RSV (respiratory syncytial virus) has no cure or specific antiviral treatment for most people. Treatment is almost entirely supportive, meaning you manage symptoms while the body fights off the infection. For the vast majority of cases, that means rest, fluids, and fever control at home. A smaller number of cases, particularly in infants and older adults, require hospital care for breathing support or hydration.
Home Care for Mild to Moderate RSV
Most RSV infections resolve on their own within one to two weeks. The goal during that time is to keep the body hydrated and comfortable while the immune system does its work. The CDC emphasizes drinking enough fluids to prevent dehydration, which is especially important because congestion and coughing can make eating and drinking harder than usual.
For infants, frequent small feedings of breast milk or formula help maintain hydration. A bulb syringe or nasal aspirator can clear mucus from a baby’s nose before feedings, since young infants breathe primarily through their noses. Saline nose drops can loosen thick mucus and make suctioning more effective. For older children and adults, water, broth, and electrolyte drinks work well.
Over-the-counter fever reducers like acetaminophen or ibuprofen (for children over six months) can bring down a fever and ease discomfort. A cool-mist humidifier in the bedroom helps keep airways moist. Keeping the head slightly elevated during sleep can also reduce congestion.
Treatments That Don’t Work for RSV
Parents sometimes expect antibiotics or breathing treatments, but neither is part of standard RSV care. RSV is a virus, so antibiotics do nothing against it. More surprisingly, common inhaled medications like albuterol, which open the airways during asthma attacks, are not recommended either. The American Academy of Pediatrics issued a strong recommendation against using albuterol for infants with bronchiolitis. Multiple studies and meta-analyses found that while bronchodilators might slightly improve symptom scores in the moment, they don’t reduce hospital admissions, shorten illness, or change outcomes in any meaningful way. The side effects (fast heart rate, tremors) aren’t worth it.
Steroids are similarly ineffective. A comprehensive Cochrane review found that corticosteroids do not significantly reduce hospital admissions or shorten hospital stays for children with bronchiolitis. The AAP strongly recommends against using them in any setting for this diagnosis.
When Hospital Treatment Is Needed
Roughly 1 to 3 percent of infants with RSV need hospitalization, typically because they can’t breathe well enough on their own or can’t take in enough fluids. Warning signs include rapid breathing, flaring nostrils, the skin pulling in between or below the ribs with each breath, a bluish tint to the lips or fingernails, and significant difficulty feeding.
Hospital treatment remains supportive but more intensive. The three pillars are supplemental oxygen, IV or tube-fed fluids, and in severe cases, mechanical ventilation. Oxygen can be delivered through a standard nasal cannula or, for babies who need more pressure to keep their airways open, a high-flow nasal cannula system. Infants who are choking, gasping, or breathing too fast to safely swallow are given fluids intravenously or through a tube into the stomach. Both methods are equally effective at correcting dehydration.
Most hospitalized children improve with this level of care and go home within a few days.
Antiviral Medication in Severe Cases
There is one antiviral drug approved for RSV, but it’s rarely used. It’s reserved almost exclusively for situations where RSV could be fatal, such as in bone marrow transplant patients or people with severely suppressed immune systems. It’s delivered as an inhaled mist over several hours and carries significant side effects and cost. For typical RSV infections in otherwise healthy infants, children, or adults, it plays no role.
Prevention for Infants
Because treatment options are so limited, prevention carries extra weight. There are two main protective options for infants, and which one applies depends on the baby’s age and risk level.
Antibody Injections for Infants
Nirsevimab is a lab-made antibody given as a single injection that provides immediate protection against severe RSV. It’s recommended for all infants under 8 months old entering their first RSV season (typically October through March) if their mother didn’t receive an RSV vaccine during pregnancy, if her vaccination status is unknown, or if the baby was born within 14 days of the mother’s vaccination. Dosing is weight-based: 50 mg for babies under 11 pounds, 100 mg for those 11 pounds and over.
Babies born during RSV season should ideally receive the injection within their first week of life, during the birth hospitalization. For certain high-risk children between 8 and 19 months old, including those with chronic lung disease, severe immune deficiency, cystic fibrosis with lung complications, and American Indian or Alaska Native children, a 200 mg dose is recommended before their second RSV season.
A separate monthly injection called palivizumab exists for the highest-risk infants: those born before 29 weeks gestation, babies with chronic lung disease of prematurity, and infants with significant congenital heart disease or neuromuscular conditions that impair their ability to cough and clear secretions. This requires one injection per month from November through March, up to five doses total.
Maternal Vaccination During Pregnancy
Pregnant women can receive Pfizer’s Abrysvo vaccine between 32 and 36 weeks of pregnancy. The vaccine prompts the mother’s body to produce RSV antibodies, which cross the placenta and protect the newborn during the first months of life. Vaccination after 36 weeks and 6 days is not recommended because there isn’t enough time for antibodies to develop and transfer before delivery. When a mother receives this vaccine in the right window, her newborn generally does not also need the infant antibody injection.
RSV Vaccines for Older Adults
Adults face a different RSV risk profile. RSV causes tens of thousands of hospitalizations among older adults each year in the U.S., and three vaccines are now available to reduce that risk. The CDC recommends a single dose of RSV vaccine for all adults 75 and older, and for adults 50 to 74 who are at increased risk of severe illness due to chronic heart or lung disease, weakened immunity, or other underlying conditions.
All three available vaccines showed strong real-world protection during the 2023-2024 season. GSK’s Arexvy was about 83% effective at preventing RSV hospitalizations and 77% effective against emergency department visits in adults over 60. Pfizer’s Abrysvo showed roughly 73% effectiveness against hospitalizations and 79% against ER visits. Moderna’s mResvia demonstrated about 80% efficacy against symptomatic RSV in the first four months after vaccination, though that dropped to 34% by 18 months. Protection from all three wanes over time, but this is not currently an annual vaccine. One dose is the complete series for now.
There is no preference among the three vaccines. Any one of them is appropriate for eligible adults.