Respiratory Syncytial Virus (RSV): Causes, Symptoms, Transmission, Treatment, and Prevention

Respiratory syncytial virus (RSV) is a common virus that can affect people of all ages, although infection is more common among children and infants.

Studies indicate that almost all children will have had an RSV infection by the age of 2. Even though respiratory syncytial virus is often associated with mild, cold-like symptoms, it can lead to severe complications.

While certain groups, including premature and very young infants (under 6 months), people with chronic heart or lung disease, immunocompromised individuals, and older adults (65+), are at an increased risk for severe illness, the potential for serious complications is a concern for all age groups.

Mode of transmission

Respiratory syncytial virus is transmitted from person to person through direct contact with an infected individual, through contact with secretions from coughing and sneezing, or by touching common objects, such as toys or door handles, that have the virus on them.

Respiratory syncytial virus can survive for several hours on hard surfaces (tables or railings). Typically, the virus lives on soft surfaces (tissues, hands) for shorter periods of time. Children are often exposed to RSV if they attend group settings (daycares, kindergartens, schools, playgrounds). They can then transmit the virus to other family members.

Respiratory syncytial virus symptoms

Like other respiratory viruses, such as the flu or COVID-19, symptoms of an RSV infection typically include runny nose, cough, sneezing, fever, decreased appetite, and wheezing.

Symptoms usually appear in stages. In infants, the only symptoms may be irritability, decreased activity, and breathing difficulties. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lungs) in children younger than 1 year.

It takes 2 to 8 days from the time of exposure for someone to show symptoms. Recovery usually takes between 1 and 2 weeks. However, some infants and people with weakened immune systems may continue to spread the virus even after they no longer show symptoms, for up to 4 weeks.

Diagnosing respiratory syncytial virus

Given the similarity of symptoms and co-circulation with other viral infections, the only way to determine if someone has an RSV infection is through clinical laboratory tests.

Respiratory syncytial virus (RSV) is diagnosed through blood tests or analysis of mucus from the airways or nasal passages.

Treatment

Treatment is symptomatic, with medications administered to relieve fever and pain. High fluid intake (water, soups, broths, natural fruit juices) is recommended.

For fever, paracetamol may be recommended, but the administration of aspirin to children under 12 is prohibited. Antibiotics do not work against RSV.

It is possible that some young children who develop bronchiolitis may need hospitalization to receive oxygen therapy. When a child cannot consume liquids due to rapid breathing, doctors will administer intravenous fluids to avoid potential dehydration. In rare cases, infected infants will need a ventilator to help them breathe. Only about 3% of children with RSV require hospital admission. Most children are discharged after two or three days.

Prevention

The best ways to prevent the spread of RSV include:

• covering the nose and mouth when sneezing or coughing
• constant hand washing with soap and water for at least 20 seconds
• avoiding close contact, such as kissing, shaking hands, and sharing glasses and utensils
• cleaning frequently touched surfaces (such as door handles or tables)

An antiviral medication called palivizumab is available to prevent severe illness in children who are at high risk of contracting the disease. However, the use of palivizumab is limited, as it can only be used in certain children considered at high risk for complications (born prematurely or with congenital heart disease or chronic lung disease). The recommended dose of palivizumab is 15 mg/kg, administered once a month during periods expected to be high-risk for the presence of RSV in the community.

Palivizumab does not help cure or treat children already suffering from RSV and cannot completely prevent RSV infection.

References
https://www.healthline.com/health/respiratory-syncytial-virus-rsv
https://www.lung.org/lung-health-diseases/lung-disease-lookup/rsv/learn-about-rsv
https://www.niaid.nih.gov/diseases-conditions/respiratory-syncytial-virus-rsv
https://www.healthdirect.gov.au/respiratory-syncytial-virus-rsv
https://www.ema.europa.eu/en/documents/product-information/synagis-epar-product-information_ro.pdf