Respiratory syncytial virus infection

Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis; nearly every child has been infected by 2 years of age.

Typical seasonal outbreaks occur during winter months from October through February in the northern hemisphere, and from May through September in the southern hemisphere.

Characterised by cough, wheeze, respiratory distress, and hypoxia.

Most episodes are mild and self-limiting.

Treatment is mostly supportive: supplemental oxygen, nasal toilet, respiratory support, and nutritional support as needed.

High-risk groups for severe illness include infants with a history of prematurity, chronic lung disease, complex congenital heart disease, and immune deficiency.

Vaccination is available for older adults and pregnant women. Immunoprophylaxis with nirsevimab or palivizumab is available for infants and vulnerable young children.

RSV disease in adults is often overlooked but is associated with lower respiratory tract infection, especially in the elderly and those with underlying lung comorbidities.

RSV is a member of the Pneumoviridae family. It is the most common cause of lower respiratory tract infection in infants and young children.[1]Bont L, Checchia PA, Fauroux B, et al. Defining the epidemiology and burden of severe respiratory syncytial virus infection among infants and children in western countries. Infect Dis Ther. 2016 Sep;5(3):271-98. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5019979 http://www.ncbi.nlm.nih.gov/pubmed/27480325?tool=bestpractice.com  

Symptoms of bronchiolitis include rhinorrhoea, cough, wheeze, respiratory distress, and hypoxaemia.[2]Ralston SL, Lieberthal AS, Meissner HC, et al; American Academy of Pediatrics. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014 Nov;134(5):e1474-502. http://pediatrics.aappublications.org/content/134/5/e1474.long http://www.ncbi.nlm.nih.gov/pubmed/25349312?tool=bestpractice.com

RSV commonly causes symptoms of upper respiratory tract infection in people of all ages as well as bronchiolitis, viral pneumonia, and laryngitis (croup). [Figure caption and citation for the preceding image starts]: Electron micrograph revealing the morphological traits of the RSVCDC/Palmer EL; used with permission [Citation ends].