The chief cause of hospitalization for respiratory tract illness in young children.
It affects everyone by three years of age, and repeatedly infects people every few years throughout life.
The most common cause of lower respiratory tract infection in infants.
RSV is a leading cause of death in infants younger than six months of age, particularly in low and middle income countries.
Most common cause of brochiolitis and pneumonia in children aged <1 year worldwide.
Severe RSV associated lower respiratory tract illness peaks in the first 2 to 3 months of life, despite the presence of naturally acquired maternal antibodies.
Among children younger than five years of age, it is associated with approximately 33 million cases of lower respiratory tract illness, 3.6 million hospital admissions, and more than 100,000 deaths each year.
Infants younger than six months of age, or at the greatest risk for RSV, associated illness and death, and more than 95% of RSV associated deaths occur in low and middle income countries.
RSV typically spreads during winter epidemics in temperate climates, and during rainy seasons in tropical climate regions.
Most infections result in mild or no disease, but as many as 2 to 3% of infants were hospitalized with RSV during their first year of life, which makes RSV a leading cause of hospitalization in children, younger than five years of age.
Estimated 75,000-125,000 hospitalizations of infants annually in the US.
It is an important cause of illness and death in older adults.
Approximately 60,000 to 160,000 RSV associate hospitalizations, and 6000 to 10,000 RSV associated deaths occur each year in older adults in the US.
An important cause of acute respiratory infections during autumn and winter months in temperate regions, and during rainy seasons in tropical areas.
Approximately one or 2 per 1000 US adults 65 years of age or older are hospitalized with RSV associated pneumonia or exacerbation of underlying cardiopulmonary conditions each year, with a case fatality rate of 1 to 2%.
Preterm infants, as well as young children with chronic lung disease of prematurity or congenital heart disease or a particularly high risk.
An estimated 177,000 hospitalizations and 14,000 deaths per year in adults 65 years of age or older.
An estimated 57,000 hospitalizations and 500,000 ED visits among children 5 years or younger each year.
Globally RSV infections in children younger than five years of age causes an estimated 3.2 million hospitalizations and 95,000 to 150,000 deaths, primarily in the developing world.
Severe disease in childhood associated with progression to asthma.
A leading cause of hospitalization in adults with community-acquired respiratory disease.
Causes 50 to 90 percent of hospitalizations for bronchiolitis, 5 to 40 percent of those for pneumonia, and 10 to 30 percent of those for tracheobronchitis.
A negative single stranded RNA virus that generates double stranded RNA during replication.
RSV is a negative-sense, single-stranded RNA virus of the family Paramyxoviridae.
Family Paramyxoviridae includes common respiratory viruses such as those causing measles and mumps.
F family Paramyxoviridaeproteins on the surface of the virus cause the cell membranes on adjacent cells to merge, forming syncytia.
RSV F protein nanoparticle vaccination in pregnant women did not need pre-specified success criteria for efficacy against RSV associated pneumonia in infants up to 90 days of life.
RSV pre-fusion S protein based vaccine (RSVPpreF) contain stabilized pre-fusion F glycoproteins from RSV sub groups A and B in trials is effective against symptomatic RSV infection and viral shedding.
A prophylactic medication exists for preterm birth infants and infants with a congenital heart defect (CHD) or bronchopulmonary dysplasia.
Treatment is limited to supportive care, including oxygen therapy.
Annual epidemic occurs during the winter months.
In tropical climates, infection is most common during the rainy season.
60% of infants are infected during their first RSV season.
The most common cause of hospital admission in the winter season during the first year of life.
RSV bronchiolitis is associated with increased rates of early wheezing, asthma, and possible allergic sensitization later in life.
Early childhood wheezing after such an infection has a high prevalence and can influence the quality of life and can generate substantial health care costs.
Essentially all children will have been infected with the virus by 2–3 years of age.
Of those infected with RSV, 2–3% will develop serious bronchiolitis requiring hospitalization.
Infection with RSV induces protective immunity which wanes with time, so individuals can be infected multiple times, even during a single RSV season.
Severe RSV infections have increasingly been found among elderly.
Capable of causing severe infection complications including bronchiolitis and pneumonia in susceptible patients including the very young, very old and those with chronic conditions such as heart disease or asthma.
25-40% of children under the age of 1, following initial exposure of virus develop symptoms of bronchiolitis or pneumonia.
Re-infection in young adults may be asymptomatic or appear as sinusitis or an URI.
Most infections associated with only mild symptoms, manifesting common colds and minor illnesses.
For some children severe respiratory illness requires hospitalization and, rarely, causes death, which is more likely to occur in premature infants or immunocompromised.
Common symptoms among infants include listlessness, anorexia, and possible fever.
Respiratory symptoms of wheezing and asthma develop more commonly among children who experience severe RSV infection.
PCR testing for RSV nucleic acids in peripheral blood can help establish diagnosis.
Most commonly used types of RSV clinical laboratory tests are;
Real-time reverse transcriptase-polymerase chain reaction (rRT-PCR), which is more sensitive than culture and antigen testing
Antigen testing, which is highly sensitive in children but not sensitive in adults
SH, G and F proteins form the viral coat.
The G protein is a surface protein, heavily glycosylated and functions as the attachment protein.
The F protein mediates fusion, allowing entry of the virus into the cell cytoplasm and is associated with formation of syncytia.
Antibodies directed at the F protein are neutralizing.
RSV spreads easily by direct contact.
Remains viable for a half an hour or more on hands or for up to 5 hours on surfaces.
No vaccine exists.
Palivizumab (Synagis), is a monoclonal antibody directed against RSV surface fusion protein moderately effective prophylactic drug is available for infants at high risk.
Palivizumab is given by monthly injections, just prior to the RSV season and are usually continued for five months in premature infants or in children with cardiopulmonary disease.
Ribavirin has limited efficacy.
Ribavirin is rarely used due to its toxicity profile teratogenic potential, and questionable efficacy.Infection can be confirmed using Direct Fluorescent Antibody detection (DFA), Chromatographic rapid antigen detection or detection of viral RNA using RT PCR and quantification of viral load can be determined by Plaque Assay, antigen capture enzyme immunoassay (EIA), and ELISA.
Assay of antibody levels can be achieved by HAI and Neutralisation assay.
Nebulized 3% hypertonic saline a safe, and effective treatment for infants hospitalized with moderately severe viral bronchiolitis, and s associated with a 26% reduction in length of stay compared with an untreated group.
Supportive care includes fluids, oxygen, and albuterol.
Corticosteroids confer no benefit.
Nirsevimab use resulted in RSV associated lower respiratory tract infection at a rate that was 70% lower than with placebo through 150 days after administration, and the incidence of hospitalization for RSV was 78% lower.
A single injection of nirsevimab administed before the RSV season protects healthy late preterm and term events from RSV associated lower respiratory tract infection (MELODY study group).
The US Food and Drug Administration (FDA) has approved Arexvy, the first respiratory syncytial virus (RSV) vaccine approved for use in the United States: for the prevention of lower respiratory tract disease caused by RSV in individuals 60 years of age and older.
CDC recommending vaccine immunization to protect infants under eight months and some older babies at increased risk of severe illness from respiratory syncytial virus.
A single dose mono clonal antibody, nirsevimab-slip, prevents respiratory syncytial virus disease, in infants and children up to two years: lowers respiratory tract infection by 70 to 75% compared with placebo.