Respiratory Syncytial Virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms but can cause more serious problems such as bronchiolitis and pneumonia in babies and young children. In the United States, 60% of infants are infected during their first RSV season, and nearly all children will have been infected with the virus by 2–3 years of age.
RSV is single-stranded RNA virus of the family Paramyxoviridae, which includes common respiratory viruses such as measles and mumps. It spreads from direct and indirect contact with nasal or oral secretions from infected people. The virus can survive on hard surfaces such as tables and crib rails for many hours, and on soft surfaces such as tissues and hands for shorter amounts of time.
Symptoms usually appear within 4 to 6 days of infection and healthy individuals usually recover within 1-2 weeks. When infants and children are exposed to RSV for the first time:
25-40% will have signs or symptoms of bronchiolitis or pneumonia
5 to 20 out of 1,000 will require hospitalization (most children hospitalized for RSV infection are younger than 6 months of age)
Researchers are developing an RSV vaccine, but none is available yet. There is no specific treatment for RSV.
Diagnosis
Several different types of laboratory tests are available for the diagnosis of RSV infection including ELISA, rapid lateral flow, direct fluorescent antibody detection (DFA), neutralization assay and RT-PCR. Most clinical laboratories currently utilize EIA antigen detection tests, and many supplement antigen testing with cell culture or immunofluorescence assays to confirm diagnosis. Two viral proteins, the attachment glycoprotein G and the surface glycoprotein F, are the main antigens responsible for inducing a neutralizing immune response and resistance to infection.
Antigen detection tests and culture are generally reliable in young children but less useful in older children and adults. Because of its thermolability, the sensitivity of RSV isolation in cell culture from respiratory secretions can vary among laboratories. IgG and IgM antibody tests are used less frequently for routine diagnosis. Although useful for seroprevalence and epidemiologic studies, a diagnosis using paired acute- and convalescent-phase sera to demonstrate a significant rise in antibody titer to RSV cannot be made in time to guide patient care.
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