What does rsv medical term mean

RS virus

RS virus: description

The term RS virus (or RSV) stands for the English term "respiratory syncytial virus". It is a virus that causes cells to fuse together (syncytia) in the respiratory tract. The pathogen is similar to the flu virus and occurs worldwide. It causes seasonal outbreaks: in Europe, most people get the RS virus between November and April, most commonly in January and February.

RS virus: common in babies and toddlers

In principle, people of all ages can get sick from the RS virus. But it affects small children more often. RS virus infection is the leading cause of hospital respiratory disease treatment in infants and young children. The disease can be particularly severe in premature babies and infants. In premature babies with lung damage and children with heart defects, the RSV infection is fatal in one out of 100 cases.

About 50 to 70 percent of all children get an RS virus infection at least once during their first year of life. After the age of two, almost all children have already gone through an RS virus infection. Girls and boys are equally affected. However, boys are much more likely to develop severe disease.

RS virus: highly infectious

The RS virus is considered to be highly infectious. That's why it's very easy to get infected from sick people. If, for example, an RS virus infection occurs in a hospital, the patient is isolated to prevent the disease from spreading to other patients and medical staff.

The RS virus is considered to be the most common infection transmitted to children in hospital.

RS virus: symptoms

The symptoms of RS virus infection can vary greatly from one patient to another. Adults who are otherwise healthy often have no symptoms at all. Then doctors speak of an asymptomatic or clinically silent RSV infection. In other cases, RS virus disease develops mildly - those affected have cold-like symptoms such as:

RSV bronchiolitis

Especially in small children, RSV infection can affect the upper respiratory tract (nose, mouth, throat) as well as the lower respiratory tract (bronchi and lungs) - more precisely, the small branches of the bronchial tree. One then speaks of RSV bronchiolitis. It often becomes noticeable one to three days after the onset of the disease with the following symptoms:

  • fever
  • accelerated breathing
  • audible rattles and wheezing when breathing
  • Cough with sputum
  • Difficult breathing with the use of auxiliary breathing muscles (prop up your arms)
  • dry, cold and pale skin
  • Sunken fontanel in children under 18 months

In addition, there are general signs of illness such as weakness, malaise, lack of appetite and refusal to drink.

The symptoms of RSV infection can worsen significantly within a few hours. Breathing stops (apneas) may occur repeatedly in premature babies.

The clinical picture of RSV bronchiolitis is reminiscent of whooping cough.

RS virus: causes and risk factors

The RS virus consists of a protein envelope and the genetic information enclosed in it (in the form of RNA). It multiplies in the superficial cells of the mucous membranes that line the airways. A special protein, the fusion (F -) protein, is anchored in the virus envelope. It causes cells to fuse (syncytia formation) in the affected mucous membranes. These syncytia as well as the immigrating defense cells of the immune system damage the mucous membranes - cells die and then obstruct the airways.

RS virus: transmission

The RS virus is only found in humans. It's going over Droplet infection transmitted: When coughing, sneezing or speaking, infected people release tiny droplets of saliva containing viruses into their surroundings. If these get on the conjunctiva or nasal mucous membrane of a healthy person, they can also get sick. Also one Smear infection for example via contaminated toys or clothing is possible.

The time between infection and the onset of the disease (incubation period) is two to eight days, an average of five days.

How long is an infected person contagious?

A patient is contagious (infectious) for about three to five days from the first day after RSV infection.

RS virus: risk factors

There are certain situations in which a child's risk of becoming seriously ill with RS virus infection is particularly high. This applies, for example, to:

  • Premature birth
  • chronic lung diseases, e.g. bronchopulmonary dysplasia, congenital airway abnormalities, but also cystic fibrosis (congenital metabolic disease that affects the lungs, among other things)
  • congenital heart defects
  • neuromuscular diseases
  • Immunodeficiency or immunosuppressive therapy (therapy that suppresses the immune system, e.g. after organ transplantation)
  • Chromosome abnormalities (such as trisomy 21 = "Down syndrome")

In addition, there are some general risk factors for a severe RS virus infection such as:

  • Age less than six months
  • Multiple birth
  • male gender
  • Siblings in toddler age
  • Visit to the crib
  • Household where people smoke
  • Malnutrition
  • Cases of atopic diseases (such as hay fever, eczema) or asthma in the family
  • low social and educational status of parents

RS virus: examinations and diagnosis

If your child has flu-like symptoms, shortness of breath and / or a high fever, see the pediatrician with them. He will first ask you in detail about your medical history (anamnesis). He will ask you the following questions, among others:

  • How long has your child had a fever?
  • Has your child been breathless since being sick?
  • Does your child drink and eat enough?
  • Does your child have an underlying disease such as a heart defect or cystic fibrosis?

RS Virus: Physical Exam

The doctor then gives his patient a thorough examination. He shines a lamp in the mouth and ears to detect possible reddening of the throat or ears. He then scans the lymph nodes on the neck for possible enlargements and listens to the lungs with a stethoscope. RSV bronchiolitis can be heard in the stethoscope as crackling and wheezing.

The doctor also checks whether the patient's fingernails or lips have a bluish discoloration (cyanosis) - a sign of insufficient oxygen in the blood (hypoxemia).

RS virus: laboratory tests

Distinguishing RS virus disease from other viral respiratory diseases is not easy. In addition to the clinical examination, the doctor will be helped by a precise description of the symptoms and the patient's age. The RS virus can be detected in the laboratory in a smear taken from the nasopharynx secretion of infected people. It is seldom possible to detect antibodies in the blood because the body produces only a few antibodies against the RS virus.

Read more about the examinations

Find out here which examinations can be useful for this disease:

RS virus: treatment

There is no causal therapy for RSV infection. Thus, only the symptoms can be treated (symptomatic therapy) by:

  • adequate hydration
  • expectorant measures such as steam baths
  • fever-lowering measures such as leg compresses or the administration of ibuprofen or paracetamol
  • Keeping the nasopharynx clear by rinsing or nasal drops
  • Breathing support (see below)

RS virus: respiratory support

Depending on how difficult it is for the patient to breathe, different methods can be used to support the oxygen supply:

If your child is having trouble breathing at home, you can use a pillow to raise their upper body. Inhalation with saline solution moisturizes and widens the airways. In addition, certain drugs (bronchodilators), such as salbutamol, can widen the airways. The patient breathes them in through an inhaler. In severe cases, adrenaline may be given, which dilates the bronchi and has an anti-inflammatory effect.

At the doctor's or in the hospital, patients with shortness of breath can be given oxygen through a breathing mask if the oxygen level in the blood drops threateningly (below 94 percent). Ventilation via a so-called CPAP mask (continuous positive airway pressure) or a tube may also be necessary. If there are apneas in infants, they must be monitored in the hospital.

RS virus: antivirals, cortisone, antibiotics?

Until a few years ago, children with severe RSV infection were given the anti-viral drug (virostatic) ribavirin. But studies have shown that it is not effective.

Cortisone (glucocorticoids, steroids) is also considered ineffective if it is inhaled. However, if it is given systemically, for example in the form of tablets, it can improve the acute symptoms and shorten the duration of the illness.

Antibiotics are not effective against RS virus because they only work against bacteria, not viruses. However, they can be prescribed if bacterial infection occurs in addition to RS virus infection.

Read more about the therapies

Read more about therapies that can help here:

RS virus: disease course and prognosis

The prognosis is usually good if you are infected with the RS virus. The duration and severity of the disease are brief and mild in otherwise healthy patients. The RS virus disease often heals on its own within a few days. The mucous membranes of the respiratory tract need about four to eight weeks to regenerate.

More severe courses affect toddlers in particular. Premature babies in particular have a high risk of developing a severe RSV infection in the first six months of life. In about one percent of cases, this ends fatally despite intensive medical care.

RS virus: complications

A possible complication of RS virus infection is otitis media (otitis media). RS virus causes about 75 percent of all otitis media in children under the age of three.

In addition, the RS virus can lead to hypersensitivity (hyperreactivity) of the respiratory tract, which can lead to early childhood asthma. Last but not least, infection with the RS virus can aggravate existing diseases such as asthma.

RS virus: Re-infection possible

The infection with RS viruses does not offer long-term protection against renewed infection. This lack of immunity is due to the fact that the body hardly makes antibodies against the RS virus. Re-infection, which often occurs in adults with close contact with young children, is usually less severe than the initial RS virus infection. Often it only manifests itself as a cough that lasts for a few weeks.

RS virus: prevention

The best measure to prevent RS virus infection is hygiene:

  • Wash your hands frequently.
  • Sneeze and cough into the crook of your elbows, not your hands.
  • Clean children's toys regularly.
  • Sick people should not visit community facilities.

Breastfeeding is also beneficial for infants: Breastfeeding children suffer less from respiratory diseases than bottle-fed children.

In addition, you should not smoke in the vicinity of children.

Passive vaccination for children at risk

There is no active RSV vaccination. However, there is a passive vaccination for children with risk factors such as premature babies with congenital heart defects or severe bronchopulmonary dysplasia (BPD). It contains ready-made antibodies against the RS virus (called palivizumab) and is injected into a muscle once a month during the RSV season. A total of five vaccine doses are planned, which will be administered every four weeks from November onwards.

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