Respiratory Syncytial Virus - LPNI

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Respiratory Syncytial Virus

LPNI Health Topic – December 2022

Respiratory Syncytial Virus (RSV) is also called human respiratory syncytial virus and human orthopneumovirus infection. It is the most common cause of bronchiolitis and pneumonia among infants under one year of age. Bronchiolitis is inflammation of the small air passages in the lungs and pneumonia is inflammation of the lung tissue itself. Almost all children will get RSV infection at least once by two years of age.

It has been said “RSV is not as bad as the flu but worse than a cold”, although it can be deadly in the very old and very young. With mask-wearing and physical distancing for COVID-19, there were fewer cases of RSV in 2020. However, once safety measures relaxed with the arrival of COVID-19 vaccines, a rise in RSV cases began in spring 2021.

RSV infection may cause respiratory disease at any age, and infections may be severe among the elderly and people of any age with heart, lung or immune system problems. Infections may recur throughout life and are most common during winter and early spring.

RSV is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby. Infection may be spread by contact with hands, tissues and other articles soiled by infected nose and throat discharges. The virus survives only for a few hours outside of the body and is easily killed by soap and water or disinfectants.

The first symptoms are usually: fever, runny nose, cough, wheezing. Ear infections are common. Pneumonia and bronchiolitis often follow, especially in infants. Most children recover from the illness in eight to 15 days, but some require hospitalisation, mostly in the very young age group (below six months of age).

Diagnosis can be made by direct detection or isolation of the virus from respiratory secretions or by blood tests. The average incubation period is five days, with a range of two to eight days. The infectious period is uncertain, but probably from before symptoms develop until recovery from the infection. Most people recover from the infection within about 10 days.

There is no specific treatment for RSV infection, though researchers are working to develop vaccines and anti-virals.

Usual management is to administer paracetamol for fever and maintaining adequate fluid intake. Aspirin should not be given to children under 12 years of age unless specifically recommended by a doctor. Very ill children and elderly people may require admission to hospital and treatment is supportive. Because RSV is a virus, antibiotics do not help.

Frequent hand washing is the most effective means of preventing spread, as the virus is easily killed by soap and water. Avoid sharing cups, glasses and eating utensils with people who have respiratory infections. Cover a cough or sneeze with a tissue or your arm. Drop used tissues immediately into a rubbish bin, then wash your hands.

Exclude people with RSV from child-care, preschool, school and work until they are well and avoid contact with babies, pregnant women, people with impaired immune systems and the elderly.

Sylvia Hutt RN,RM retired

Adelaide, South Australia, Member Lutheran Nurses Association of Australia

Information from www.sahealth.sa.gov.au