Croup caused by RSV

RSV may begin with a runny nose, reduced appetite or cough. When infection causes swelling around the voice box and upper windpipe, a child can develop the barking cough, hoarseness and noisy breathing recognised as croup. The [Croup](/conditions/croup/) guide explains this airway pattern.

RSV can also affect the lower airways, where wheezing, fast breathing or feeding difficulty may be more prominent. A fever can occur, but temperature alone cannot distinguish the location or seriousness of the illness. See [Fever](/symptoms/fever/) for general information.

Keep your child calm and upright, offer regular fluids, and check breathing when they are settled. Clear nasal secretions gently if congestion makes drinking difficult. Use only medicines recommended for your child’s age and follow the label or clinical advice.

Do not rely on steam or over-the-counter cough medicines to treat airway swelling. Arrange a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) if symptoms are worsening or you cannot tell whether the noise is from the throat or chest. A clinician may consider [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) in an urgent setting.

Call emergency services for severe breathing effort, pauses in breathing, blue or grey lips, inability to stay awake, or a child who cannot drink because of breathlessness. Drooling with difficulty swallowing is another urgent warning sign.

Seek prompt medical assessment if noisy breathing occurs while resting, breathing becomes faster or harder, or the child is tiring. A cough that sounds harsh is worth describing accurately; use the [Cough](/symptoms/cough/) information to help communicate changes.

Ask whether the symptoms suggest croup, bronchiolitis or another problem, what breathing signs to count or watch, and when your child should be reviewed again.