Respiratory Syncytial Virus
February 05, 2009 by Keith Gautreaux, MD
Respiratory syncytial virus, or RSV, is a respiratory virus that infects the lungs and breathing passages. Most otherwise healthy people recover from RSV infection in 1 to 2 weeks. However, infection can be severe in some people, such as certain infants, young children, and older adults. In fact, RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children under 1 year of age in the United States. In addition, RSV is more often being recognized as an important cause of respiratory illness in older adults.
Respiratory syncytial virus (RSV) was discovered in 1956 and has since been recognized as one of the most common causes of childhood illness. The virus is a member of the family Paramyxoviridae and the subfamily Pneumovirinae. It is an enveloped RNA virus and two strains (subgroups A and B) are recognized, the clinical significance of which is unclear.
Some quick facts about respiratory syncytial virus, or RSV:
- It is a contagious viral disease that infects a person’s lungs and breathing passages.
- RSV mostly strikes younger children and older adults.
- Almost everyone gets RSV by age 2.
- People can get the disease more than once.
- Most people recover from the disease in a week or two, but RSV can be severe, most commonly for children 6 months of age and younger.
- The number of RSV cases typically rise in the fall, winter, and early spring, but the exact timing of RSV season varies by location.
Who is at risk for severe illness?
Premature infants, children less than 2 years of age with congenital heart or chronic lung disease, and children with compromised (weakened) immune systems due to a medical condition or medical treatment are at highest risk for severe disease. Adults with compromised immune systems and those 65 and older are also at increased risk of severe disease.
Almost all children will have had an RSV infection by their second birthday. When infants and children are exposed to RSV for the first time, 25% to 40% of them have signs or symptoms of bronchiolitis or pneumonia, and 0.5% to 2% will require hospitalization. Most children hospitalized for RSV infection are under 6 months of age.
When is the risk for infection the greatest?
RSV infections generally occur in the United States from November to April. However, the timing of the season may differ among locations and from year to year.
How is RSV spread?
RSV can be spread when an infected person coughs or sneezes into the air. Coughing and sneezing send virus-containing droplets into the air, where they can infect a person if they inhale these droplets or these droplets come in contact with their mouth, nose, or eye.
Infection can also result from direct and indirect contact with nasal or oral secretions from infected persons. Direct contact with the virus can occur, for example, by kissing the face of a child with RSV. Indirect contact can occur if the virus gets on an environmental surface, such as a doorknob, that is then touched by other people. Direct and indirect transmissions of virus usually occur when people touch an infectious secretion and then rub their eyes or nose.
How can RSV infection be prevented?
Researchers are working to develop RSV vaccines, but none is available yet. However, there are steps that can be taken to help prevent the spread of RSV. Specifically, people who have cold-like symptoms should
- Cover their coughs and sneezes
- Wash their hands frequently and correctly (with soap and water for 15–20 seconds)
- Avoid sharing their cups and eating utensils with others
- Refrain from kissing others
In addition, cleaning contaminated surfaces (such as doorknobs) may help stop the spread of RSV.
Special attention should be paid to protecting children who are at high risk for developing severe disease if infected with RSV. Such children include premature infants, children under 2 with chronic lung or heart conditions, and children with weakened immune systems. Ideally, people with cold-like symptoms should not interact with children at high risk for severe disease. But, if this is not possible, they should carefully follow the prevention steps mentioned above, and they should wash their hands before interacting with children at high risk. When possible, limiting the time that high-risk children spend in child-care centers or other potentially contagious settings may also help prevent infection and spread of the virus during the RSV season.
More information can be found at the following sites:
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