Respiratory syncytial virus
Updated: Wikipedia source
Respiratory syncytial virus (RSV), also called human respiratory syncytial virus (hRSV) and human orthopneumovirus, is a virus that causes infections of the respiratory tract. It is a negative-sense, single-stranded RNA virus. Its name is derived from the large, multinucleated cells known as syncytia that form when infected cells fuse. RSV is a common cause of respiratory hospitalization in infants, and reinfection remains common in later life, though often with less severity. It is a notable pathogen in all age groups. Infection rates are typically higher during the cold winter months. Infections can cause bronchiolitis in infants, common colds in adults, and more serious respiratory illnesses, such as pneumonia, in older individuals and those with immunocompromise resulting from, e.g., cardiopulmonary disease. RSV can cause outbreaks in both community and hospital settings. Following initial infection via the eyes or nasal passages, the virus infects the epithelial cells of the upper and lower airways, causing inflammation, cell damage, and airway obstruction. A variety of methods are available for detecting and diagnosing RSV, including antigen testing, molecular testing, and viral culture. Other than vaccination, prevention measures include hand-washing and avoiding close contact with infected individuals. The carriage of RSV in respiratory aerosols, along with the production of fine and ultrafine aerosols during normal breathing, talking, and coughing, and the emerging scientific consensus around transmission of all respiratory infections, may suggest airborne precautions are needed for reliable protection. In May 2023, the US Food and Drug Administration (FDA) approved the first RSV vaccines, Arexvy (developed by GSK plc) and Abrysvo (Pfizer). The prophylactic use of palivizumab or nirsevimab (both are monoclonal antibody treatments) can prevent RSV infection among infants with high-risk predispositions. Treatment for severe illness is primarily supportive, including oxygen therapy and more advanced breathing support with continuous positive airway pressure (CPAP) or nasal high flow oxygen, as required. In cases of severe respiratory failure, intubation and mechanical ventilation may be required. Ribavirin is an antiviral medication licensed for the treatment of RSV infection in children.