Why Doctors Say You Probably Don’t Need an RSV Test
WHEN YOU HEAR about the respiratory syncytial virus, or RSV, you probably think it's an illness that mostly affects kids. While it’s definitely common among babies and toddlers, adults can get RSV, too, and cases are rising across the country.
For most people, RSV brings mild, cold-like symptoms. “That run-of-the-mill runny nose, coughing infection,” says David Dobrzynski, M.D., assistant professor of infectious diseases at the University of Rochester Medical Center.
While most people get exposed to RSV before age 2, he says it’s becoming more common among adults, especially those over 65, mainly because testing for the illness has become more available.
RSV is a contagious respiratory infection that’s spread via sneezing, coughing, shaking hands, and close contact—similar to how Covid-19 and the flu are spread, says Robert Salata, M.D., chairman of the Department of Medicine at Case Western Reserve University.
This year, the “interseasonal activity” of RSV is occurring earlier than usual, which Salata says is causing increased cases among both adults and children, and hospitals around the country seeing an increase in RSV patients.
Combined with rising flu cases and Covid still causing infections, some medical experts say we’ll be dealing with a “tripledemic” this winter.
Still, most healthy adults don’t need to worry too much about RSV and will recover in about a week if they get sick, Dr. Dobrzynski says. What’s tricky about RSV is that it’s usually hard to distinguish from Covid and the flu, because symptoms overlap.
So, how do you know if your cold-like symptoms are RSV? The only way to truly tell is by getting a test. Yet most people don’t actually need to get tested, doctors say. (But it's smart to get tested for Covid and flu, which can look like RSV.) Here’s why.
Why Are RSV Cases Rising Among Adults?
RSV isn’t new, even among adults. But, there are a few reasons more cases are cropping up now.
“Over the past two-plus years, all the things we did to protect ourselves from Covid protected us from other respiratory infections, too,” says Georges Benjamin, M.D., executive director of the American Public Health Association. Think: masking, hand washing, and staying away from others when you’re sick.
Now, as Covid measures are relaxed, you’re spending more time in public around others, it’s cold and flu season, and the colder months keep you indoors, he says. “So we transmit these viruses to one another more.”
RSV is also just being identified more frequently, Dr. Dobrzynski says. In hospitals, “triple testing” for Covid, the flu, and RSV is becoming more common.
Who’s Most at Risk for RSV?
Anyone can get RSV, but two major adult groups are most at risk for the infection: people age 65 and older and individuals with chronic illnesses or who are immunocompromised.
Every year, 60,000 to 120,000 older people are hospitalized for RSV in the U.S., and 6,000 to 10,000 die from the infection, according to the Centers for Disease Control and Prevention (CDC).
Older people and anyone of any age with chronic conditions, like heart or lung disease or who have a weakened immune system, are also at risk, Dr. Benjamin says. That includes people who’ve received transplants or who are going through chemotherapy.
“RSV is generally a mild cold-like syndrome, but it can be severe, especially if it progresses to the lower respiratory tract where it’s associated with pneumonia,” Dr. Salata says. “It can be fatal in some cases.”
Are the Symptoms of RSV Different from Covid and the Flu?
Not really. The basic symptoms of RSV, Covid, and the flu overlap, which makes it tough to distinguish one illness from the other.
According to the CDC, basic RSV symptoms typically include:
Runny nose
Coughing
Sneezing
Fever
Wheezing
Decreased appetite
“Wheezing is one symptom that we see more in RSV than in influenza and Covid,” Dr. Dobrzynski says. “That's the one, obviously, we worry about in people with a background of COPD [chronic obstructive pulmonary disease] or asthma. They get into these attacks that cause worsening wheezing with RSV, and that leads to potentially severe complications.”
Generally, RSV symptoms typically appear gradually, similar to Covid. The flu often comes on more suddenly.
If you’re in a high-risk group and have any severe symptoms, it’s a good idea to get checked out by your doctor, Dr. Salata recommends. RSV can progress to pneumonia or bronchitis.
When to Get Tested for RSV?
The only way to really know if your illness is RSV is to get tested—but you probably don’t need a test unless you’re in a high-risk group or your symptoms are severe. Most healthy adults will see their respiratory illness clear up in a week or so.
But if you are getting tested, Dr. Salata says it’s best to get tested for RSV, Covid, and the flu at the same time.
You can get tested at your doctor’s office, or at-home tests are available for all three viruses. Dr. Benjamin says if you have easy access to an at-home Covid test, you can test yourself for that virus to rule it out.
How to Take Care of Yourself When You Have RSV
Anyone—even healthy people—can get sick from RSV. So if you’re feeling crummy, just be vigilant of your symptoms, Dr. Dobrzynski says.
“If you're having trouble breathing, if you're having trouble getting over a wheeze, those are the times you want to talk to your health care provider,” he says.
Also, see your doctor if your fever is over 101 degrees Fahrenheit and persists for a few days or you can’t keep fluids down, Dr. Benjamin says.
Otherwise, you can likely treat your symptoms at home by:
Getting plenty of rest
Staying hydrated
Keeping up with your medications for underlying conditions
Taking over-the-counter medications, like Tylenol for fever and muscle aches or decongestants
Typically, you’ll start feeling better in a few days, but stay away from others until you do.
There aren’t specific treatments for RSV yet. But, Dr. Salata says some antiviral medications for the infection are in the works. And, clinical trials for an RSV vaccine given to pregnant women have shown it can help protect newborns from contracting the virus, but it hasn’t been approved by the FDA yet.
How to Protect Yourself and Others from RSV
Cold weather means you’ll be spending lots of time indoors over the next few months. And, holiday gatherings might put you in contact with older relatives. So, it’s vital to take some steps to protect yourself and others from RSV—as well as Covid and the flu:
Stay home when you’re sick. Skipping family get-togethers isn’t fun, but if you have fever or a cough, you could easily spread the illness to others.
Wear a mask. Just like Covid, RSV is a respiratory illness spread through coughing, sneezing, and close contact. Masks will decrease transmission.
Wash your hands. Always a good tip, but hand-washing can stop the spread of illnesses and other germs.
Get vaccinated. There might not be an RSV vaccine yet, but getting a flu shot and a Covid vaccine (and the latest booster) will reduce your risk for those viruses. “If it's been two months since you've had your last Covid shot, get your booster, and try to get the bivalent one if possible,” Dr. Benjamin says. The bivalent boosters contain multiple components of the original Covid virus and Omicron variants to offer broad, updated protection.
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