Disease Burden

Respiratory syncytial virus (RSV) is the leading cause of hospitalization in infants and young children and the leading cause of acute lower respiratory infections (ALRI) in children globally. RSV is the number-one cause of sickness, re-hospitalization and death for premature babies. Morbidity of RSV infection worldwide was estimated to be around 64 million people per year of which 96% occurred in the developing countries. In addition, RSV infection is the most common cause of virus-induced mortality in children under five years old and causes 200 thousand deaths every year.

Etiopathology

RSV is a single-stranded RNA virus belonging to the family Pneumoviridae and is most common during fall, winter, and spring. RSV replicates in the mucosal cells in the respiratory tract and causes inflammation in the bronchioles, edema and mucosal blockage. RSV can spread when an infected person coughs or sneezes. People can get infected if they get droplets from a cough or sneeze in the eyes, nose, or mouth, or if they touch a surface that has the virus on it and then touch their face before washing the hands.

Clinical Symptoms

RSV infection can cause various symptoms. The cold-like symptoms appear in the beginning, including a runny nose, cough, and inappetence. RSV infection can spread to the lower respiratory tract, causing serious diseases such as pneumonia or bronchiolitis. The signs and symptoms may include a severe cough, wheezing, rapid breathing, or fever. In severer cases, it may cause the bluish color of the skin due to lack of oxygen (cyanosis). In high-risk populations, RSV infection may cause severe complications or become life-threatening, leading to long-term damages to the lungs or death.

Treatments

There is no medication can treat the virus itself. Supportive care is the main therapy for RSV infection. Giving anti-RSV monoclonal antibody (Palivizumab) monthly is the only way to prevent the RSV infection. However, Palivizumab is out of reach for many patients in LMICs due to the high cost of treatment. Please refer to Taiwan Association of Family Medicine for more information.