Overview
Respiratory syncytial virus (RSV) is a respiratory virus that causes infection of the lungs. It is the most common cause of childhood illness and infects most children before age two, though it can also affect adults.
RSV is highly contagious during the first week of infection when the symptoms are visible. Those at higher risk (younger infants, people with weaker immune systems) can still spread the infection for up to one month, even after the disappearance of symptoms.
The virus spreads through the air when infected individuals cough and sneeze and enters the body through the eyes, nose, and mouth. RSV can also be transmitted by touching objects contaminated with the virus, as this virus can survive for several hours on hard objects such as; doorknobs, toys, and countertops.
Symptoms in most healthy children and adults are usually mild and imitate typical cold symptoms. However, in severe cases of respiratory syncytial virus infection, which occur in younger infants, older adults (65 years and above), children, and adults with weakened immune systems or heart and lung disease, symptoms are usually life-threatening and may require hospital care.
Keys Facts
- The respiratory syncytial virus is a common childhood infection of the lungs and the lower airways.
- Approximately half of all infants become infected with RSV in their first year of life, and others during their second year. Similarly, there is a high incidence of reinfection in 70% of children exposed to the virus for the second time.
- Premature infants and people with chronic heart and lung problems are at increased risk of more severe RSV.
- It travels through respiratory droplets when an infected person coughs or sneezes and through contact with an infected person or objects. RSV gains access into the body through the eyes, nose, or mouth.
- Infected people show symptoms within 4-6 days after infection. Symptoms are mild at the initial phase but become severe as the condition progresses.
- The respiratory syncytial virus is the most common cause of pneumonia and inflammation of the lungs.
- There is no vaccine for RSV; thus, the importance of preventive measures to decrease transmission among children and adults.
Symptoms and Diagnosis
Symptoms
The symptoms of RSV appear in phases and frequently occur 4-6 days after entry of the virus into the body.
In infants below 12 months, symptoms such as; difficulty in breathing, irritability, decreased activity, and decreased appetite may be the only symptoms.
Mild symptoms in children include:
- Runny nose
- Sore throat
- General body discomfort
- Mild headache
- Low-grade fever
- Sneezing
- Cough
Severe symptoms are found in high-risk individuals, and they may include:
- Rapid breathing
- Flaring of nostrils during breathing: This shows the respiratory difficulty
- Cyanosis: Bluish discolouration of the lips, mouth, and fingernails
- Wheezing: A high-pitched sound heard during expiration
Common complications of RSV are:
- Dehydration: Dehydration is fatal in infants, and it is caused by the tightening of the muscles around the airways, which makes breathing harder, resulting in the loss of a considerable amount of fluid through the lungs.
- Bronchiolitis and pneumonia: Infection may also affect the lungs and smaller airways(bronchioles), causing inflammation.
- Otitis media, an infection of the middle ear, is common in infants and young children.
Diagnosis
A medical history of the symptoms and physical examination may be adequate to diagnose the respiratory syncytial virus in young children and adults.
During a physical examination, the doctor may listen to the child’s lungs to check for wheezing and other abnormal sounds. The doctor may also check the oxygen level in the blood using pulse oximetry.
Laboratory and imaging tests may be used to diagnose severe cases of RSV that require hospitalization.
The tests for RSV include:
- Blood and urine test: White blood cell count is performed to look for signs of bacterial infection, and a urine test is used to check dehydration.
- Chest X-rays: This procedure is used to look for signs of pneumonia or inflammation of the bronchioles.
- Nose or mouth swab: This is used to test for viruses.
Causes and Prevention
Causes
The respiratory syncytial virus spreads through contact with infected respiratory droplets, and the point of entry into the body is through the eyes, mouth, or nose.
It affects people of all ages but is very common in children, especially infants. Children who attend schools with a higher incidence of an outbreak and those with siblings with the infection are at 98% risk of exposure and 70% risk of reinfection.
According to the Mayo Clinic, certain people are at higher risk of severe RSV infection.
They include:
- Premature infants and infants younger than seven months.
- Children with an abnormality in the heart that develops before birth (congenital heart disease) or chronic lung disease.
- Immunocompromised individuals- Children and adults with weak immune systems.
- Adults with heart or lung disease.
- Adults above 65 years of age.
Prevention
Since there are no vaccines for RSV, safety measures can reduce the risk of exposure and transmission.
These measures include:
- Cleansing your hands with water and soap or with alcohol-based hand sanitiser.
- Avoiding touching your eyes, nose, and mouth with unwashed hands.
- Covering your mouth and nose carefully with a tissue while sneezing or coughing and get rid of the tissue afterwards.
- Staying away from the crowd if you’re susceptible to infection or have a weakened immune system.
- Avoid sharing eating utensils and cups with others when you or they are sick.
- Cleaning and disinfecting surfaces often touched( doorknobs, countertops).
- Keeping your child away from anyone with cold symptoms.
- Keeping your baby away from tobacco smoke increases the risk of RSV in babies and causes grave symptoms in them dramatically.
- Washing baby toys frequently and avoiding the sharing of these toys with other children.
Typical Treatments
Mild symptoms may not require any prescription since the symptoms become nonexistent after a week or two.
Supportive care is usually recommended to make the affected child comfortable.
Some of these measures include:
- Employ a cool-mist humidifier to keep the air moist and make breathing less difficult for the infant.
- Use saline drops and nasal aspirators to remove sticky fluid from your baby’s nostrils.
- Use acetaminophen to treat fever. Never give aspirin to children with a viral infection, and never use over-the-counter cold medication to treat them.
- Offer plenty of fluid to avoid dehydration.
For serious RSV- related symptoms, hospital treatment may be necessary.
You may require the following:
- Intravenous fluid
- Oxygen
- Medication: An antiviral drug called palivizumab may be given to high-risk individuals to prevent certain respiratory syncytial virus infection complications. However, this does not cure the infection.
Conclusion
The respiratory syncytial virus is a widespread respiratory virus that infects the lower respiratory tract of most children.
For most affected children, the infection occurs with cold-like symptoms that disappear within a week. The condition can result in more severe symptoms, such as pneumonia, for a small percentage.
MOST COMMON
