RSV (Respiratory Syncytial Virus) is a respiratory virus that causes inflammation of the small airway tubes called bronchioles and can progress to severe pneumonia in certain groups of people. It is common in the autumn, winter, and spring months in the USA. We are not sure why it is causing severe disease in children this year but it may be from lack of exposure to RSV last year with Covid prevention practices which would decrease immunity and cause longer and more severe illness this year. Those with severe disease may require oxygen, a ventilator, and can sometime lead to death. People at highest risk for severe disease include:
- Premature infants
- Very young infants, especially those 6 months and younger
- Children younger than 2 years old with chronic lung disease or congenital heart disease
- Children with suppressed immune systems
- Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions
- Adults with compromised immune systems
- Older adults, especially those with underlying heart or lung disease
You can acquire it just like other respiratory viruses.( An infected person coughs or sneezes and the virus droplets get into in your eyes, nose, or mouth, you touch a surface that has the virus on it, like a doorknob and then touch mouth (eat), face or eyes, or you have direct contact with the virus, like kissing the face of a child with RSV.) RSV is usually contagious for 3 to 8 days. Some infants, and people with weakened immune systems, can continue to spread the virus even after they stop showing symptoms, for as long as 4 weeks. Daycare is a common source of RSV. RSV can survive on hard surfaces for hours.
Testing: Done in a physician’s office. PCR test is the most sensitive. Antigen tests only available in physician offices can be used in children but the results are less reliable than PCR and not reliable for adults.
Prevention: The usual: hand sanitizers, hand washing, cover face with elbow when coughing, sanitize multitouch surfaces often at home and at work. People with cold-like symptoms should not interact with children at high risk for severe RSV disease or should wear masks.
Palivizumab (SYNAGIS) is a monoclonal antibody made in a laboratory. It is given as a shot monthly during RSV season, usually in the thigh, to high-risk infants and young children with underlying medical conditions (those noted above). Palivizumab has been used for many years with success. Several companies are in the final stages of testing their RSV vaccine but they are only available through a research protocol at a participating health center.