Yes, RSV is still circulating in the United States. The CDC reports that RSV activity is elevated and increasing in some regions of the country. While RSV follows a seasonal pattern that typically peaks between November and March, the exact timing varies significantly by state, and the virus doesn’t disappear all at once.
When RSV Peaks and How Long It Lasts
RSV season in the U.S. generally runs from fall through early spring, but the peak hits different parts of the country at different times. During the 2024-2025 season, the earliest peaks occurred in late November in Florida, Georgia, and Mississippi, while states like Montana and South Dakota didn’t peak until early March. That means even as southern states are winding down, northern and more rural states may still be seeing high levels of transmission.
Since the pandemic, RSV timing has also become more synchronized with flu season, meaning both viruses tend to surge at roughly the same time. Before COVID-19, RSV often peaked slightly earlier than the flu. This overlap can make it harder to tell which virus you’re dealing with based on symptoms alone.
Who RSV Hits Hardest
RSV is a serious concern at both ends of the age spectrum. In older adults (65 and up), the virus causes an estimated 60,000 to 160,000 hospitalizations and 6,000 to 10,000 deaths each year in the U.S. For infants, the numbers are striking in a different way: during the 2024-2025 season, the hospitalization rate for babies under 8 months was roughly 8.5 to 10.7 per 1,000 children under five, depending on the surveillance system tracking it. Babies under 2 months old had a rate of about 6 to 7 per 1,000.
Healthy adults who catch RSV typically experience something that feels like a bad cold and recover within a week or two. But for infants, older adults, and anyone with lung or heart conditions or a weakened immune system, the virus can progress to pneumonia or bronchiolitis, sometimes requiring hospitalization.
RSV vs. Flu vs. COVID-19 Symptoms
All three major respiratory viruses share overlapping symptoms, which is why it’s difficult to identify RSV by feel alone. RSV’s hallmark symptoms are cough, fever, stuffy or runny nose, and decreased appetite. It tends to be a simpler symptom profile compared to the flu and COVID-19.
The flu typically brings body aches, chills, headache, and fatigue on top of the cough and fever. COVID-19 has the widest range of symptoms, potentially including loss of smell or taste, nausea, vomiting, diarrhea, and shortness of breath alongside the usual respiratory symptoms.
Incubation periods differ too. RSV symptoms show up quickly, usually within one to four days of exposure. The flu takes two to three days, while COVID-19 can take anywhere from two to 14 days, making it harder to trace back to a specific exposure.
You Can Now Test for RSV at Home
For the first time, there’s an FDA-cleared at-home test that detects RSV alongside flu and COVID-19. The Flowflex Plus 4-in-1 test from Acon Laboratories uses a single nasal swab to check for RSV, influenza A, influenza B, and COVID-19. It’s cleared for adults and children as young as six months (when an adult administers the swab using a child-safe guard). This is a significant change from previous years, when RSV could only be confirmed through a doctor’s office or hospital lab test.
Vaccines and Prevention for Adults
The CDC recommends a single dose of RSV vaccine for all adults 75 and older and for adults ages 50 to 74 who are at increased risk of severe illness. Three vaccines are available for adults 50 and up: GSK’s Arexvy, Moderna’s mResvia, and Pfizer’s Abrysvo. The CDC has no preference among them.
One important detail: this is not an annual vaccine. If you’ve already received one dose, you don’t need another one each season. The recommendation is currently for a single lifetime dose for eligible adults.
Protecting Infants
For babies, the main preventive tool is nirsevimab, a monoclonal antibody (not a traditional vaccine) that gives infants temporary protection against severe RSV. It’s recommended for all infants under 8 months who are born during or entering their first RSV season, and for higher-risk children ages 8 to 19 months heading into their second season. The dose depends on the baby’s weight: 50mg for infants under about 11 pounds, and 100mg for those 11 pounds and above.
Supply was tight during the 2023-2024 season, with the manufacturer unable to produce enough of the 100mg dose for all eligible infants. During that shortage, the CDC recommended prioritizing doses for the youngest babies (under 6 months) and those with underlying health conditions. Supply has improved since then, but availability can still vary by provider and region, so it’s worth asking your pediatrician about timing if you have a newborn or young infant heading into RSV season.