November 19, 2021 | Black & Kletz Allergy
Respiratory syncytial virus (RSV) causes annual outbreaks of respiratory illnesses in all age groups. It is one of the most common illnesses in children. Though it can occur any time of the year, RSV infections are most common from the late Fall to the early Spring with a peak predominance in February.
Virtually all children get an RSV infection by the time they are 2 years old. Most of the time, RSV will cause a mild, cold-like illness, however, it may also cause severe illness such as bronchiolitis (i.e., inflammation of the small airways in the lung) and/or pneumonia (i.e., infection of the lungs).
The initial symptoms of RSV usually include a runny nose, nasal congestion, mild fever, cough, and/or occasional wheezing. Most individuals generally recover fully within a week. It is important to note that the illness may be more severe in children under the age of 2 with chronic lung disease, congenital heart disease, suppressed immune systems, and neuromuscular disorders. Children who have difficulty swallowing or clearing mucus secretions are at greater risk for developing more severe disease as well.
Approximately 1 or 2 out of every 100 children younger than 6 months of age with RSV infection may need to be hospitalized. Those who are hospitalized may require oxygen, intubation, and/or mechanical ventilation to help with breathing. Most affected children improve with this type of supportive care and are usually discharged in a few days. Recently, a number of studies have established a relationship between infants with severe RSV infections and the subsequent development of asthma later in childhood. Respiratory syncytial virus is the leading cause of lower respiratory tract (i.e., lungs) infection in children and is a common cause of wheezing in infants and young children.
In adults, RSV infections present as mild cold-like illness with symptoms of runny nose, sore throat, cough, mild fever, achiness, and/or fatigue. In healthy adults the symptoms usually subside spontaneously within 5 days.
Some adults, however, may have more severe symptoms consistent with a lower respiratory tract infection, such as pneumonia. Those at high risk for severe illness from RSV include older adults (i.e., especially those 65 years and older), adults with chronic lung or heart disease, and adults with weakened immune systems. RSV can sometimes also lead to the exacerbation of serious conditions such as asthma, chronic obstructive pulmonary disease (COPD), and/or congestive heart failure.
Diagnosis:
Clinical symptoms of RSV are nonspecific and can overlap with other viral respiratory infections, as well as some bacterial infections. Several types of laboratory tests are available for confirming an RSV infection. These tests may be performed on upper and lower respiratory specimens.
The most commonly used types of RSV clinical laboratory tests are real-time reverse transcriptase-polymerase chain reactions (rRT-PCR), which are more sensitive than cultures and antigen testing. It should be noted that antigen testing is highly sensitive in children but not sensitive in adults.
Transmission:
RSV spreads just like a common cold virus―from one person to another. It enters the body through the nose or eyes, usually occurring from direct person-to-person contact with saliva, nasal discharge, unclean hands, or contaminated objects/surfaces. It should be noted that RSV can survive 30 minutes or more on unwashed hands and up to 6 hours on surfaces such as toys, keyboards, door knobs, etc.
Symptoms:
The symptoms of respiratory syncytial virus can appear 2 to 8 days after contact with RSV. The typical symptoms may include a runny nose, nasal congestion sore throat, achiness, fatigue, mild fever, cough, and/or occasional wheezing. According to the Centers for Disease Control and Prevention (CDC), individuals infected with RSV are usually contagious for 3 to 8 days.
Treatment:
There is no specific treatment to cure the infection but symptomatic relief can be obtained by nasal saline irrigation with gentle suctioning to allow easier breathing and feeding. A cool-mist humidifier can help break up mucus which may result in easier breathing. Hydration by means of drinking plenty of fluids is also important when fighting an RSV infection. Acetaminophen (i.e., Tylenol) and ibuprofen (i.e., Motrin, Advil) may help relieve body aches and fevers. Antibiotics and corticosteroids are not helpful. Aspirin should be avoided.]
Prevention:
Frequent hand washing, covering coughs and sneezes, avoiding people who are ill, cleaning and disinfecting surfaces, and staying home when sick will go a long way to help prevent spreading the infection.
A vaccine for RSV is not currently available but intense research is going on to develop one. A medication named Synagis (i.e., palivizumab)) may reduce the risk of severe RSV infection in some high-risk infants. It is a monoclonal antibody that is administered by means of an intramuscular injection.
The board certified allergists at Black & Kletz Allergy have been diagnosing and treating upper respiratory infections in both adults and children for more than 50 years. Black & Kletz Allergy has offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. All 3 of our offices have on-site parking. For further convenience, our Washington, DC and McLean, VA offices are Metro accessible. Our McLean office location offers a complementary shuttle that runs between our office and the Spring Hill metro station on the silver line. To schedule an appointment, please call one of our offices or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day. If you suffer from allergies, recurrent upper respiratory infections, asthma, sinus-related symptoms, or have had an RSV infection, we are here to help you manage and alleviate your symptoms. Black & Kletz Allergy is dedicated to providing the highest quality allergy care in a caring, relaxed,, and professional environment.
