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Respiratory syncytial virus

Orthopneumovirus hominis
Filamentous RSV particles
Electron micrograph of filamentous RSV particles
Virus classification Edit this classification
(unranked): Virus
Realm: Riboviria
Kingdom: Orthornavirae
Phylum: Negarnaviricota
Class: Monjiviricetes
Order: Mononegavirales
Family: Pneumoviridae
Genus: Orthopneumovirus
Species:
Orthopneumovirus hominis
Synonyms[1]
  • Human respiratory syncytial virus (hRSV)
  • Respiratory syncytial virus (RSV)

Respiratory syncytial virus (RSV),[a] also called human respiratory syncytial virus (hRSV) and human orthopneumovirus, is a contagious virus that causes infections of the respiratory tract. It is a negative-sense, single-stranded RNA virus.[2] Its name is derived from the large cells known as syncytia that form when infected cells fuse.[2][3]

RSV is a common cause of respiratory hospitalization in infants, and reinfection remains common in later life, though often with less severity. It is a notable pathogen in all age groups. Infection rates are typically higher during the cold winter months, causing bronchiolitis in infants, common colds in adults, and more serious respiratory illnesses, such as pneumonia, in the elderly and immunocompromised.[4]

RSV can cause outbreaks both in the community and in hospital settings. Following initial infection via the eyes or nose, the virus infects the epithelial cells of the upper and lower airway, causing inflammation, cell damage, and airway obstruction.[2] A variety of methods are available for viral detection and diagnosis of RSV including antigen testing, molecular testing, and viral culture.[3]

Other than vaccination, prevention measures include hand-washing and avoiding close contact with infected individuals.[5] The detection of RSV in respiratory aerosols,[6] along with the production of fine and ultrafine aerosols during normal breathing, talking,[7] and coughing,[8] and the emerging scientific consensus around transmission of all respiratory infections,[9] airborne precautions may also be required for reliable protection. In May 2023, the US Food and Drug Administration (FDA) approved the first RSV vaccines, Arexvy (developed by GSK plc) and Abrysvo (Pfizer).[10][11] The prophylactic use of palivizumab or nirsevimab (both are monoclonal antibody treatments) can prevent RSV infection in high-risk infants.[5][12]

Treatment for severe illness is primarily supportive, including oxygen therapy and more advanced breathing support with continuous positive airway pressure (CPAP) or nasal high flow oxygen, as required. In cases of severe respiratory failure, intubation and mechanical ventilation may be required. Ribavirin is an antiviral medication licensed for the treatment of RSV in children.[13] RSV infection is usually not serious, but it can be a significant cause of morbidity and mortality in infants and in adults, particularly the elderly and those with underlying heart or lung diseases.

  1. ^ "ICTV Taxonomy history: Human orthopneumovirus". International Committee on Taxonomy of Viruses (ICTV). Archived from the original on 25 September 2022. Retrieved 27 December 2018.
  2. ^ a b c Griffiths C, Drews SJ, Marchant DJ (January 2017). "Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment". Clinical Microbiology Reviews. 30 (1): 277–319. doi:10.1128/CMR.00010-16. PMC 5217795. PMID 27903593.
  3. ^ a b Cite error: The named reference Jha_2016 was invoked but never defined (see the help page).
  4. ^ Coultas JA, Smyth R, Openshaw PJ (October 2019). "Respiratory syncytial virus (RSV): a scourge from infancy to old age". Thorax. 74 (10): 986–993. doi:10.1136/thoraxjnl-2018-212212. hdl:10044/1/73848. PMID 31383776. S2CID 199449874.
  5. ^ a b Cite error: The named reference Ralston_2014 was invoked but never defined (see the help page).
  6. ^ Kulkarni H, Smith CM, Lee Ddo H, Hirst RA, Easton AJ, O'Callaghan C (August 2016). "Evidence of Respiratory Syncytial Virus Spread by Aerosol. Time to Revisit Infection Control Strategies?". American Journal of Respiratory and Critical Care Medicine. 194 (3): 308–316. doi:10.1164/rccm.201509-1833OC. PMID 26890617.
  7. ^ Stadnytskyi V, Bax CE, Bax A, Anfinrud P (June 2020). "The airborne lifetime of small speech droplets and their potential importance in SARS-CoV-2 transmission". Proceedings of the National Academy of Sciences. 117 (22): 11875–11877. Bibcode:2020PNAS..11711875S. doi:10.1073/pnas.2006874117. PMC 7275719. PMID 32404416.
  8. ^ Zayas G, Chiang MC, Wong E, MacDonald F, Lange CF, Senthilselvan A, et al. (December 2012). "Cough aerosol in healthy participants: fundamental knowledge to optimize droplet-spread infectious respiratory disease management". BMC Pulmonary Medicine. 12 (1): 11. doi:10.1186/1471-2466-12-11. PMC 3331822. PMID 22436202.
  9. ^ Cite error: The named reference prather_jimenez_marr_1 was invoked but never defined (see the help page).
  10. ^ Cite error: The named reference FDA PR was invoked but never defined (see the help page).
  11. ^ Cite error: The named reference Abrysvo approved was invoked but never defined (see the help page).
  12. ^ Cite error: The named reference ctv-202304 was invoked but never defined (see the help page).
  13. ^ Simões EA, DeVincenzo JP, Boeckh M, Bont L, Crowe JE, Griffiths P, et al. (March 2015). "Challenges and Opportunities in Developing Respiratory Syncytial Virus Therapeutics". Journal of Infectious Diseases. 211 (suppl 1): S1–S20. doi:10.1093/infdis/jiu828. PMC 4345819. PMID 25713060.


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