Respiratory Syncytial Virus

By Melanie McGrath

Respiratory Syncytial Virus (RSV) is the most common cause of bronchiolitis and pneumonia among infants and children under 1 year of age. RSV causes infection of the lungs and breathing passages[i].
In adults, it may only produce symptoms of a common cold, most frequently with fever, runny nose, cough, and sometimes wheezing. But RSV infections can lead to other more serious illnesses in premature babies and kids with diseases that affect the lungs, heart or immune system[ii]. During their first RSV infection, between 25% and 40% of infants and young children have signs and symptoms of bronchiolitis or pneumonia, and 0.5% to 2% require hospitalization. Most children recover from the illness in eight to fifteen days. the majority of children hospitalized for RSV infection are under six months of age.

RSV is highly contagious and can be spread though droplets containing the virus when a person coughs or sneezes. RSV is spread from respiratory secretions through close contact with infected persons or contact with contaminated surfaces or objects. Infection can occur with infectious material contacts mucous membranes of the eyes, mouth or nose and possibly through the inhalation of droplets generated by a sneeze or cough. In temperate climates, RSV infections usually occur during annual community outbreaks, often lasting four to six months, during the late fall, winter or early spring months. The timing and severity of outbreaks in a community vary from year to year. RSV spreads efficiently among children during the annual outbreaks, and most children will have serologic evidence of RSV infection by two years of age[iii].

For children with mild disease, no specific treatment is necessary other than the treatment of symptoms, like acetaminophen to reduce fever[iv]. Children with severe disease may require oxygen therapy and sometimes mechanical ventilation[v].

Current prevention options include good infection-control practices, RSV-IGIV, and an anti-RSV humanized murine monoclonal antibody. RSV-IGIV or the anti-RSV humanized murine monoclonal antibody can be given during the RSV outbreak season to prevent serious complications of infection in some infants and children at high risk for serious RSV disease. Frequent hand washing and not sharing item such as cups, glasses, utensils with persons who have RSV illness should decrease the spread of virus to others.

If you think your child may have RSV, call the doctor if your child has a high fever with ill appearance, thick nasal discharge that is yellow, green or gray, or a worsening cough or cough that produces yellow, green or gray mucus. Call also if you think your child might be dehydrated. In infants, besides the symptoms already mentioned, call the doctor if your baby is unusually irritable or inactive or refuses to breastfeed or bottle-feed. Seek immediate medical help if you feel your child is having difficult breathing or is breathing very rapidly, is lethargic or if their lips or fingernails appear blue[vi].

Sources:
[i] World Health Organzation (2008) ‘Acute Respiratory Infections” http://www.who.int/vaccine_research/diseases/ari/en/index3.html
[ii] Kids health (2006) “Infections: Respiratory Syncytial Virus” http://www.kidshealth.org/parent/infections/bacterial_viral/rsv.html
[iii] CDC (2008) Respiratory Syncytial Virus http://www.cdc.gov/ncidod/dvrd/revb/respiratory/rsvfeat.htm
[iv] RSV info Center (2008) Treating Mild RSV at Home http://www.rsvinfo.com/managing/treatmild_b.html
[v] RSV info Center (2008) Treating Severe RSV in the Hospital http://www.rsvinfo.com/managing/treathosp_b.html
[vi] Children’s memorial Hospital (2008) Respiratory Syncytial Virus” http://www.childrensmemorial.org/depts/infectious/rsv.aspx