by Rosenblum L

Respiratory Syncytial Virus

(RSV)

Definition

Respiratory syncytial virus (RSV) is a common cause of many types of infections of the respiratory system. The term respiratory system refers to the lungs and breathing passages. These infections include:
These infections are common. They are usually most severe in infants, young children, and older people. However, these infections can happen at any age. In severe cases, RSV infections can cause death.
Respiratory System Anatomy of an Infant
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Copyright © Nucleus Medical Media, Inc.

Causes

RSV is spread through infected fluids in the mouth and nose. The virus most often enters the body from touching the mouth, nose, or eyes. It can also be spread by inhaling droplets from a sneeze or cough.
RSV is spreads easily. It can survive on surfaces and objects for hours. It is easily passed from person to person. Virus shedding usually lasts for 3-8 days, but may last for up to four weeks.

Risk Factors

RSV is more common in infants and young children, especially under 2 years old. Other factors that may increase your chance of RSV include:
  • Exposure to a person infected with the virus or an object contaminated with the virus
  • Premature birth of an infant
  • Problems with the heart, lungs, or immune system
  • Current or recent use of chemotherapy
  • Previous organ or bone marrow transplant
  • Problems associated with muscle weakness

Symptoms

The symptoms of RSV infection vary with age and previous exposure to RSV. Very young children, elderly people, and people with chronic diseases are more likely to have severe symptoms.
In children younger than three years old, RSV can cause illnesses such as bronchiolitis and pneumonia. Symptoms may include:
  • Stuffy or runny nose
  • High fever
  • Severe cough
  • Wheezing
  • Shortness of breath
  • Very fast rate of breathing
  • Bluish color of the lips or fingernails
  • Abnormal drowsiness or irritability
  • Lack of appetite
  • Discharge from the eyes
In children older than three years old, and healthy adults, RSV typically causes an upper respiratory infection or cold. Symptoms commonly include:
  • Runny or stuffy nose
  • Sore throat
  • Mild cough
  • Headache
  • Low-grade fever
  • Discharge from the eyes

Diagnosis

Your doctor will ask about you or your child's symptoms and medical history. A physical exam will be done. A variety of tests are available to diagnose RSV. Lab tests called antigen detection assays are commonly done using secretions from the nose.

Treatment

In most cases, antibiotics are not needed because the infection is caused by a virus, not bacteria.

Mild Infections

Mild infections such as colds do not need special treatment. The goal is to ease the symptoms so that you or your child feels more comfortable while the body fights the virus. For symptom relief, try the following:
  • Drink plenty of liquids, especially water and fruit juice, to help keep nasal fluid thin and easy to clear.
  • Use a cool-mist vaporizer to humidify the air. This may help reduce coughing and soothe irritated breathing passages.
  • Use salt water nose drops to loosen mucus in the nose.
  • Use non-aspirin fever medication, such as acetaminophen, as needed to reduce fever.

Severe Infections

People of all ages can develop severe infections from RSV. However, it is most common in very young people. Severe infections include pneumonia and bronchiolitis. These may require treatment in a hospital. This treatment is aimed at opening up breathing passages. It may include:
  • Humidified air
  • Supplemental oxygen
  • Treatments to improve breathing
  • In certain cases, mechanical ventilation may be used if you or your child is unable to breathe without assistance

Prevention

To help reduce your chance of RSV:
  • Practice healthy habits, such as:
    • Wash your hands often, especially after touching someone who may have a cold or other RSV infection.
    • Avoid touching your face and rubbing your eyes.
    • Do not share items such as cups, glasses, silverware, or towels with people who may have a cold or other RSV infection.
    • Avoid smoke exposure.
  • If your baby has a high risk of serious illness from RSV, your doctor may recommend a medicine to help prevent infection. The medication is given by injection. It is injected monthly through the fall and winter in children under 2 years old. Talk with your doctor to see if this medication would help your child.

RESOURCES

American Lung Association http://www.lung.org

Nemours Kids Health http://www.kidshealth.org

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca

Health Canada http://www.hc-sc.gc.ca

References

Bronchiolitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 8, 2014. Accessed September 26, 2014.

Committee on Infectious Diseases, American Academy of Pediatrics. Red Book 2006. 27th ed.

The Merck Manual of Diagnosis and Therapy. Simon and Schuster, Inc.; 1999.

Respiratory syncytial virus. American Lung Association website. Available at: http://www.lung.org/lung-disease/respiratory-syncytial-virus. Accessed September 26, 2014.

Respiratory syncytial virus. Nemours Kids Health website. Available at: http://kidshealth.org/parent/infections/lung/rsv.html. Updated September 2012. Accessed September 26, 2014.

Respiratory syncytial virus (RSV). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/rsv. Updated April 1, 2014. Accessed September 26, 2014.

Respiratory syncytial virus (RSV) infection in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 20, 2011. Accessed September 26, 2014.

1/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kabir AR, Mollah AH, Anwar KS, Rahman AK, Amin R, Rahman ME. Management of bronchiolitis without antibiotics: a multicentre randomized control trial in Bangladesh. Acta Paediatr. 2009;98:1593-1599.

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