Management and Prevention Strategies for Respiratory Syncytial Virus (RSV) Bronchiolitis in Infants and Young Children: A Review of Evidence-Based Practice Interventions

Allison C. Cooper; Nancy Cantey Banasiak; Patricia Jackson Allen

Disclosures

Pediatr Nurs. 2003;29(6) 

In This Article

Epidemiology

Approximately 80% of infants are infected with RSV during the first year of life with a peak incidence between 2-6 months of life. Nearly 100% have been infected by the age of 2 years (Agency for Healthcare Research and Quality [AHRQ], 2003; Gadomski, 2002; Meissner et al., 1999). In the northern hemisphere, RSV occurs in epidemics that tend to last 5 months, beginning in the fall between late October through mid-December, and lasting through early spring. In tropical climates, the pattern is less predictable, occurring more during the rainy periods (CDC, 2002; McIntosh, 2000).

Although most RSV infections are usually mild to moderate in severity and can be treated on an outpatient basis, each year RSV is responsible for approximately 125,000 pediatric hospitalizations, with a mortality rate of about 2% (Panitch, 2001). In infants with chronic lung or heart disease, the RSV mortality rate may be as high as 5% (Shay et al., 1999).

RSV infection is more common in infants who are not breast fed, live in crowded conditions, attend daycare, and live with mother's who smoke cigarettes and are socially disadvantaged (Orenstein, 2000). Reinfection is also common because RSV antibodies do not provide long-lasting immunity. However, the clinical severity of subsequent infections is usually less severe than that of initial infection (Levy & Graber, 1997). Anti-RSV antibodies transmitted via the placenta are partially protective during the first 6 weeks of life in full-term infants. Premature infants often lack sufficient maternal antibodies for protection and are, therefore, more susceptible to RSV infection early in life.

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