Respiratory Syncytial Virus (RSV)

Facts you should know about respiratory syncytial virus (RSV) infection

  • RSV is a highly contagious virus infection that is most prevalent during the winter season.
  • Most children who develop an RSV infection have mild symptoms of fever, nasal congestion, nasal discharge, and cough.
  • High-risk groups are more likely to have a more severe disease process, including wheezing (bronchiolitis in infants) and/or pneumonia. Such high-risk groups include premature infants, those children with a compromised immune system, or those with chronic pulmonary disease or congenital/acquired cardiac disease.
  • Supportive care is the mainstay of therapy. For high-risk patients, palivizumab (Synagis) preventative therapy is available.

 

What is respiratory syncytial virus (RSV)?

 

The respiratory syncytial virus (RSV), discovered in 1956, is capable of causing a broad spectrum of illnesses. Older children and adults will commonly experience a “bad cold” lasting one to two weeks. Fever, nasal congestion, and cough are their most common complaints. However, in babies and toddlers, RSV can produce severe pulmonary diseases, including bronchiolitis (inflammation of the terminal airways that produces wheezing) and pneumonia (infection of these terminal airways).

Is RSV Contagious?

Respiratory syncytial virus (RSV) is contagious. In the United States, it’s the most common cause of inflammation of the small airways in the lungs (bronchiolitis) and of pneumonia in children under 1 year of age. It also is significant cause of respiratory illnesses in older adults. Nearly all children in the U.S. will have been infected by RSV by 2 years of age. RSV usually causes a mild respiratory infection, but it can occasionally cause more serious infections that require hospitalization from breathing compromise with bronchiolitis or pneumonia.

 

When does RSV infection occur, and who gets it?

 

Infection with RSV is seasonal. In temperate climates, RSV infections usually occur during the late fall, winter, or early spring months.

  • Annual community outbreaks of RSV infection often last four to five months.
  • The winter season (November through April) tend to be most likely to experience RSV epidemic disease.
  • For unknown reasons, severity of illness and frequency of disease often alternate on an annual basis. For example: a “bad” year (large number of patients with moderately severe disease) is followed by a “good” year (fewer number of patients with less severe disease).

More than half of all infants are exposed to RSV by their first birthday. Many have few or mild symptoms. However, some babies with RSV become very ill. RSV is the most common cause of bronchiolitis and pneumonia among infants and children under 1 year of age.

Since an initial RSV infection does not trigger a robust long-term immune system response, after childhood, RSV may cause repeated infections throughout life.

  • These infections are usually associated with cold-like symptoms.
  • However, severe lower respiratory tract disease (for example, wheezing and/or pneumonia) may occur at any age, especially among the elderly or among those with compromised cardiac, pulmonary, or immune systems.
  • An RSV infection may exacerbate conditions such as asthma, COPD, and congestive heart failure.

 

Who is at risk for severe disease?

 

Several broad categories of patients are most vulnerable to RSV infection. These include:

  • premature infants and all infants less than 1 year of age,
  • children 2 years old with cardiac disease or chronic lung disease (for example, asthma, cystic fibrosis, etc.),
  • those of any age with a compromised immune system, and
  • those 65 years of age or older.

 

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