Respiratory Syncytial Virus

What is RSV?

It is a virusDiscovered in 1956Infects the lungs and

breathing passages Can cause a wide

spectrum of illnessesSeasonal

http://www.cdc.gov/Features/dsRSV/

Highly contagious airborne virusAnnually 75,000-125,000 infants <1 yr require

hospitalization~1%-2% die (750—1,500 children)

Contagious period during first 3-8 days of their illness

http://www.kuleuven.be/rega/mvr/research.html

Who gets it?Anyone, but experience different levels of severityMost at risk:

premature infants and all infants less than 1 year of agechildren < 2 years old with cardiac disease or chronic

lung disease (for example, asthma, cystic fibrosis, etc.)those of any age with a compromised immune systemthose 65 years of age or older

DiseasesBronchiolitis Pneumonia Colds

Spread through respiratory secretions- coughing, sneezing

SymptomsVary from person to personSymptoms most severe in children under the age of two4-6 after exposure

Runny noseDecreased appetite

1-3 days laterWheezingCoughingFever

Very young infants, irritability, decreased activity, and breathing difficulties may be the only symptoms of infection.

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Diagnostic TestsTesting for RSV, proper

testing of respiratory secretions will: Positively identify RSV Rule out bacterial infection

Nasopharyngeal secretions containing epithelial cells are necessary for positive diagnosis of severe RSV infections

There are two strains, A and B A causes severe cases B is asymptomatic and is

transmitted to most people

http://keiji-hagiwara.blogspot.com/2011/02/rapid-diagnostic-test-for-influenza.html

Treatment Currently no RSV vaccine availableNo treatment given in mild disease

just antipyreticsOxygen therapy, pulmonary inhalation therapy, airway suction,

and mechanical ventilation (severe disease)Ribavirin aerosol (severe disease)

Sometimes used---IGIV (immune globulin intravenous) with RSV-IGIV (e.g. Synagis) and Ribavirin (Virazole). [severe disease]

Recovery 1-2 wks (non hospitalized & hospitalized)

PreventionFrequent hand washingAt-Risk children can be given an injection of RSV antibodies monthly

during peak season.Keep school-age children away from younger siblings (anyone under 2

years of age) if cold symptoms are presentMinimize number of visitors with the infantAvoid any crowded places Don’t take child to daycare during RSV season (if possible)Obtain influenza vaccinations

According to CDC, almost all children will have infection by 2nd birthday; however, only 25%-40% will have symptoms of bronchiolitis or pneumonia. Of those, 0.5%-2% require hospitalization.

http://www.ctahr.hawaii.edu/new/GermCity/

Epidemiology Transmission

Transmitted via large, aerosolized respiratory particles or through contact with nasal secretions. May even be transmitted indirectly by contact with contaminated objects such as bathroom fixtures or clothing. The most common sites of inoculation are the eyes and nose

Prevalence Winter months Most frequently transmitted between family members and

hospitals The incubation period is three to five days for most patients Strain A more prevalent than Strain B

Global Distribution Warmer climates tend to have longer periods of outbreaks without

any peak times USA is generally November til May

References

Centers for Disease Control and Prevention . (2010). Respiratory Syncytial Virus Infection. Accessed March 4, 2012 from http://www.cdc.gov/rsv/index.html

WebMD, LLC. (2012). Respiratory Syncytial Virus Infection. Accessed March 4, 2012 from http://www.webmd.com/lung/tc/respiratory-syncytial-virus-rsv-infection-topic-overview