School-aged children who are infected with RSV and have a mild upper respiratory tract infection often introduce RSV into the home. RSV can spread when a person with the virus coughs or sneezes into the air.  Virus-containing droplets generated from these activities may cause infection when they come into contact with another person’s nose, mouth, or eyes. 

Infection can also result from direct and indirect contact with nasal or oral secretions from infected persons, such as kissing an infected child’s face or touching a common surface (e.g., a doorknob) on which viruses have been deposited. People infected with RSV can spread the virus for 3 to 8 days. However, some infants and people with weakened immune systems can spread the virus for up to 4 weeks. 

Symptoms of RSV are similar to other respiratory infections. Illness begins 4 to 6 days after being exposed to the virus. In adults and older children, typical RSV symptoms include a low-grade fever, congested or runny nose, cough, sore throat, headache, fatigue, and occasionally wheezing. In children younger than age 2, RSV can cause a lower respiratory tract illness such as bronchiolitis or pneumonia; more severe cases can result in respiratory failure. For people with severe illness, symptoms may include a worsening croupy cough, unusually rapid breathing, difficulty breathing, and a bluish color of the lips or fingernails caused by low levels of oxygen in the blood. RSV can cause middle ear infections (otitis media) in preschool children.

The majority of children hospitalized for an RSV infection are under the age of six months. The elderly (those 65 years of age and older), premature infants, persons with chronic lung or heart problems, and persons with weak immune systems are at higher risk for developing serious illness. Those who are exposed to tobacco smoke, attend daycare, live in crowded conditions, or have school-aged siblings could also be at higher risk. 

Individual cases of RSV are not reportable by law in Texas.

Vaccines are available to protect older adults from severe RSV. Vaccines for pregnant women or monoclonal antibody products are available to protect infants and young children from severe RSV. Vaccines are available to protect older adults from severe RSV. Vaccines for pregnant women or monoclonal antibody products are available to protect infants and young children from severe RSV. Nirsevimab is an injectable monoclonal antibody that prevents severe RSV disease in infants and young children.  Monoclonal antibodies do not activate the immune system, as would occur with infection or vaccination (active immunization). Rather, the antibodies themselves protect against disease (i.e., passive immunization). Because nirsevimab does not activate the immune system, protection is likely most effective the weeks after nirsevimab is given and wanes over time. Nirsevimab does not provide long-term immunity to RSV disease but provides protection to infants when they are most at risk of getting severe RSV disease. As children get older, they are less likely to get severe symptoms from RSV infection.

The Advisory Committee on Immunization Practices (ACIP) recommends adults 50–59 years of age who are at increased risk of severe RSV disease receive a single dose of RSV vaccine. At this time, RSV vaccination is recommended as a single dose only. Persons who have already received RSV vaccination are not recommended to receive another dose. RSV vaccine can be administered with any product licensed in this age group. As of March 27, 2025, that includes GSK's Arexvy and Pfizer's Abrysvo. There is no preferential recommendation for any licensed product over another.

There are steps that can be taken to help prevent the spread of RSV. Covering coughs and sneezes, practicing frequent hand washing, refraining from kissing other people, and disinfecting surfaces may help stop the spread of RSV. Persons with RSV illness should not share cups or eating utensils with others, and persons with cold-like symptoms should not interact with high-risk children. When possible, limiting the time that high-risk children spend in child-care centers or other potentially contagious settings may help prevent infection and spread of the virus during the RSV season. 

A drug called palivizumab is available to prevent severe RSV illness in certain infants and children who are at high risk. The drug can help prevent development of serious RSV disease, but it cannot prevent infection with RSV or help cure or treat children already suffering from serious RSV disease.

Children with a fever should be kept out of school or childcare until they are fever free for 24 hours without the use of fever suppressing medications. Rules for exclusion of sick children from school and childcare are outlined in the Texas Administrative Code, specifically Rule 97.7 for schools and Rule 746.3603 for childcare. 

RSV activity typically begins to increase in Texas in September or October and peaks in December or January. The timing of the RSV season and the seasonal peaks can vary by region in Texas. For surveillance reports, see the Data link.

• Respiratory Syncytial Virus Infection (RSV) 
  Centers for Disease Control and Prevention 
  Information about RSV including disease description, symptoms, treatment, and prevention
   
• National Respiratory and Enteric Virus Surveillance System (NREVSS)
  Centers for Disease Control and Prevention
  National surveillance data for RSV and other viruses
   
• Child Care Minimum Standards
  Texas Department of Family and Protective Services (DFPS)
  Rules and minimum standards for childcare licensing, including DFPS disease reporting requirements