing it as an ordinary cold with congestion, a low fever, and a cough. The illness tends to be milder with each reinfection in healthy people, but for those in high-risk groups, a reinfection can still be serious.
Practical Steps to Reduce Exposure
Because RSV spreads through both droplets and contaminated surfaces, prevention comes down to a few straightforward habits. Washing your hands frequently, especially before touching your face or handling a baby, removes the virus effectively. Alcohol-based hand sanitizer is a reliable backup when soap and water are not available.
Cleaning high-touch surfaces like doorknobs, light switches, and countertops with standard household disinfectants during RSV season reduces the chance of indirect transmission. If you have cold symptoms, keeping your distance from infants and older adults makes a meaningful difference, particularly since you may be most contagious before you even feel very sick. Avoiding shared cups, utensils, and towels during active illness also helps break the chain of contact.