Respiratory Syncytial Virus

(RSV)

The Facts

Most infants are exposed to the respiratory syncytial virus (RSV), and almost all children are infected at least once by the age of 2. **RSV can cause a serious lung infection in infants and younger children **and is more common in premature babies and infants or younger children with health problems, such as heart or lung disease.

Seniors and adults with heart or lung problems may also experience a severe infection. People with a weakened immune system are also at risk. RSV does not cause such a serious infection for healthy children and adults, who may experience symptoms similar to the common cold.

Even though people, including infants, develop antibodies (immune defenses) against the virus after an infection, it appears the virus is able to reinfect individuals throughout their lifetime. In cases of reinfection, symptoms are usually less severe than the first infection.

The Causes

Viruses are biological agents made of genetic materials and proteins that are able to infect a host (a living organism) and replicate. RSV can enter the body through the eyes, nose, or mouth. Physical contact, kissing, or inhaling air droplets containing the virus (from an infected person's cough or sneeze) all increase the possibility of acquiring the infection.

The virus particles can live for hours on surfaces, such as keyboards, toys, and doorknobs so you can also become infected by touching your eyes, nose, or mouth after coming into contact with an infected surface.

Much like the flu, which is also caused by a virus, RSV is a seasonal condition. RSV appears to spread most rapidly from autumn to spring. As children enter daycare or interact with other children, RSV moves easily from one child to the next.

Symptoms And Complications

RSV causes different symptoms and complications in different people. Signs and symptoms of the condition generally occur 3 to 4 days after exposure to the virus.

The symptoms of severe infection include:

coughing
high fever
low oxygen level in blood (skin may appear bluish)
shallow or rapid breathing
wheezing or difficulty breathing

Medical attention is most important for infants under 6 months of age, those born prematurely, or infants with heart or lung problems. These infants may require hospitalization because the infection could progress to the point of requiring specialized machines to assist breathing (mechanical ventilation). You should also see a doctor for RSV if you are over the age of 65 or have a weakened immune system.

The symptoms of a mild infection are similar to the symptoms of a cold and do not usually lead to hospitalization. The symptoms of mild infection may include:

congestion
cough
headache
runny nose
sore throat

Possible complications include ear infections, sinus infections, pneumonia, or in severe cases, respiratory failure.

Making A Diagnosis

Your doctor may use several types of tests to diagnose RSV. The most commonly used types are real-time reverse transcriptase-polymerase reaction (RT-PCR) and antigen testing. These tests can be done by taking a sample from the nose or throat. Your doctor may also perform blood tests.. If pneumonia is suspected, additional testing may be required, such as an X-ray of the chest or a CT scan, which can provide more information.

Treatment And Prevention

Since the condition is caused by a virus, treatment focuses on relieving the symptoms while the infection is present and treating complications should they occur. With time, the virus will disappear by itself.

Medications such as acetaminophen* or ibuprofen can help reduce a fever or relieve discomfort. Complications such as ear infections, sinus infections, or pneumonia can be treated with antibiotics if they are caused by bacteria. Antibiotics destroy the bacteria, but they have no effect on RSV.

When an infected person is having severe problems breathing, inhaling a mist of medication into the lungs can help open the airways. In addition, a supply of oxygen or a breathing machine may help infants who are not breathing easily on their own. Most children do not need to be hospitalized. When they are treated at home, parents should monitor for signs of serious breathing difficulties and make sure to give enough fluids to prevent dehydration.

**Until RSV vaccination is widely available, your doctor may suggest monthly injections of palivizumab as a preventative measure. **Palivizumab can be given in the first 2 years of life to premature babies and young children with heart or lung problems who may be at an increased risk of developing RSV. It is an intramuscular injection given monthly during the high-risk season. Children who receive palivizumab may have less risk for hospitalization, but it is unclear whether this treatment prevents death or serious complications.

While it may not be easy to completely prevent RSV, there are some simple things you and your family can do to reduce the risk of RSV and prevent its spread:

Practice good hygiene by washing your hands frequently, especially before holding or touching an infant.
Keep infants away from people who have a cold, fever, or other infectious conditions.
Practice good cough hygiene (e.g., coughing into elbow).
Clean your home, including children's toys, to keep it free from germs.
Do not smoke in the home, as exposure to second-hand smoke increases a person's chances of catching RSV.