Respiratory Syncytial Virus (RSV)

Respiratory Syncytial Virus (RSV) Respiratory Syncytial Virus (RSV) is a viral infection that affects both the upper and lower respiratory tracts. It can occur in individuals of all ages, but is most common in children under 2 years old. In cases where RSV infects the lower respiratory tract, approximately 70% of individuals develop pneumonia and bronchiolitis.

 

Transmission of the Disease:

- RSV can be found worldwide, with higher prevalence during the winter season in Western countries. In Thailand, it can be present throughout the year, but is more prevalent towards the end of the rainy season between July and November.

- The virus spreads easily through direct contact with secretions such as nasal mucus, sputum, and saliva from infected individuals. Transmission can occur through contact with the eyes, nose, or respiratory tract. Infected individuals can also release the virus into the air within a three-foot radius through coughing or sneezing.

- RSV infection can occur multiple times in some individuals due to the presence of multiple viral strains.

 

Symptoms:

- The incubation period is approximately 5 days.

- During the first 2-4 days, symptoms resemble those of a common cold, including low-grade fever, cough, sneezing, nasal congestion, and clear runny nose. Some children may experience laryngitis.

- As the disease progresses to the lower respiratory tract, it can cause bronchitis, pneumonia, or pneumonitis. Children may exhibit high fever, persistent cough, increased sputum production, and respiratory distress. Severe cases can involve difficulty breathing, wheezing, cyanosis, reduced oral intake, and in rare cases, respiratory failure leading to death.

 

Prognosis:

- The exact mechanism of RSV infection is not fully understood. Symptoms of the disease are triggered by the body's production of antibodies against RSV, resulting in an allergy-like reaction and secretion of substances in the respiratory system, leading to wheezing and other symptoms.

- RSV is a common cause of lower respiratory tract infections in children under 5 years old, and continuous inflammation in the respiratory system can lead to chronic and persistent symptoms. Children infected with RSV have a higher risk of developing asthma as they grow older, and even a simple cold infection can trigger asthma attacks and recurrent coughing.

 

High-Risk Patients: 

- Premature infants, low birth weight infants, and individuals with weakened immune systems, including those with congenital heart disease.

- Individuals with compromised immunity, such as the elderly, those with congenital diseases, and patients with chronic respiratory and heart diseases.

- Children under 2 years old.

 

Treatment:

- Currently, there is no specific treatment for RSV. Symptomatic relief can be provided through antipyretics, cough medicine, bronchodilators, and supplemental oxygen if necessary. Chest physiotherapy and suctioning may be required in cases with excessive sputum production.

- Oral leukotriene modifiers, non-steroidal anti-inflammatory drugs, can be used to help alleviate coughing and shortness of breath.

 

Disease Prevention:

- Currently, there is no vaccine available for RSV.

- Avoid taking children to crowded places.

- Minimize contact between healthy children and those who have cold symptoms.

- Dress children warmly in cold weather or when in air-conditioned environments.

- Encourage frequent handwashing for children, as it helps eliminate 80% of hand-borne germs.

- If a child is sick at home or in a childcare facility, keep them separated from healthy children.

- Breastfeeding is recommended to provide infants with immunity against various respiratory diseases.

 

Physician: 

Dr. Pranee Sitaposa,

Pediatric Infectious Disease Specialist