- highly contagious respiratory infection that affects almost all children by age 2
- those younger than age 2 are more likely to experience the severe form of the disease
- presents as a cold after age 2, or asymptomatically
- older adults with impaired oxygenation may also be at risk for a severe form
Respiratory Syncytial Virus (RSV)
- lower respiratory tract illness that occurs when an infecting agent causes inflammation and obstruction of the small airways
- increased incidence of asthma and reactive airway disease later in life
- most common cause is RSV
bronchiolitis
what type of cells does RSV infect?
squamous epithelial cells of bronchioles and alveoli
what is meant by “syncytia”?
- infected cells merge with adjacent cells
- masses of cells created, called syncytia
- cells subsequently burst and die, creating debris
what are the mild clinical manifestations of RSV?
- presents 3-5 days after exposure
- rhinorrhea
- low grade fever
- cough
- irritability
- mucous secretions are usually green in colour
how is RSV spread?
- highly contagious
- spread by respiratory secretions and direct physical contact
what are some diagnostic tests for RSV?
- immunofluorescent or enzyme immunoassay
- viral cell culture
- CXR
- ABGs
why are children under 2 in greater danger from RSV?
- smaller airways of infants and toddlers
- immature immune system
what are severe clinical manifestations of RSV?
- wheezing, crackles in airways (from edema and mucosal secretions)
- acute rhinorrhea
- atelectasis
- hypoxemia (because of V-Q mismatch)
- apnea
- pulmonary edema
- coughing, wheezing, retractions between ribs
- nasal flaring
- cyanosis
- listlessness
RSV test:
-sample from a posterior nasopharyngeal specimen
immunofluorescent or enzyme immunoassay
RSV test:
-imaging to show hyperinflation, patchy atelectasis and other signs of inflammation
CXR
RSV test:
-blood test that shows effectiveness of gas exchange
ABGs
what medications are used to treat RSV?
- few medications used
- antipyretics
- antiviral (Ribavirin - marginal benefits)
- antibiotics if there is also a bacterial infection
what clinical therapies are used for people hospitalized with RSV?
- no effective therapy exists
- humidified oxygen
- attempt to maintain O2sat of >90%
- hydration, suctioning
- cpap
- play therapy for children
