This document discusses respiratory syncytial virus (RSV), a common virus that infects the respiratory tract. RSV spreads through respiratory droplets from coughs or sneezes or touching contaminated surfaces. Each year in the US, millions of children under 4 get RSV infections and over 100,000 are hospitalized. Symptoms include coughing, fever, and wheezing. Those at high risk for severe infection include premature infants, young children, and older adults. While most cases are mild, some may lead to pneumonia or bronchiolitis. Proper handwashing and disinfecting surfaces can help prevent the spread of RSV.

1. Respiratory Syncytial Virus
Infection
Fatma Ibrahim Abdel-Latif Megahed
Lecturer of family and community health nursing-Suez Canal University

4. Respiratory syncytial (sin-SISH-uhl) virus (RSV) is
a common respiratory virus that infects the nose,
throat, lungs, and breathing passages. RSV spreads
through contact with respiratory droplets
(coughing, sneezing, or kissing) from an infected
person or touching surfaces contaminated with the
virus and then touching your eyes, nose, or mouth.

5. Each year, 4-5 million children younger than 4
years acquire an RSV infection, and more than
125,000 are hospitalized annually in the United
States because of this infection. The impact of RSV
infection is not limited to only young children. In
United States, it is responsible for 177,000
hospitalizations and 14,000 deaths in the elderly ≥
65 years of age.

6. It is a highly contagious, seasonal lung infection
and is a common childhood illness that can affect
adults too. Most children get the virus by 2 years of
age. Most cases are mild, with cold-like symptoms.
A severe infection leads to pneumonia and
bronchiolitis.

7. Infants and adults who are at a higher risk of
developing severe RSV include:
 Premature infants.
 Infants under 6 months of age.
 Infants born with heart or lung conditions.
 Children and adults with weakened immune systems (like
after organ transplant or chemotherapy).
 Children who have difficulty swallowing or can’t clear
mucus.
 Adults above age 65.
 Adults with congestive heart failure, chronic obstructive
pulmonary disease (COPD) or asthma.

8. Signs & Symptoms of RSV infection:
Respiratory syncytial virus (RSV) causes acute respiratory
tract illness in persons of all ages. The clinical
manifestations vary with age, health status, and whether
the infection is primary or secondary.
Like the majority of other respiratory viruses [e.g.
influenza (flu) or COVID-19], symptoms include runny
nose, coughing, sneezing, fever, decreased appetite, and
wheezing. The symptoms usually appear in stages.
However, In very young infants, the only symptoms may be
irritability, decreased activity, and breathing difficulties.

10. Signs & Symptoms of RSV infection cont.,:
Those infected with RSV usually show symptoms
within 4 to 6 days after getting infected. Healthy adults
infected with RSV may have few symptoms but can still
spread virus to others. Individuals infected with RSV
are usually contagious for 3 to 8 days and recovery
usually takes 1 to 2 weeks. However, some infants, and
those with weakened immune systems, can continue to
spread the virus even after they stop showing
symptoms, for as long as 4 weeks.

11. Signs & Symptoms of RSV infection cont.,:
RSV typically circulates with other seasonal respiratory
viruses, like flu. However, the COVID-19 pandemic has
impacted normal transmission patterns of RSV,
leading recently to more unusual, “out of season”
exposures and infections. Given its similarities in
symptoms and co-circulation with other viral
infections, the only way to determine if someone has
an RSV infection is through clinical laboratory testing.

12. Some children with RSV may be at increased risk of
developing a bacterial secondary infection, such as an ear
infection. Call your doctor if your child has:
o Symptoms that worsen or do not start to improve after 7
days.
o A fever (with a rectal temperature of 100.4°F or higher)
and they are younger than 3 months of age (12 weeks).
o A fever that rises above 104°F repeatedly for a child of
any age.
o Poor sleep or fussiness, chest pain, ear tugging or ear
drainage.

13. RSV has become a notifiable disease from 1
September 2022. A nasal swab test may be used
(in serological tests) to determine if the child
has RSV or another virus. A chest x-ray and/or
oxygen saturation test may also be done to
check for lung congestion.

14. RSV spreads just like a common-cold virus, from one
person to another. It enters the body through the nose
or eyes or, usually from:
• Direct person-to-person contact with saliva, mucus,
or nasal discharge.
• Unclean hands (RSV can survive 30 minutes or
more on unwashed hands).
• Unclean objects or surfaces (RSV can survive up to
6 hours on surfaces, toys, keyboards, door knobs, …
etc).

15. Most people's immune system will fight off the infection.
Most symptoms are mild and can be managed with:
 Bed rest.
 Regular paracetamol and ibuprofen to relieve pain and
fevers, if the child is uncomfortable.
 Keeping hydrated with regular sips of water or frequent
feeds for babies.
Sometimes both children and older adults may need to be
hospitalized and treated with intravenous fluids and extra
oxygen. Antibiotics will not help the infection unless there
is a secondary bacterial infection.

16. Prevention Tips:
 Wash your hands more often with soap and water for at least 20
seconds, and help young children do the same.
 Cover your coughs and sneezes with a tissue or your upper shirt
sleeve, not your bare hands. Throw the tissue in the trash after
use, and then wash your hands.
 Avoid touching your eyes, nose, and mouth with unwashed hands.
 Avoid close contact, such as kissing, or sharing cups or eating
utensils, with sick people.
 The virus can survive on surfaces or objects for about 4 to 7 hours.
It is therefore important to clean and disinfect frequently touched
surfaces, such as toys and doorknobs.

17. There is a monoclonal antibody treatment that may reduce
the risk of severe RSV infection in some high-risk infants.
Also, an antiviral drug called palivizumab (pah-lih-VIH-
zu-mahb) is available to prevent severe RSV illness in
high-risk infants (born prematurely or with congenital
heart disease or chronic lung disease). However, the use of
palivizumab is limited as it can only be used in certain
children considered at high risk for complications, does
not help cure or treat children already suffering from
serious RSV disease, and cannot prevent RSV infection.

18. Sources:
• https://www.nfid.org/infectious-diseases/rsv/
• https://my.clevelandclinic.org/health/diseases/8282-
respiratory-syncytial-virus-in-children-and-adults
• https://www.cdc.gov/dotw/rsv/index.html
• https://www.healthychildren.org/English/health-
issues/conditions/chest-lungs/Pages/RSV-When-Its-
More-Than-Just-a-Cold.aspx
• https://emedicine.medscape.com/article/971488-
overview
• https://www.health.nsw.gov.au/Infectious/factsheets/P
ages/respiratory-syncytial-virus.aspx
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