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Is it just a cold or deadly RSV? The 6 signs to tell as more children are rushed to A&E with deadly bug


WITH many winter illnesses now in circulation it’s important to be able to recognise the signs of different viruses, as some can be more serious than others.

One illness experts are warning Brits to be wary of is respiratory syncytial virus (RSV).

a bunch of blue balls with white dots on them
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RSV cases are increasing – most cases are mild and get better on their own[/caption]

a little girl wrapped in a blue blanket is coughing
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Emergency departments seeing an increase in acute bronchiolitis, caused by RSV, among children[/caption]

RSV is a common cause of coughs and colds and usually only causes a mild respiratory illness that gets better on its own.

But for a small number of people who are at risk of more severe respiratory disease, RSV infection might cause pneumonia or even death. 

The latest data from the UK Health Security Agency (UKHSA) shows RSV cases are increasing, with emergency departments seeing an increase in acute bronchiolitis among children.

Acute bronchiolitis is a lung infection in children that’s most commonly caused by RSV.

Dr Alexander Allen, Consultant Epidemiologist at UKHSA, said: “RSV is now circulating at higher levels across most age groups, with emergency departments seeing an increase in acute bronchiolitis among children. Flu has also increased this week and we expect to see all respiratory illnesses increasing further over the winter.

“For the first time this year, vaccination is being offered against RSV as well as for flu and COVID-19. Ahead of the peaks expected this season, those eligible are strongly encouraged to get vaccinated as it offers the best protection heading into winter.”

a graph showing the number of cases of rsv surge

Cold or RSV?

RSV and the common cold have similar symptoms. But RSV can be more serious, especially for infants and young children.

Both RSV and a cold can cause a runny or stuffy nose, cough, sneezing, and fever. 

But RSV is more likely to cause wheezing, while a cold is more likely to cause a sore throat.

The NHS shares how the different symptoms compare.


Cold symptoms come on gradually over two to three days. The main symptoms include:

  • a blocked or runny nose
  • sneezing
  • a sore throat
  • a hoarse voice
  • a cough
  • feeling tired and unwell

You may also have:

  • a high temperature
  • aching muscles
  • a loss of taste and smell
  • a feeling of pressure in your ears and face

Symptoms of a cold can last longer in young children, and they may also be irritable, have difficulty feeding and sleeping, breathe through their mouth, and get sick after coughing.

Symptoms of an RSV infection usually start within a few days of getting infected, and most people only get cold-like symptoms, such as:

  • a runny or blocked nose
  • a cough
  • sneezing
  • tiredness
  • a high temperature – signs include your back or chest feeling hotter than usual, sweatiness and shivering (chills)

Babies with RSV may also be irritable and feed less than usual.

But if RSV leads to a more serious infection (such as pneumonia or bronchiolitis) the following six signs might occur:

  • a cough that gets worse
  • shortness of breath
  • faster breathing or long gaps between breaths
  • difficulty feeding (in babies) or loss of appetite
  • noisy breathing (wheezing)
  • confusion (in older adults)

When to call 999

Cold-like symptoms are very common in babies and children and aren’t usually a sign of anything serious.

But you should call 999 if:

  • your child is having difficulty breathing – you may notice grunting noises, long pauses in their breathing or their tummy sucking under their ribs
  • you have severe difficulty breathing – you’re gasping, choking or not able to get words out
  • you or your child is floppy and will not wake up or stay awake
  • you or your child’s lips or skin are turning very pale, blue or grey – on brown or black skin, this may be easier to see on the palms of the hands
  • your child is under 5 years and has a temperature below 36C

RSV vaccine

Since September 1 2024, pregnant women have been offered RSV vaccination around the time of their 28 week antenatal appointment.

Having the vaccine in week 28 or within a few weeks of this will help build a good level of antibodies to pass on to their baby before birth.

This will give the newborn baby the best protection, including if they are born early.

Those who turn 75 and those age 75 to 79 are also eligible for a free NHS vaccine to protect them from RSV.

Top tips to manage winter illnesses

Boots Superintendent Pharmacist Claire Nevinson has shared advice on how to relieve winter illness symptoms, like flu, the common cold and COVID-19 and help prevent the spread to others.

Rest is key

When you’re sick, your immune system works overtime to fight off the infection. Giving your body time to rest through sleep is one of the most effective ways to recover from a cold. If you are experiencing a runny or blocked nose, a nasal decongestant can help you breathe more freely as you sleep.

Stay hydrated

It’s important to stay hydrated when you have a cold to help support your general wellbeing and to help avoid getting dehydrated. Aim to drink at least six to eight cups a day and don’t forget that decaffeinated hot drinks like tea and coffee count towards your fluid intake. A hot lemon and honey drink can also work to help soothe a sore throat.

Try some home remedies

Alongside ibuprofen, paracetamol and cough medicines there are a couple of things you can do at home to look after yourself. I would recommend a hot lemon and honey drink or cold and flu sachets, especially if you’re suffering with a sore throat. Remember it is important not to take two products with the same active ingredient at the same time.

Gargle salt water to soothe a sore throat

Gargling warm salt water can help ease a sore through by relieving discomfort and inflammation. To make the solution, dissolve half a teaspoon of salt in a glass of warm water. Gargle the liquid for a
few seconds and spit it out and be careful not to swallow it. This is not suitable for children.

Practice good hygiene

Often, we can share our personal items with others without thinking about it. When you’re unwell, it’s important to avoid sharing items with others to help prevent the risk of spreading infection. Remember to cough and sneeze into a tissue and be sure to throw any used tissues into the bin and wash hands regularly for at least 20 seconds, being sure that you have covered the palms, fingers, thumbs, back of the hands and wrists.

Speak to your pharmacist

If you are feeling under the weather, remember that your local pharmacy team can be on hand to help. With no appointment needed, pharmacy teams are able to offer advice and recommend appropriate treatments to help relieve symptoms. There are some over-the-counter options like decongestants, cough syrups, or throat lozenges that may help you feel more comfortable throughout recovery.

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