- Knowledgebase: Information on Specific Illnesses
- Here you will find discussions of specific illnesses and their management.
- 43. RSV Infection - Top
- RSV is a member of the genus Pneumovirus. RSV causes upper and lower respiratory illness in infants and young children.
Causes, Incidence and Risk Factors
Respiratory syncytial virus (RSV) is associated with outbreaks of acute respiratory illness each year in the winter and spring. In infants and young children, it can cause pneumonia, bronchiolitis (inflammation of the small airways of the lungs), and tracheobronchitis (croup). In healthy adults and older children, it is usually a mild respiratory illness. People with underlying pulmonary (lung) disease and the elderly are also susceptible to the infection. Although studies have shown that people produce antibody against the virus, infections continue to occur in people of all ages.
Symptoms
nasal congestion
nasal flaring
cough
rapid breathing (tachypnea)
breathing difficulty or labored breathing
shortness of breath
cyanosis (bluish discoloration of skin caused by lack of oxygen)
wheezing
fever
croupy cough (often described as a "seal bark" cough)
Note: Symptoms are variable and differ with age. Infants less than one year old are most severely affected and often have the most trouble breathing.
Signs And Tests
Listening to the chest with a stethoscope (auscultation) may reveal wheezes or other abnormal lung sounds.
Tests used in the diagnosis of RSV include:
a chest X-ray (may show pneumonia or bronchiolitis)
a serology for RSV (positive for RSV)
arterial blood gas analysis (demonstrates decreased oxygen saturation)
Treatment
Mild infections resolve without treatment. A severe infection in infants and children may require hospitalization to provide supplemental oxygen, humidified air, and hydration by intravenous fluids. Respiratory support may be needed, using a breathing machine (ventilator). Aerosol ribavirin, an antiviral medication, may be administered to infants. Ribavirin is most effective if given within the first 48 hours following onset of symptoms. Ribavirin is not used in older children. A medication to open the airways of the lungs (bronchodilator) is helpful for some people. It is important to remember that in children less than nine months RSV bronchiolitis can be life threatening. These young infant are usually hospitalized and the small and extremely young infant may spend time in the Intensive Care Unit with an endotracheal tube and a ventilator.
Expectations (Prognosis)
RSV infection may cause death in infants but this is unlikely if the child is seen early in the course of the illness. In older children and adults, the disease may be mild. There is evidence suggesting an increased incidence of asthma in children who have developed RSV bronchiolitis. It is unknown whether the factors that predispose the child to asthma also predisposed him to developing bronchiolitis as an infant or if the RSV bronchiolitis itself predisposes the child to develop asthma later.
- Updated: March 5, 2001
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