RSV in adults is treated primarily with supportive care at home, since no widely used antiviral medication exists for typical cases. Most healthy adults recover in one to two weeks with rest, fluids, and over-the-counter symptom relief. The virus needs to run its course, but there are specific steps you can take to manage symptoms and clear warning signs worth knowing if things take a turn.
Managing Symptoms at Home
RSV treatment for most adults looks a lot like treating a bad cold. The goal is to keep yourself comfortable and hydrated while your immune system does the work. Keep cool water at your bedside and drink warm fluids like broth or soup, which help loosen thickened mucus in your airways. Ice pops can soothe a raw throat.
For fever and sore throat, acetaminophen (Tylenol) works well. Saline nasal drops or sprays are a simple, effective way to relieve congestion without adding another medication. Follow the product instructions and use them as needed throughout the day.
If you develop wheezing or chest tightness, your doctor may prescribe an inhaled bronchodilator to open your airways. These are the same types of inhalers used for asthma flare-ups. Some physicians also use inhaled corticosteroids, though clinical evidence for their benefit in RSV specifically is limited, and current guidelines generally don’t support routine steroid use for RSV-related inflammation in the airways.
What Recovery Looks Like
Symptoms typically start improving within a week, and most adults feel back to normal within two weeks. You’re contagious for roughly 3 to 8 days after symptoms appear, so it’s worth limiting close contact during that window. A lingering cough can hang on after other symptoms resolve, which is normal and doesn’t necessarily mean the infection is worsening.
If you develop pneumonia or another complication, recovery stretches longer. People with weakened immune systems can remain contagious for up to a month and often face a slower path back to full health.
When RSV Becomes Serious
For most adults, RSV stays in the “miserable but manageable” category. The real concern is for people at higher risk of the infection moving into the lower lungs and causing pneumonia or respiratory failure. Risk factors include chronic lung disease, heart disease, a weakened immune system, severe obesity (BMI of 40 or higher), chronic kidney or liver disease, and conditions that impair your ability to clear your airways, like post-stroke swallowing problems or neuromuscular disorders.
If you’re monitoring at home, pay attention to your breathing. Increasing shortness of breath, a bluish tint to your lips or fingertips, or confusion are signs the infection is outpacing your body’s ability to keep up. If you have a pulse oximeter, a blood oxygen reading of 88% or lower warrants a trip to the emergency department. Even without one, the feeling of not being able to catch your breath while resting is reason enough to seek immediate care.
Treatment for High-Risk and Hospitalized Adults
Hospitalized patients receive oxygen therapy and IV fluids as the backbone of care. Beyond that, treatment options are limited. Ribavirin is the only FDA-approved antiviral for RSV, but it’s reserved for a narrow group of patients, not prescribed broadly. Guidelines from major transplant centers restrict it to people who meet all three criteria: active respiratory symptoms, a confirmed positive molecular test for RSV, and high risk for the disease getting worse.
That high-risk category includes people who recently received a stem cell transplant (within 30 days), those with very low immune cell counts, lung transplant recipients, and patients with active graft-versus-host disease on immunosuppressive therapy. For these patients, treatment may combine ribavirin with intravenous immunoglobulin (a concentrated dose of antibodies) to bolster the immune response. The evidence for adding immunoglobulin is mixed, but many transplant programs use the combination, particularly for lung transplant recipients.
How RSV Is Diagnosed
If your doctor suspects RSV rather than a standard cold or flu, they’ll typically order a molecular test (PCR) from a nasal swab. PCR tests are highly sensitive and can detect even small amounts of virus. Rapid antigen tests are also available and return results faster, but they’re less sensitive, meaning they can miss some infections. In practice, adults with mild symptoms often aren’t tested at all, since the treatment is the same regardless. Testing matters most when someone is at high risk and the result would change the treatment plan.
RSV Vaccines for Adults
Prevention is now an option for many older adults. The CDC recommends a single dose of RSV vaccine for all adults 75 and older, and for adults 50 to 74 who have conditions that raise their risk of severe illness. That includes chronic heart disease (not just high blood pressure), chronic lung conditions like COPD or asthma, diabetes with organ damage or requiring insulin, severe obesity, moderate to severe immune compromise, chronic liver disease, sickle cell disease, and residence in a nursing home.
You don’t need medical records to prove you qualify. Your own statement that you have a risk factor is considered sufficient, and vaccinators are instructed not to deny the vaccine for lack of documentation. If you’re in the 50-to-74 range and unsure whether your health history qualifies, your provider can help you assess. The vaccine is given once, not annually like the flu shot.