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Viral Infections in Childhood: Respiratory Syncytial Virus Infection

Description

Respiratory Syncytial Virus , or RSV, is one of the viruses responsible for mild symptoms of the common cold in older children and adults. In infants and young children, RSV infection may cause only mild cold symptoms; however, it frequently produces serious lower respiratory tract infections, particularly pneumonia (lung infection) and bronchiolitis (infection of the smaller airways).

RSV can spread in the fluid droplets of coughs and sneezes and in the nasal secretions of someone with an RSV infection. RSV can also be carried on unwashed hands and on contaminated objects (dirty tissues, doorknobs and desktops). It typically enters the body through the eyes or nose when someone with contaminated fingers touches their face or rubs their eyes.

The highest rates of serious RSV illness occur in infants between 2 and 8 months old. RSV outbreaks usually occur between late fall and early spring. Almost all children are exposed to RSV by age 3, and most do not become dangerously ill. Reinfection is common, but subsequent infections are generally mild.

Symptoms and Signs

RSV usually causes typical cold symptoms, including sore throat, runny nose, blocked nasal passages, cough, mild wheezing, slight headache and mild fever. Symptoms generally begin 4 to 6 days after exposure to someone with an RSV infection.

In infants and children younger than age 3, RSV infection may cause symptoms of more severe lower respiratory tract illness . These symptoms include high fever, severe cough, abnormally rapid breathing, wheezing and difficulty breathing. In infants with breathing difficulties, there may be retractions, an abnormal drawing-in of the chest muscles so that the ribs can be seen as the baby struggles to take a breath.

Diagnosis and Treatment

A doctor usually bases the diagnosis on the symptoms. Laboratory tests can identify the virus or antibodies to the virus in blood samples but are rarely needed.
For mild RSV infections, treatment consists of treating the patient's cold symptoms. Treatment may include:

  • Acetaminophen or ibuprofen for fever and headache
  • Increased fluid intake to prevent dehydration
  • Bed rest
  • A humidifier to soothe the throat and nasal passages and relieve cough
  • Saline nose drops
  • A bulb syringe to gently loosen mucus blocking a child's or infant's nose

Mild RSV infections generally resolve completely with no lasting effects. Infants and younger children with severe RSV infection may need to be hospitalised. In the hospital, they may receive humidified oxygen and medications to help them breathe easier. They may also receive ribavirin, an antiviral medication that shortens the course of the illness. Use of ribavirin remains a controversial issue among paediatricians.

To help prevent infection in premature infants with underlying respiratory disease, passive immunisation with antibodies (palivizumab given intramuscularly or RSV immune globulin given intravenously) may be given monthly during the late Autumn and Winter.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. Intelihealth.com, Children's Health Section: http://www.intelihealth.com/


Other HON resources 
   From MedHunt
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Respiratory Syncytial Virus Infection
RSVI
RSV immune globulin
 

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  http://www.hon.ch/Dossier/MotherChild/child_virus/virus_rsvi.html Last modified: Jun 25 2002