Respiratory Syncytial Virus (RSV) Infection

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: Mary D. Nettleman, MD, MS, MACP
    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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How is RSV infection diagnosed?

The diagnosis of RSV infection can be made by a number of different laboratory tests, including isolation of the virus, detection of viral antigens, detection of viral RNA, demonstration of a rise in serum antibodies, or a combination of these approaches. Most clinical laboratories today use nasal swab tests based on antigen detection to diagnose RSV infection. This technique is 80%-90% reliable. A newer test protocol (RT-PCR) is more reliable and is replacing the antigen-detecting test in many hospitals and community laboratories.

What is the treatment for an RSV infection?

For children with mild RSV disease, no specific treatment is necessary other than the treatment of symptoms (such as acetaminophen [Tylenol] to reduce fever).

Children with more severe disease may require oxygen therapy and sometimes mechanical ventilation. Ribavirin aerosol (Virazole) may be used in the treatment of some patients with severe disease. Some investigators have used a combination of intravenous immune globulin (IVIG) with high titers of neutralizing RSV antibody (RSV-IVIG) and ribavirin to treat patients with compromised immune systems.

How can RSV infection be prevented?

Frequent hand washing and not sharing items such as cups, glasses, and utensils with people who have RSV illness should decrease the spread of virus to others.

Excluding children with colds or other respiratory illnesses (without fever) who are well enough to attend child care or school settings will probably not decrease the transmission of RSV, since it is often spread in the early stages of illness prior to the development of more severe symptoms.

In a hospital setting, RSV transmission can and should be prevented by strict attention to contact precautions, such as hand washing and wearing gowns and gloves.

In 1998, a new product called palivizumab (Synagis) was licensed to help prevent severe RSV disease in certain high-risk infants with predisposing factors such as moderate/severe prematurity, chronic lung disease, congenital heart disease, etc. Palivizumab is not a treatment for RSV but rather a tool to help prevent RSV infection. Those receiving Synagis receive a monthly injection during the RSV season. Synagis is quite expensive, and insurance companies often have strict guidelines limiting those for whom they will pay this medication.

Medically Reviewed by a Doctor on 11/18/2015
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