Respiratory Syncytial Virus (RSV) is a common respiratory pathogen that infects the lungs and breathing passages. While often discussed in the context of infants and young children, RSV circulates widely among adults. For most adults, the infection presents with symptoms similar to a common cold, though duration and severity vary significantly. This article examines the expected timeline of the illness in adults and the factors that can extend the recovery period.
The Typical Timeline of RSV in Adults
For a healthy adult, the acute phase of an RSV infection typically runs its course over five to seven days. Symptoms usually begin four to six days after initial exposure to the virus. Initial symptoms often resemble a mild cold, including a runny nose, a low-grade fever, and a mild cough.
The illness tends to reach its peak severity around days three through five. During this time, the cough may become more pronounced and persistent, and nasal congestion can be at its worst. After this peak, symptoms generally start to improve as the body’s immune response gains control.
Most adults feel significantly better, with main symptoms resolving within one to two weeks. However, a lingering, dry cough or fatigue commonly persists beyond this two-week mark. This residual cough indicates ongoing irritation and inflammation within the airways, not active infection.
Factors Influencing Severity and Recovery Time
While the five-to-seven-day timeline holds true for many healthy individuals, certain physiological factors can prolong the illness and increase its severity.
Age
Advancing age diminishes the body’s immune response. Adults over the age of 65 often experience a more severe disease course and an extended recovery period, which can stretch to two or three weeks or even longer.
Underlying Conditions
Adults with underlying pulmonary or cardiac conditions are at a higher risk for a protracted and complicated infection. For individuals with chronic obstructive pulmonary disease (COPD) or asthma, RSV can trigger an acute exacerbation of their existing condition. This inflammation in the small airways can lead to severe breathing difficulty, pneumonia, or bronchiolitis.
Similarly, those with chronic heart failure may see their condition worsen, as the stress of the respiratory infection places additional strain on the cardiovascular system. In these high-risk groups, the body struggles to clear the virus, leading to a longer period of active illness and a higher likelihood of hospitalization.
Immunocompromised Individuals
People who are immunocompromised, such as those undergoing chemotherapy or who have received an organ transplant, may experience an inability to effectively mount an immune defense. This significantly impairs viral clearance and can lead to a chronic, prolonged infection lasting several weeks.
When Adults Are Still Contagious
The period during which an infected adult can transmit the virus, known as viral shedding, is distinct from the duration of physical symptoms. Adults are typically contagious for three to eight days. Viral shedding can begin a day or two before any symptoms actually appear.
The period of highest infectivity aligns with the peak of the illness, when coughing and sneezing are most frequent. These actions release virus-laden respiratory droplets, facilitating transmission. Contagiousness can persist for a short time even after the most acute symptoms begin to resolve.
However, the viral shedding window is significantly longer for those with weakened immune systems. Immunocompromised adults can continue to shed detectable virus for four weeks or more, even if they no longer feel acutely ill. This difference underscores the need for high-risk individuals to maintain precautions long after their symptoms have improved.