Respiratory Syncytial Virus

Introduction

Respiratory syncytial virus (RSV) is a virus that causes infections of the lungs and respiratory tract. It's so common that most children have been infected with the virus by age 2. Respiratory syncytial (sin-SISH-ul) virus can also infect adults. In adults and older, healthy children, the symptoms of respiratory syncytial virus are mild and typically mimic the common cold (Olson et al, 7958-7969). Self-care measures are usually all that's needed to relieve any discomfort. Infection with respiratory syncytial virus can be severe in some cases, especially in premature babies and infants with underlying health conditions. RSV can also become serious in older adults and adults with heart and lung diseases. Common-sense precautions can help prevent the spread of respiratory syncytial virus.

Symptoms

Signs and symptoms of respiratory syncytial virus infection typically appear about four to six days after exposure to the virus. In adults and older children, RSV usually causes mild cold-like signs and symptoms. These include (Murawski et al, 1110-1123):

Congested or runny nose

Dry cough

Low-grade fever

Sore throat

Mild headache

A general feeling of unease and discomfort (malaise)

Causes

Respiratory syncytial virus enters body through eyes, nose or mouth. It spreads easily when infectious respiratory secretions — such as those from coughing or sneezing — are inhaled or passed to others through direct contact, such as shaking hands. The virus can also live for hours on objects such as countertops and toys. Touch mouth, nose or eyes after touching a contaminated object and you're likely to acquire the virus. An infected person is most contagious in the first few days after infection, but respiratory syncytial virus may spread for up to a few weeks after the start of infection (Mohapatra et al, 495-504).

Risk factors

By age 2, most children will have been infected with respiratory syncytial virus. Children who attend child care centers or who have siblings who attend school are at a higher risk of exposure. People at increased risk of severe sometimes life-threatening infections include (Gorelick et al, 422-423):

Infants younger than 6 months of age

Younger children, especially under 1 year of age, who were born prematurely or who have an underlying condition, such as congenital heart or lung disease

Children with weakened immune systems, such as those undergoing chemotherapy or transplantation

Older adults

Adults with congestive heart failure or chronic obstructive pulmonary disease

People with immunodeficiency, including those with HIV/AIDS

Complications

Complications of respiratory syncytial virus include (Collins, pp 2040-2055):

Hospitalization. When respiratory syncytial virus infection causes severe illness, hospitalization may be required so that doctors can monitor and treat breathing problems and give intravenous (IV) fluids. Most at risk of hospitalization are babies younger than 6 months old, babies that are born prematurely, and babies with congenital heart or lung disease.

Pneumonia or bronchiolitis. When the respiratory syncytial virus moves from upper respiratory tract to lower respiratory tract, inflammation of the lungs (pneumonia) or the lungs' airways (bronchiolitis) can result.

Middle ear infection. When microorganisms infiltrate the space behind the eardrum, a middle ear infection (otitis media) can result. This happens most frequently in infants and young children (Gorelick et al, ...