A Cold or RSV

31 October 2023

It can be extremely difficult to distinguish between a bad cold and RSV (Respiratory Syncytial Virus).  Sadly the difference is that in those vulnerable individuals, RSV can result in complications sending them into the hospital, or even causing death.  The most at risk are children under the age of 5 and significantly older adults.  The common factor is that each class can have compromised immune systems resulting in their high risk factor.


We all are familiar with the sniffles, runny nose, sneezing, and congestion.  If it is RSV, there will be a noticeable amount of mucus, plus it is sticky and thick.  In children who have smaller airways, the virus’ increase in mucus can move into pulmonary issues.

Going forward, the individual can present with a fever and reduced appetite.  All of this will tend to make the person irritable and lethargic.  This is true for both colds and RSV.

If you have concerns, be on the lookout for issues with breathing.  It can be sharp, shallow, and/or rapid.  For infants and small children, if they begin to pant, look carefully under the ribcage or the base of the neck to see if the muscles are contracting inward with each breath.  This constitutes an emergency and don’t waste time.

Another indicator is a high fever, especially if the skin, lips, and/or nails start to look blue.  That means the oxygen is not sufficient and you need to call 9-1-1.

RSV is contagious for three to eight days.  However, note you may not show signs for a day or two even if you are infected.

The best way to confirm RSV is through a test.  These are available through a healthcare provider, including your primary care, pediatrician, urgent care, or emergency room.  It is commonly a fluid sample from the nose.  If this discharge shows specific proteins, they will diagnose RSV.  This test will take about an hour.  Just like for COVID, LabCorp offers a home test swab, which you need to mail back to the company using an expedited (overnight) service.  The results are available within a day or two.

Obviously, the key is early diagnosis before it develops into bronchiolitis or pneumonia.  These are prevalent in not only young children but in some elderly folks as well, especially if they have other conditions that have weakened their immune system such as COPD (chronic obstructive pulmonary disease).  The virus won’t accelerate any high-risk condition, but the body fighting the virus will place higher demands on any organs that are already struggling.

Of course, the usual prevention measures should be used like avoiding close proximity to others, covering sneezes and coughs, disposing of tissues promptly, and washing hands with soap and water and using hand sanitizer.  When you use the sanitizer, don’t forget to wipe off the outside where you touched it with your icky hands.

The next month or two is prime season for both colds and RSV, and the seasonality varies by region of the country.  New vaccines are available.  Infants need either maternal RSV vaccine or the immunization for babies, but not both.  For those who are 32 to 36 weeks pregnant, they should seriously consider the shot.  For those aged 60 or older, discuss the options with your primary care team.

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