Respiratory syncytial virus

WHAT IS IT?
- Respiratory syncytial virus (RSV) is a major factor in bronchiolitis and pneumonia in young children, and sporadic acute bronchitis and mild upper respiratory tract infections in adults.

- It produces a variety of symptoms in different areas of the respiratory tract, from the nose to the lungs.

- In more severe cases respiratory syncytial virus can result in respiratory failure.

CAUSES
- RSV is a negative-sense, enveloped RNA virus. The virus causes the formation of giant cells or syncytia.

- It survives only a few hours in the environment and can be easily destroyed with disinfectant.

- RSV is spread via respiratory secretions.

- It results from close contact with infected people or with contaminated objects.

- The virus enters the body through the mucous membranes of the eyes, mouth or nose, sometimes through inhalation of droplets caused by an infected person sneezing or coughing.

SYMPTOMS
- Wheezing.

- Fever.

- Cough.

- Rapid breathing.

- Difficulty breathing.

- Blue lips or fingernails caused by reduced blood oxygen.

- In infants with severe infection there can be abnormal retractions of the muscles between the ribs, due to the effort of drawing breath.

- Infants born prematurely or those with compromised lung, heart or immune systems are at greatest risk of developing serious complications from RSV infection.

DIAGNOSIS
- The virus can be identified from fluid obtained from the nose.

- Auscultation can reveal abnormal lung sounds.

- Chest X-ray can show pneumonia or bronchiolitis.

- Arterial blood gas analysis can identify decreased oxygen saturation.

TREATMENT
- Mild infections normally resolve without treatment.

- More severe infections may require hospital treatment with oxygen therapy, humidified air, and hydration using intravenous fluids.

- A ventilator may be used to provide respiratory support.

- Bronchodilators can be administered to open the airways of the lungs. In very serious cases antiviral drugs such as ribavirin may be tried.

- Antibiotics are of no use in the treatment of RSV.

PREVENTION
- Advise parents to avoid contact with anyone who has a cold or fever.

- Advise parents that kissing an infected baby can spread infection.

- Environmental tobacco smoke inhalation is linked to RSV exacerbation, therefore smoking cessation advice should be given to parents.

- If a child is considered to be at high risk, for example one born before 32 weeks' gestation, parents should seek medical advice.

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