Everything You Need to Know About Respiratory Syncytial Virus (RSV)

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Respiratory Syncytial Virus Structure

The word “virus” is familiar to the world, especially after the COVID-19 pandemic! Although the pandemic is over, the game of viruses isn’t. 

As the season shifts from hot to cold, seasonal diseases surface, and flu and respiratory diseases are the most common. While the world cares for corona and influenza viruses, the Respiratory Syncytial Virus (RSV) is often ignored. 

Most RSV infections are mild, but some may get severe and lead to hospitalization. With a surging prevalence rate of 16.2% among the general population, RSV is more common, especially among children under 5 years and the elderly. These reasons are enough to emphasize knowing more about it. 

This article contains everything you need to know about Respiratory syncytial virus and how to keep yourself safe. 

What Is Respiratory Syncytial Virus (RSV)?

Respiratory syncytial virus (RSV) belongs to a family of viruses that cause respiratory infections. It impacts the airway in the respiratory system and lungs. They are highly contagious, that is, readily spread from an infected person to the community. RSV can cause outbreaks in communities and mostly affects young children including premature babies and neonates, the elderly, and immunocompromised individuals. The rate of infections rises during fall and winter. 

What Are The Symptoms Of RSV?

RSV causes mild symptoms which usually appear 2-8 days after exposure to the virus. The symptoms include:  

In severe cases, RSV infections can also cause bronchitis and pneumonia.

Who Is At Risk Of Severe RSV Infections?

The general population is at risk of acquiring RSV infections. However several groups are at higher risk of developing the infection. The groups include: 

 

Premies, Infants And Young Children Under 5: 

Premature babies, infants, and young children under 5 are at highest risk of developing infection with RSV. Those under 1.5 years and with a history of bronchopulmonary dysplasia are at increased risk. 

 

Children With Pre-existing Health Conditions:

Children with pre-existing health conditions such as any congenital health problems, cardiovascular issues, and genetic diseases. 

 

Older Adults: 

Older adults at age 65 or above, especially with chronic heart or lung diseases, history of pneumonia, or diabetes. 

 

Individuals With Weakened Immune Systems: 

Individuals, children, or adults with weakened immune systems due to any deficiency, medical conditions, or disease treatment. 

 

Adults With Chronic Conditions: 

Adults with chronic health conditions especially with asthma, COPD, or any other chronic respiratory diseases are at high risk of developing severe RSV infections. 

How To Identify RSV Infection?

The following steps help identify the RSV infection: 

 

Assess The Signs And Symptoms: 

Respiratory Syncytial Virus (RSV) infections are often confused with other respiratory infections as they initially resemble mild cold symptoms. These symptoms include congestion, runny nose, sore throat, cough, and fever.

As the infection gains severity, particularly in infants and adults, whistling or wheezing sounds in breathing, short and rapid breathing, and persistent cough with grey, green, or yellow mucus become prominent, hinting that the infection is an RSV infection. Unusual irritability, or lethargy is also prominent in severe RSV infection. 

 

Clinical Evaluation: 

Medical officers check the signs and symptoms and take a medical history to evaluate if the infection is an RSV infection. 

 

Diagnostic Tests: 

Various diagnostic tests including a swab test, X-ray, and pulse oximetry confirm the RSV infection. 

  • Swab Test: The diagnostic test involves collecting secretions from the nose or throat and testing them for the presence of the virus. 
  • X-ray:  X-ray imaging allows physicians to see if there is inflammation in the lungs or not. 
  • Pulse Oximetry: It checks the oxygen saturation level in blood. Pulse oximetry is a bedside procedure and lets the physician know if the patient is in oxygen distress. 

How Does RSV Spread?

With the surging prevalence rate of RSV infection, it is important to know how the Respiratory syncytial virus spreads. 

RSV is a small virus with a size of 150-300 nm. It is highly spreadable and chooses various ways to spread, which include: 

 

Respiratory Droplets:

The Respiratory syncytial virus gets into the air and travels through the respiratory droplets formed when an infected person sneezes or coughs. People get infected by inhaling these respiratory droplets. 

These respiratory droplets can travel distances of up to 3 feet and stay contagious for hours depending on the surface they land on. 

 

Direct Contact: 

RSV spreads when an infected person comes in direct contact with a healthy individual. Direct contact includes shaking hands and hugging and kissing the infected individuals. 

 

Contaminated Surfaces:

Surfaces become contaminated with viruses from infected persons and spread to others when they touch the surface. The RSV virus can survive for hours on soft or hard surfaces, such as door knobs, countertops, or toys. Touching the face after touching contaminated surfaces can lead to the transmission of infection. 

 

Close Contact

Staying in close contact or proximity with an infected person increases the risk of virus spread. 

How To Protect Myself And Others From RSV Infection?

The following guidelines help protect yourself and others around you from acquiring RSV infection. 

Avoid Close Contact: 

On visiting the sick person, keep a safe distance and avoid sitting closely or shaking hands with the infected person. Do not share utensils as they can also transfer the virus. 

Hand Hygiene: 

Taking care of hand hygiene greatly protects against RSV or any other kind of infection. Always wash your hands after coming from outside with soap and water or rub them with a 60% alcohol hand sanitiser when water isn’t available. 

Avoid Touching Your Face:

Abstain from touching eyes, nose, and mouth with unwashed hands to protect yourself from getting infected. 

Cover Coughs And Sneezes:

Always cover coughs and sneezes with hand or tissue paper to prevent the spread of the virus and save others. 

Stay Home When Sick:

An infected person spreads the RSV virus to a noninfected person via respiratory droplets, direct contact, or any other way. Experts recommend staying home till the active period of the virus ends and there are no chances for the spread of the virus to the community. 

Clean And Disinfect: 

Cleaning the surfaces and disinfecting frequently touched surfaces helps minimize viral transmission and protect others from getting infected. 

Keep The Indoor Air Clean: 

Using an air purifier with HEPA filters, filters out the virus particles from the indoor air, reducing the risk of acquiring viral infections. 

Are The Vaccines Available For RSV?

RSV vaccines are only available for high-risk groups. These vaccines help in reducing the severity of diseases caused by RSV. 

 

For Your Baby 

If your baby is in a high-risk group for acquiring RSV infection, he is eligible for getting the RSV infection. This vaccine will protect the baby from getting severe. 

RSV vaccine is called Beyfortus (nirsevimab) which is administered for babies under 1 year. 

 

Pregnant Women 

Pregnant women receive an RSV vaccine named Abrysvo between 32 to 36 weeks of pregnancy to provide immunity to the fetus against RSV infection. 

 

For The Elderly Aged About 60 

GSK Arexvy and Pfizer Abrysvo are two licensed vaccines for the elderly at risk of acquiring RSV infection. These vaccines reduce the incidence of RSV infections among the elderly population and protect them from their severity.

What Is The Treatment Of RSV Infections?

RSV infections are mild and often resolve without developing any complications. The treatment of RSV includes:

 

Supportive Care: 

Supportive care is a must for all RSV infections. It helps the patient to maintain health and protect from the severity of the disease. 

  • Hydration: 

Staying hydrated helps maintain electrolytes, support mucus clearance, protect from dehydration and aid in fever management. Thus supporting the general well-being of the infected person. 

  • Nasal Salina Drops And Suctioning:

Nasal saline drops and suctioning help in opening up the nasal pathways for breathing. They prevent stuffy nose and breathlessness, especially in infants. 

  • Pain And Fever Management: 

Use acetaminophen and ibuprofen must be taken regularly to reduce fever and pain. 

 

Medication:

If supportive care isn’t enough, or if the patient is in the high-risk group, the following medicines are administered:

  • Palivizumab

A passive immunity dose for premature babies, or infants with lung/ heart disease to prevent RSV complications.

  • Ribavirin:

An antiviral drug used in high-risk cases to prevent from severity of disease. 

  

In Severe Cases, Hospitalisation: 

If the patient’s condition isn’t stable, it’s better to rush ER and prefer hospitalization for proper care. Hospitals provide supplemental oxygen and maintain intravenous fluid and mechanical ventilation to support life.

How To Manage RSV?

When learning about the Respiratory syncytial virus, it is important to know its management concerning the age group to ensure the well-being of patients and prevent disease complications. 

The general management guidelines include resting, hydration, and administering ibuprofen or acetaminophen for pain and fever management. 

 

RSV In Infants And Young Children 

  • Vaccination before fall/ winter 
  • Hydration
  • Supportive care. 

Older Children:

  • Symptomatic relief. 
  • Monitoring to prevent severity. 

Adults:

  • Vaccination for age 60 or above. 
  • Preventive measures. 
  • Supportive care. 

Elderly Or Immunocompromised: 

  • Preventive measures and early treatment. 
  • Medical attention. 

Respiratory syncytial virus (RSV) is an infectious virus affecting the respiratory tract and lungs. It is a highly contagious virus, rapidly spreading among the population via respiratory droplets, direct contact close contact and touching contaminated surfaces. Usually, it causes a mild flu-like infection which is manageable with supportive care. But if the case worsens, a person may need hospitalization. High-risk groups including premature babies, infants with heart and lung diseases, the elderly and immunocompromised are at greater risk of developing RSV complications. The spread of RSV virus can be easily prevented with some simple precautions. Vaccines are available for infants, pregnant women and the elderly to prevent the severity of RSV infection. 

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