Respiratory Syncytial Virus

McCarthy CA, Hall CB: Respiratory syncytial virus: concerns and control. Pediatr Rev 2003; 24(9): 301-308.

Over 125,000 infants are hospitalized yearly with respiratory syncytial virus (RSV) and there is no successful immunization or control of RSV. Development of an effective vaccine against RSV remains a challenge. There are two licensed products developed for prophylaxis (intravenous immune globulin or RSV-IGIV and palivizumab). The American Academy of Pediatrics recommends these agents in children under 2 years of age who have chronic illness, but they are expensive and difficult to administer.

This review article looks at virology, epidemiology, pathogenesis, immunity, clinical features, therapy, and complications. RSV has been identified worldwide. By age 2, most children have had one or more RSV infections. Young infants, babies with chronic conditions and the elderly are most severely affected. RSV is difficult to diagnose because of the wide spectrum of symptoms (cough, nasal congestion, fever, otitis descending into lower respiratory disease with tachypnea, dyspnea, intercostals retractions, feeding difficulties, and hypoxia) and there are no methods of definitive diagnosis. Treatment is largely supportive oxygen, intravenous fluids and antiviral agents (Ribavirin).