Respiratory Syncytial Virus

Abstract

1. Toni Darville, MD* 2. Terry Yamauchi, MD† 1. 2. *Assistant Professor of Pediatrics, Department of Pediatric Infectious Diseases, Arkansas Children’s Hospital and the University of Arkansas for Medical Sciences, Little Rock, AR. 3. 4. †Editorial Board (at time of writing). 1. The two classic signs of bronchiolitis are wheezing and hyperexpansion of the lung. 2. Because the degree of hypoxemia is difficult to assess clinically, the infant’s arterial oxygen saturation must be measured. 3. The mainstay of treatment for respiratory syncytial virus (RSV) infection is supplemental oxygen and hydration. 4. The use of gowns and gloves has been shown to decrease nosocomial spread of RSV significantly. 5. Complicated RSV infection is most likely to occur in very young infants and in those who have underlying diseases, especially in the presence of cardiopulmonary and congenital disorders. Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract disease in infants and young children. Each year in the United States nearly 90,000 children are hospitalized due to infection with RSV. Outbreaks occur worldwide during the late fall, winter, and early spring. In the United States, the season generally begins in early November and continues through April. Symptoms of RSV infection range from those of a bad cold to severe bronchiolitis or pneumonia. Involvement of smaller intrapulmonary airways is the hallmark of RSV infection, with bronchiolitis being the most important and distinctive clinical syndrome produced. RSV is an enveloped, single-stranded RNA virus. Two glycosylated surface proteins, the attachment (G) and fusion (F) proteins, are essential for RSV to infect cells. The G protein is important for physical attachment to the cell; the F protein is responsible for fusing viral particles to target cells and for fusing infected cells to neighboring cells, resulting in characteristic syncytia formation. Both F and G proteins elicit neutralizing antibodies. There is antigenic variation among strains of RSV, and monoclonal antibodies have made it possible to divide RSV isolates into two major groups (A and B) and into subtypes within each group. The severity of infection may vary with subgroup; RSV A infections …