Healthcare providers should consider RSV in patients with respiratory disease, especially during RSV season.
Clinical Description and Diagnosis
RSV infection can cause a variety of respiratory illnesses in infants and young children. It most often causes a cold-like illness, but may also cause lower respiratory tract infections such as bronchiolitis and pneumonia. Between 1% and 2% of children under 6 months of age with RSV infection may require hospitalization. Severe illness most often occurs in very young babies. Additionally, children with any of the following underlying conditions are considered at high risk:
Infants, especially those 6 months and younger
Children under 2 years of age with chronic lung disease or congenital heart disease
children with suppressed immune systems
Children with neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions
Infants and young children with RSV infection may experience rhinorrhea and loss of appetite before any other symptoms develop. Cough usually develops after one to three days. Shortly after the onset of coughing, sneezing, fever, and wheezing may occur. In very young infants, irritability, reduced activity, and/or apnea may be the only symptoms of infection.
Most healthy infants and young children infected with RSV do not require hospitalization. Hospitalized patients may require oxygen, intubation, and/or mechanical ventilation. Most improve with supportive care and are discharged within a few days.
In older adults and adults with chronic medical conditions
Adults infected with RSV usually have mild or no symptoms. Symptoms are often consistent with an upper respiratory infection and include rhinorrhea, pharyngitis, cough, headache, fatigue, and fever. The illness usually lasts less than five days.
However, some adults may develop more serious symptoms consistent with a lower respiratory tract infection, such as pneumonia. People at high risk for severe disease from RSV include:
older adults, especially those 65 and older
adults with chronic lung disease or heart disease
adults with weakened immune systems
RSV can also sometimes lead to the exacerbation of serious conditions, such as:
Chronic Obstructive Pulmonary Disease (COPD)
congestive heart failure
Clinical Laboratory Tests
The clinical symptoms of RSV are nonspecific and can overlap with other viral respiratory infections as well as some bacterial infections. There are several types of laboratory tests available to confirm RSV infection. These tests can be performed on upper and lower airway samples.