RSV

Question 1

• 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

Answer 1

Respiratory Syncytial Virus (RSV)

Question 2

• 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

Answer 2

bronchiolitis

Question 3

what type of cells does RSV infect?

Answer 3

squamous epithelial cells of bronchioles and alveoli

Question 4

what is meant by “syncytia”?

Answer 4

• infected cells merge with adjacent cells
• masses of cells created, called syncytia
• cells subsequently burst and die, creating debris

Question 5

what are the mild clinical manifestations of RSV?

Answer 5

• presents 3-5 days after exposure
• rhinorrhea
• low grade fever
• cough
• irritability
• mucous secretions are usually green in colour

Question 6

how is RSV spread?

Answer 6

• highly contagious

- spread by respiratory secretions and direct physical contact

Question 7

what are some diagnostic tests for RSV?

Answer 7

• immunofluorescent or enzyme immunoassay
• viral cell culture
• CXR
• ABGs

Question 8

why are children under 2 in greater danger from RSV?

Answer 8

• smaller airways of infants and toddlers

- immature immune system

Question 9

what are severe clinical manifestations of RSV?

Answer 9

• 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

Question 10

RSV test:

-sample from a posterior nasopharyngeal specimen

Answer 10

immunofluorescent or enzyme immunoassay

Question 11

RSV test:

-imaging to show hyperinflation, patchy atelectasis and other signs of inflammation

Answer 11

CXR

Question 12

RSV test:

-blood test that shows effectiveness of gas exchange

Answer 12

ABGs

Question 13

what medications are used to treat RSV?

Answer 13

• few medications used
• antipyretics
• antiviral (Ribavirin - marginal benefits)
• antibiotics if there is also a bacterial infection

Question 14

what clinical therapies are used for people hospitalized with RSV?

Answer 14

• no effective therapy exists
• humidified oxygen
• attempt to maintain O2sat of >90%
• hydration, suctioning
• cpap
• play therapy for children