Respiratory syncytial virus (RSV) is a highly contagious infection that usually causes the same symptoms as a bad cold, but which can develop severe respiratory illness such as bronchiolitis and pneumonia. It predominantly causes severe infection in children in the first year of life, particularly neonates born prematurely and/or with congenital conditions such as chronic lung or heart disease and Down syndrome.
Symptoms
In adults, RSV may only produce symptoms of a common cold, such as a stuffy or runny nose, sore throat, mild headache, cough, fever, and a general feeling of being ill. In babies with RSV it stands out that they 'Bob' the head forward while breathing in, lack of energy, act fussy or cranky, be less hungry than usual.
These symptoms appear within 4 to 5 days after infection. These may be the expression of a mild infection that can be managed at home or with the pediatrician's consultation
Sometimes RSV causes a more severe infection, leading to bronchiolitis and/or pneumonia. Symptoms of these complications may include: Breathing more rapidly than normal, skin under the chest, between the ribs or over the rib cage pulling in with every breath, coughing that is getting worse. A child may choke or vomit from intense coughing, a highly pitched whistling noise while breathing, a gray, mottled, or blue color to the skin (skin color changes in the fingernail beds or lips).
In premature babies and kids with diseases that affect the lungs, heart, or immune system, RSV infections can lead to other more serious illnesses.
If the child shows any of these signs and has breathing difficulties, a professional should be seen immediately.
These symptoms appear within 4 to 5 days after infection. These may be the expression of a mild infection that can be managed at home or with the pediatrician's consultation
Sometimes RSV causes a more severe infection, leading to bronchiolitis and/or pneumonia. Symptoms of these complications may include: Breathing more rapidly than normal, skin under the chest, between the ribs or over the rib cage pulling in with every breath, coughing that is getting worse. A child may choke or vomit from intense coughing, a highly pitched whistling noise while breathing, a gray, mottled, or blue color to the skin (skin color changes in the fingernail beds or lips).
In premature babies and kids with diseases that affect the lungs, heart, or immune system, RSV infections can lead to other more serious illnesses.
If the child shows any of these signs and has breathing difficulties, a professional should be seen immediately.
Highly contagious
RSV is highly contagious and can be spread through droplets containing the virus when someone coughs or sneezes. It also can live on surfaces (such as countertops or doorknobs) and on hands and clothing, so it can be easily spread when a person touches something contaminated.
RSV can spread rapidly through schools and childcare centers. Babies often get it when older siblings carry the virus home from school and pass it on to them. Almost all kids have been infected with RSV at least once by the time they're 2 years old.
RSV can spread rapidly through schools and childcare centers. Babies often get it when older siblings carry the virus home from school and pass it on to them. Almost all kids have been infected with RSV at least once by the time they're 2 years old.
Risk Factores
RSV infections occur mostly in yearly epidemic outbreaks, during the winter months in temperate countries or during the rainy season in tropical countries.
Epidemics
RSV infections often occur in epidemics that last from late fall through early spring. Respiratory illness caused by RSV — such as bronchiolitis or pneumonia — usually lasts about a week, but some cases may last several weeks.
Diagnosis
Doctors typically diagnose RSV by taking a medical history and doing a physical exam. Generally, in healthy kids it's not necessary to distinguish RSV from a common cold. But if a child has other health conditions, a doctor might want to make a specific diagnosis; in that case, RSV is identified in nasal secretions.
Treatment
There is no specific treatment for children with RSV infection. Antibiotics do not treat RSV. Mild to moderate infections resolve without treatment and can be managed at home. However, close monitoring is important, especially in at-risk children (see Risk factors). Nasal suction may be useful in removing the mucus, especially before feeding the baby and nebulized hypertonic saline can be useful.
A monthly injection with palivizumab, a monoclonal against the RSV F glycoprotein, during the RSV season prevents RSV-related hopital admission in children with congenital heart disease and preterm children with gestational age <= 35 weeks.
Infants and children with a severe RSV infection may be admitted to a hospital. Treatment may include:
Many other therapies have been assayed or used in the management of RSV patients with limited or absent benefits, including broncho dilators, corticosteroids.
A monthly injection with palivizumab, a monoclonal against the RSV F glycoprotein, during the RSV season prevents RSV-related hopital admission in children with congenital heart disease and preterm children with gestational age <= 35 weeks.
Infants and children with a severe RSV infection may be admitted to a hospital. Treatment may include:
- Oxygen supplementation
- Fluids through a nasogastric tube or a vein (by IV)
- Respiratory support with noninvasive/invasive positive pressure
Many other therapies have been assayed or used in the management of RSV patients with limited or absent benefits, including broncho dilators, corticosteroids.
Prognosis
Globally, RSV infection is the second most important cause of death during infancy. Annual RSV related deaths have been estimated at 253.000, accounting for up to 6.7% of the mortality of children aged <1 year. Of these deaths, 99% occur in developing countries. In addition to severe acute disease, RSV infection has been linked to an increased risk in the development of asthma in later life.
In high income countries death due to RSV infection is a rare event. Children may experience cough and feeding difficulties up to 2 months after infection. About half of all children hospitalized for RSV infection will go on to have recurrent episodes of wheeze. It is not known whether RSV causes asthma.
In high income countries death due to RSV infection is a rare event. Children may experience cough and feeding difficulties up to 2 months after infection. About half of all children hospitalized for RSV infection will go on to have recurrent episodes of wheeze. It is not known whether RSV causes asthma.