Respiratory syncytial virus infection

Respiratory syncytial virus is the most common cause of bronchiolitis; nearly every child has been infected by 2 years of age.

Seasonal outbreaks occur worldwide during winter months.

Characterised by cough, wheeze, respiratory distress, and hypoxia.

Most episodes are mild and self-limiting.

Treatment is mostly supportive: supplemental oxygen, nasal and pulmonary toilet, respiratory support, nutritional support.

RSV disease in adults is often overlooked but is well associated with lower respiratory tract infection especially in the elderly and those with underlying lung comorbidities.

High-risk groups for severe illness include infants with a history of prematurity, chronic lung disease, complex congenital heart disease, and immunocompromise.

Immunoprophylaxis with palivizumab is available for high-risk groups.

Respiratory syncytial virus (RSV) was historically placed in the Paramyxovirus family. It has been recategorised to the order Mononegavirales as a member of the Pneumoviridae family. It is the most common cause of bronchiolitis. Symptoms include rhinorrhoea, cough, wheeze, respiratory distress, and hypoxaemia.[1]Shay DK, Holman RC, Newman RD, et al. Bronchiolitis-associated hospitalizations among US children, 1980-1996. JAMA. 1999 Oct 20;282(15):1440-6. http://jama.jamanetwork.com/article.aspx?articleid=192009 http://www.ncbi.nlm.nih.gov/pubmed/10535434?tool=bestpractice.com RSV can also cause pneumonia in children and, rarely, in immunocompetent adults.[Figure caption and citation for the preceding image starts]: Electron micrograph revealing the morphological traits of the RSVCDC/Palmer EL; used with permission [Citation ends].