The respiratory syncytial virus, a member of the Paramyxoviridae family, is the leading cause of LRI (lower respiratory tract illness).
The age distribution of RSV( Respiratory Syncytial Virus) disease burden is bimodal, with the most significant impact felt in the first three years of life and in older adults. According to estimates, RSV disease causes 100,000 deaths and 3.6 million hospitalizations yearly. The respiratory syncytial virus can be treated with preventive and supportive medical interventions, but vaccination holds the possibility of reducing disease prevalence.
Let’s learn more about prevention, diagnosis, and treatment.
What is Respiratory Syncytial Virus (RSV)?
RSV is a common respiratory virus that usually presents symptoms similar to a common cold. But it can also cause severe lung infections, especially in infants, older people, or anyone with a weak immune system (immunocompromised). The NIFD (National Foundation for Infectious Diseases) has called RSV “a hidden annual epidemic in older people.” It’s usually more of a nuisance than a threat. Most children are infected with the virus by age of three because of its ability to spread quickly.
The symptoms of RSV are mild in older people and healthy children and usually resemble the symptoms of a common cold. While for some, the infection results only in the cold, for others, it can result in serious, sometimes life-threatening complications like pneumonia. Self-care measures are usually all that is needed to relieve any discomfort. However, if not treated on time, RSV can cause severe illness or death.
Symptoms of respiratory syncytial virus infection usually appear within four to six days of illness. Some common symptoms of RSV usually include
- Runny nose
- Intense coughing
- Barking or wheezing.
It is common for children and adults to experience some of these symptoms. However, depending on the age group and severity of the infection, the symptoms may differ.
Symptoms in infants younger than six months
- Anger or irritability.
- Unusual agitation or inactivity
- Decrease or loss of appetite
- The inability to breathe normally or changes in breathing patterns
Symptoms in children aged 1-3
- Trouble eating, drinking, or swallowing
- A rapid pace of breathing than normal
- Bluish or greyish color of the skin due to oxygen deficiency
- Sore throat
Symptoms of RSV in adults
- Wheezing or straining while breathing
- Nasal congestion
- Mild Headache
- Runny nose
The symptoms usually appear in stages, not all at once. If a person has weakened immunity or chronic heart/lung disease, they may be infectious for longer than 4-9 days after symptoms begin. For severe signs, it is recommended to see a doctor.
Causes of RSV
The RSV virus is highly contagious, spreading through droplets produced by coughing, sneezing, or coming in contact with contaminated surfaces and objects. Shaking hands also spread the virus. Hence, airborne particles can transmit viruses through the eyes, nose, and mouth to the body.
According to the CDC, viruses can stay contagious for up to four weeks in infants and adults with weak immune systems.
Medical conditions associated with RSV
RSV is most likely to cause bronchiolitis and pneumonia in children under two years of age. It can spread to the lower respiratory tract, which can cause more severe infections such as bronchiolitis and pneumonia. The risk of developing asthma may be greater in children who have been diagnosed with RSV-induced bronchiolitis.
Children who have been diagnosed with RSV are also prone to ear infections and croup. Neurological alterations such as seizures and ataxia have also been associated with the respiratory syncytial virus. According to a study, RSV may also affect the blood-brain barrier’s (BBB) permeability, which could result in infection of the central nervous system and cognitive decline. As a result, the opening of the BBB could allow for the infiltration of RSV and inflammatory cells into the brain.
It is possible to be hospitalized if you have an RSV infection, especially if you are over 65 years old or have an infant under six months.
Bronchiolitis and RSV:
RSV can cause bronchiolitis, a lower respiratory tract infection common among infants.
Although severe bronchiolitis occurs in only a small number of infants each year, more than 500,000 cases of RSV are reported each winter in the United States. Inflammation of the airways and infection of the lungs are possible symptoms of this condition:
- High fever
- Cough and Cold
- Nasal congestion
- Appetite reduction
- An increase in mucus production
- Difficulty breathing producing wheezing, gurgling, or bubbling sounds
Most cases are not severe, but if a child is experiencing changes in his breathing or feeding, has a high-grade fever, or seems exhausted or irritable, it is best to contact a doctor. The following symptoms are worrisome:
- The skin or lips are blueish.
- Inhalation pauses
- Breathing difficulties (coughing, wheezing, or shallow breathing)
Risk factors for RSV
Children with human immunodeficiency virus (HIV), particularly those born very young, prematurely, with BPD, CHD, or who are immunosuppressed, are more at risk for respiratory syncytial virus disease. Worldwide, more immature infants are at the most significant risk of RSV. Four-month-old infants risk developing RSV infections with central apnea that is not caused by hypoxia.
Infant mortality rises during RSV outbreaks, which can only be explained by a documented link to one or two severity factors: chronic medical problems, younger age, prematurity, low birth weight, or a multifactorial disease.
RSV infection is also linked to significant morbidity and mortality in infants with CHD. Severe RSV disease is a well-known and sometimes fatal complication of individuals with bone marrow disease. In organ transplant patients, approximately 40–80% of RSV-infected patients develop pneumonia, and more than 50% of patients with RSV lower respiratory tract infection die of respiratory syncytial virus infection. RSV infection can be fatal for older adults, particularly those with heart or lung disease. People with neuromuscular conditions like muscular dystrophy are at a high risk of developing a severe RSV infection. Children with viral wheeze or asthma may have symptoms triggered by RSV.
Prevention of RSV
A vaccine is the first thing that comes to mind when hearing the word prevention, but unfortunately, there has been no vaccine for RSV till now.
So what can you do about it? It is possible to reduce your risk of contracting and spreading the virus by following a few habits and methods.
- Keep your hands clean by washing them with soap, handwash, and warm water.
- Use a tissue when coughing and sneezing, and wash your hands afterward. Avoid exposing your baby to people who have a fever or cold.
- Avoid sharing utensils and cups when you are sick.
Tobacco smoke has a higher risk of causing RSV in infants exposed to it, resulting in more severe symptoms and a higher hospitalization rate. Therefore, avoid smoking near the baby. Another way to prevent this virus is to give high-risk infants palivizumab (Synagis) shots until they reach 24 months.
In order to diagnose RSV, health providers primarily use medical histories and physical examinations. Rapid diagnostic tests may, however, be recommended if a child has more severe symptoms. You can detect the virus by collecting a sample obtained by sucking on nasal secretions or wiping them with cotton swabs.
Your sample can be tested for RSV genetic material via RT-PCR (polymerase chain reaction). Children and adults over 18 are more likely to get RT-PCR tested as their nasal cavities contain fewer viruses. The best thing about these tests is that virus concentrations can be found in smaller quantities with them than with antigen tests. The doctor may also offer a panel for respiratory pathogens to screen simultaneously for RSV and other respiratory viruses and bacterial infections. However, if a doctor suspects a more complex condition, he may order a blood test, a urine test, an X-ray, or a CT scan.
Besides this, several at-home test kits are available without a prescription for those who do not feel like visiting the doctor. With one sample, you can get tested for RSV, flu, and COVID-19. An in-kit nasal swab is included to collect samples for lab testing. Therefore, if you wish to self-diagnose, you should consult your healthcare provider and follow his advice.
Treatment for RSV
Even though palivizumab may help prevent serious complications from RSV, it can’t treat existing illnesses. Thus, other therapies and medicines have proven effective in treating this virus.
Have a look at them.
- Tylenol may help reduce fever in kids with mild RSV infection.
- Ribavirin is to be used to treat children with severe RSV disease in some cases, and mechanical ventilation may be required in extreme cases.
- Ribavirin and intranasal immune globulin effectively treat RSV disease in children with immune deficiencies.
- Acetaminophen or ibuprofen can reduce fever at home.
To aid in a child’s recovery, it’s also critical to avoid hot-water humidifiers, use saline drops to clear mucus, get enough rest, and drink plenty of water. Additionally, it is crucial that kids stay away from hot-water humidifiers, use saline drops to clear mucus, and get enough rest and water during recovery. Pediatricians recommend that people at risk for or experiencing a respiratory syncytial virus (RSV) infection stay home from work, school, and group activities until the infection has cleared up. To improve survival rates for RSV disease in children, studies have shown that a vitamin A supplement, given by mouth or injection, reduces the risk of lower respiratory tract disease and helps them recover faster from infections.
When to Consult a Doctor for RSV?
Parents can consult a doctor if their child’s symptoms are worsening, if their child is still running a high fever more than 24 hours after being infected with RSV, or if their child is under two months old. Children with severe symptoms, such as difficulty breathing or eating, should be taken to an emergency room immediately. If a child has mild RSV symptoms and the fever is low, parents should try to reduce their child’s fever using some of these tips, and if it does not work, consult a doctor for a prescription for a fever-reducing medicine.
FAQs About RSV Answered By Your Doctors Online Team
Viruses such as RSV, a seasonal virus, can be contagious and even cause death if left untreated. There is a need for people to be vigilant when it comes to protecting themselves. Although people are most at risk of contracting this virus when they have young children, the elderly should also be aware that the symptoms can manifest in anyone of any age group.
RSV and Coronavirus are two types of respiratory infections that are similar in some ways. It appears that this new Coronavirus is more dangerous for adults, especially those who are older. Young children are more at risk for RSV, but old age and other health problems can also make it dangerous. The COVID-19 virus can be detected by nasal swaps. In contrast, a physician typically diagnoses RSV through a physical examination.
Using hand sanitizer or washing your hands after sneezing or coughing and before eating is one of the most effective ways to prevent RSV. Using a tissue is the best method for covering a sneeze or cough. If you do not have a tissue, coughing into the bend of your elbow or covering your mouth and nose with your sleeve will also prevent droplets from spreading.
The rise in RSV may be linked to coronavirus prevention measures, such as masks and social isolation, which result in less exposure to RSV and other viruses; due to these RSV precautions, children develop less immune protection.
RSV is one of the most severe diseases affecting children under the age of two, causing many deaths. RSV can sometimes be severe enough to cause serious symptoms in people with asthma or chronic obstructive pulmonary disease (COPD). Depending on the severity of the case, a person who has been diagnosed with RSV may need to remain in the hospital for longer.