Respiratory Syncytial Virus (RSV)

Abstract and Introduction

Respiratory syncytial virus (RSV) is one of the most common diseases of childhood. Virtually all children have been exposed to this virus by age two. RSV causes common cold symptoms in most patients. In vulnerable children, RSV can progress to bronchiolitis and/or pneumonia with an increased chance of significant morbidity or death. The nature of the virus and mode of infection protects it from the human immune system. Treatment for RSV is largely supportive. Key elements of treatment are maintenance of hydration, and oxygenation, as well as keeping the airways clear of mucus. Prevention of RSV in vulnerable infants is important because of the increased morbidity and mortality. A modest effort spent identifying vulnerable infants, educating the parents about RSV and its prevention, and providing immunoprophylaxis to those who qualify for it, increases the chances that these vulnerable children get through the first several years of life without RSV bronchiolitis.

Respiratory syncytial virus (RSV) is one of the most common human pathogens on this planet. By the age of two years, nearly every human child has been exposed to the virus, resulting most often in mild upper respiratory tract illness. But RSV may also be one of the most serious human pathogens on this planet. Worldwide, RSV directly or indirectly contributes to the deaths of between 600,000 and 1,000,000 infants and children under the age of five each year. In the United States, several hundred infants may die directly from the infection, while the deaths of an additional several thousand may be attributed to RSV-related complications. RSV infections account for over 100,000 hospitalizations each year.^[1,2,3,4] For the neonatal caregiver, an understanding of the virus and how to treat and/or prevent infection is an important part of management of the premature infant.

Cite this: Respiratory Syncytial Virus (RSV): Overview, Treatment, and Prevention Strategies - Medscape - Mar 01, 2004.

Table 1. Recommendations from the American Academy of Pediatrics, Committee on Infectious Disease (Red Book, 2003)
RSV prophylaxis should be initiated at the onset of the RSV season and terminated at the end of the RSV season. Synagis (palivizumab) or RespiGam (RSV-IGIV) prophylaxis should be considered for the following: - Infants and with chronic lung disease (CLD) who have required medical treatment within 6 months or less prior to the RSV season Less than 2 years of age at the start of RSV season - Infants without Chronic Lung Disease o ≤28 weeks gestation Less than 1 year of age at start of RSV season o 29-32 weeks gestation Less than 6 months of age at start of RSV season o 32-35 weeks gestation. With additional risk factors that include: child care attendance, school-age siblings, exposure to environmental air pollutants, congenital abnormalities of the airway, or severe neuromuscular disease Less than 6 months of age at start of RSV season - Infants and children with hemodynamically significant cyanotic and acyanotic congenital heart disease Less than 2 years of age at the start of RSV season Synagis (palivizumab) is preferred for most high-risk children because of its ease of administration, safety, and efficacy. It also does not interfere with live vaccines.

Table 1. Recommendations from the American Academy of Pediatrics, Committee on Infectious Disease (Red Book, 2003)
RSV prophylaxis should be initiated at the onset of the RSV season and terminated at the end of the RSV season. Synagis (palivizumab) or RespiGam (RSV-IGIV) prophylaxis should be considered for the following: - Infants and with chronic lung disease (CLD) who have required medical treatment within 6 months or less prior to the RSV season Less than 2 years of age at the start of RSV season - Infants without Chronic Lung Disease o ≤28 weeks gestation Less than 1 year of age at start of RSV season o 29-32 weeks gestation Less than 6 months of age at start of RSV season o 32-35 weeks gestation. With additional risk factors that include: child care attendance, school-age siblings, exposure to environmental air pollutants, congenital abnormalities of the airway, or severe neuromuscular disease Less than 6 months of age at start of RSV season - Infants and children with hemodynamically significant cyanotic and acyanotic congenital heart disease Less than 2 years of age at the start of RSV season Synagis (palivizumab) is preferred for most high-risk children because of its ease of administration, safety, and efficacy. It also does not interfere with live vaccines.