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Appendices

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Section 3. Summaries of Infectious Diseases

Respiratory Syncytial Virus

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Respiratory syncytial virus (RSV) causes acute respiratory tract illness in patients of all ages. In infants and young children, RSV is the most important cause of bronchiolitis and pneumonia. During the first few weeks of life, particularly among preterm infants, infection with RSV may produce minimal respiratory tract signs. Lethargy, irritability, and poor feeding, sometimes accompanied by apneic episodes, may be the presenting manifestations in infants. Most previously healthy infants infected with RSV do not require hospitalization, and many who are hospitalized improve with supportive care and are discharged in fewer than 5 days. Characteristics that increase the risk of severe or fatal RSV infection are preterm birth; cyanotic or complicated congenital heart disease, especially conditions causing pulmonary hypertension; underlying pulmonary disease, especially chronic lung disease of prematurity; and immunodeficiency disease or therapy causing immunosuppression at any age. The association between RSV bronchiolitis early in life and subsequent reactive airway disease remains poorly understood. After RSV bronchiolitis, many children will have episodes of recurrent wheezing, which usually diminish in subsequent years. Some children may develop wheezing at older ages or develop long-term abnormalities in pulmonary function. This association may reflect an underlying predisposition to reactive airway disease rather than a direct consequence of RSV infection.

Almost all children are infected at least once by 2 years of age, and reinfection throughout life is common. Respiratory syncytial virus infection in older children and adults usually manifests as upper respiratory tract illness, but more serious disease involving the lower respiratory tract also can develop in immunocompromised patients or in the elderly. Exacerbation of acute asthmatic bronchitis or other chronic lung conditions may occur.


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ETIOLOGY: Respiratory syncytial virus . . . [Go to Full Text]


Related text in Red Book:

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Red Book 2006: 67-69. [Extract] [Full Version]  

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  • Thatayatikom, A., Liu, A. H. (2005). Vascular Endothelial Growth Factor (VEGF) Induces Remodeling and Enhances Th2-Mediated Sensitization and Inflammation in the Lung. Pediatrics 116: 556-557 [Full Version]  
  • Pinto, R. A., Arredondo, S. M., Bono, M. R., Gaggero, A. A., Diaz, P. V. (2006). T Helper 1/T Helper 2 Cytokine Imbalance in Respiratory Syncytial Virus Infection Is Associated With Increased Endogenous Plasma Cortisol. Pediatrics 117: e878-e886 [Abstract] [Full Version]  
  • Uzel, G., Premkumar, A., Malech, H. L., Holland, S. M. (2000). Respiratory Syncytial Virus Infection in Patients With Phagocyte Defects. Pediatrics 106: 835-837 [Abstract] [Full Version]  
  • Bockova, J., O'Brien, K. L., Oski, J., Croll, J., Reid, R., Weatherholtz, R. C., Santosham, M., Karron, R. A. (2002). Respiratory Syncytial Virus Infection in Navajo and White Mountain Apache Children. Pediatrics 110: e20-20 [Abstract] [Full Version]  
  • Titus, M. O., Wright, S. W. (2003). Prevalence of Serious Bacterial Infections in Febrile Infants With Respiratory Syncytial Virus Infection. Pediatrics 112: 282-284 [Abstract] [Full Version]  
  • Gavin, P. J., Katz, B. Z. (2002). Intravenous Ribavirin Treatment for Severe Adenovirus Disease in Immunocompromised Children. Pediatrics 110: e9-9 [Abstract] [Full Version]  
  • Choudhuri, J. A., Ogden, L. G., Ruttenber, A. J., Thomas, D. S.K., Todd, J. K., Simoes, E. A.F. (2006). Effect of Altitude on Hospitalizations for Respiratory Syncytial Virus Infection. Pediatrics 117: 349-356 [Abstract] [Full Version]