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Respiratory Syncytial Virus

The Perfect Storm of Respiratory Viruses

Since its discovery in 1956, the respiratory syncytial virus (RSV) has been acknowledged as one of the most frequent causes of pediatric sickness. The common respiratory virus is known to cause mild, cold-like symptoms and is one of the drivers for pneumonia and bronchiolitis (inflammation of the tiny airways in the lung). As per our analysis, RSV is known to affect more than 60 million people each year.

How is RSV Transmitted?

  • A person can come into contact with the virus directly, for instance, by kissing an RSV-infected child's face.
  • If a person touches a doorknob or other surface that has the virus on it, then touches his face without first washing their hands, the virus is then spread.
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Symptoms of Respiratory Syncytial Virus (RSV):

RSV typically results in mild cold-like symptoms in adults and older kids. These may consist of:

  • Low-grade fever
  • Congested or runny nose
  • Dry cough
  • Sore throat
  • Sneezing
  • Headache

The following symptoms may be exhibited in infants affected with a severe RSV infection:

  • Rapid, shallow, and short breaths
  • Breathing difficulties
  • Cough
  • Poor nutrition
  • Unusual fatigue (lethargy)
  • Irritability

The lower respiratory tract can get infected with respiratory syncytial virus (RSV), leading to pneumonia or bronchiolitis. Some warning signs and symptoms include:

  • Fever
  • Acute cough
  • Wheezing is a high-pitched sound that is typically made when exhaling (exhaling)
  • Rapid or difficult breathing may make the person prefer to sit up instead than lying down.
  • Lack of oxygen causes the skin to be bluish in tone (cyanosis)

Which Category of People are at Highest Risk for Severe Respiratory Syncytial Virus Disease?

  • Age is a risk factor for dangerous symptom development, with people over 80 years of age and older having the highest risk.
  • Immune systems that have been compromised in kids or adults due to conditions like cancer or treatments like chemotherapy
  • Adults suffering from lung or heart disease
  • Children suffering from neuromuscular diseases, such as muscular dystrophy are most likely at risk to get infected with RSV.
  • Babies, especially those who are premature or less than six months old. The majority of kids will have contracted the respiratory syncytial virus by age 2, but they can contract RSV more than once. Children who attend daycare facilities or who have siblings who are students are more likely to be exposed to and contract an infection again.

Prevention

Respiratory syncytial virus has no vaccination. However, the following lifestyle choices can aid in limiting the spread of this infection:

  • Washing of the hands regularly for a minimum of 20 seconds with soap and water.
  • Frequently washing toys of children.
  • Avoiding exposure of kids to people who are sick with the flu or a fever.
  • Maintaining cleanliness and proper hygiene.
  • Restricting sharing of goods with the people affected with the disease.
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How Contagious is RSV?

RSV spreads quickly as the disease is airborne. RSV infected individuals are typically contagious for 3 to 8 days and may become contagious up to two days prior to the onset of symptoms. Even after the symptoms of the virus have subsided, some newborns and individuals with weakened immune systems may still be contagious for up to four weeks. This is because their immune systems are less effective at eliminating the virus.


Protective Medication

The American Academy of Pediatrics (AAP) suggests giving high-risk newborns and young children a monoclonal antibody called Palivizumab (Synagis). Palivizumab is administered as an injection, and can provide protection for some newborns and kids younger than 2 years old who are at a high risk of developing significant complications from RSV. The initial injection is administered at the beginning of the RSV season, and subsequent monthly injections are administered all season. Only preventing RSV infection is helped by this drug. Once symptoms start to appear, it does not help or treat it. As an alternative, maternal immunization (MI) has been suggested. According to studies, receiving a vaccine in the final trimester of pregnancy may increase the amount of RSV antibodies that are passed from the mother to the fetus, thereby protecting the infant from RSV for the first few weeks or months of life. For instance, high-risk newborns and kids have been taken Synagis for nearly 20 years to lower the risk of RSV-related hospitalizations.

How is RSV Treated?

RSV infections often go away on their own after a week or two. However, at the current moment, no specific treatment for RSV infection are available. Researchers around the globe are working to develop vaccines and antivirals to treat this viral disease. An elderly person may require hospitalization and undergo a chronic respiratory disease treatment, if they are dehydrated or experiencing breathing difficulties. Infants under six months of age are treated similarly. In the direst situations, a patient might require additional oxygen, intravenous fluids (if they are unable to take enough food or liquids), or intubation with mechanical ventilation. However, following actions can be taken to ease the symptoms:

  • Over-the-counter painkillers and fever reducers, such as acetaminophen or ibuprofen can be used to control fever and pain.
  • To avoid dehydration, take in adequate liquids. It is very important that patients affected with RSV stay hydrated all the time.
  • Before giving your child over-the-counter cold medications, see your doctor. Some of the pharmaceutical drugs are known to have compositions that may harm children.

How is RSV Diagnosed?

There are numerous lab tests available to confirm RSV infection. Antigen detection assays and RT-PCR are both reliable ways to identify RSV infection in newborns, young children, older children, and adults. However, older children and adults may have lower virus loads in their respiratory sample, making antigen testing insensitive for them. For already infected individuals, respiratory monitoring devices are being used to monitor the health of the individuals.

What are the Complications Associated with RSV?

Respiratory syncytial virus complications include:

  • After contracting human respiratory syncytial virus (RSV), one could contract it again. It might even take place during the same RSV season. However, symptoms are frequently milder and take the guise of a normal cold.
  • Severe RSV in children may increase a child's risk of acquiring asthma in later life.
  • In babies, RSV most usually results in lung or lung airway inflammation (pneumonia or bronchiolitis). Lung inflammation can also be extremely dangerous for young children, elderly people, those with compromised immune systems, and people who have ongoing heart or lung conditions. Approximately 100,000 people die each year from complications associated with the infection.
  • In order for medical professionals to monitor and treat breathing issues and administer intravenous (IV) fluids, a severe RSV infection may necessitate a hospital stay. According to the Centers for Disease Control and Prevention RSV causes more than 50,000 hospitalizations each year.

How has RSV Affected the United States?

In the US and other nations with comparable climates, RSV circulation frequently starts in the fall and peaks in the winter. Additionally, compared to most other states, Florida suffers an earlier start and longer duration of the RSV season. Before 2020, RSV seasonal trends in the US were impressively reliable. Among the United States, RSV is the most frequent cause of bronchiolitis in children under the age of one. According to estimates, RSV infection kills 14,000 persons over 65 each year in the United States. The RSV Hospitalization Monitoring Network (RSV-NET), a population-based surveillance system, monitors hospitalizations for respiratory syncytial virus in children and adults in the US.

Government Initiatives Promoting Treatment of Respiratory Syncytial Virus

  • The United States has deployed the PEDSIDEA programme for the real-time digital surveillance of influenza and RSV disease incidence and severity. It is anticipated that the initiative will continue to closely track the clinical results of "natural" RSV and other viral respiratory illnesses in both children and adults, including individuals who are at the age extremes.
  • In support from the Bill & Melinda Gates Foundation, the World Health Organization (WHO) launched the RSV surveillance strategy Phase I under its Global Influenza Programme. This program was based on the Global Influenza Surveillance and Response System (GISRS) and was to be conducted in 14 countries globally. The program aimed at standardizing RSV surveillance and provide evidence for supporting Public Health and also inform RSV vaccination policy.

Recent Progresses Related to Respiratory Syncytial Virus

  • Pfizer announced positive top-line data from its bivalent respiratory syncytial virus (RSV) vaccine candidate's Phase 3 global maternal immunization trial. The RSV vaccine candidate from Pfizer may be the first maternal immunization to help protect young infants from this frequent and potentially fatal respiratory infection.
  • GSK plc announced that the phase III trial results for its respiratory syncytial virus (RSV) vaccine candidate was positive. This vaccine candidate was designed to treat adults aged 60 years and above. The results which displayed a cumulative vaccination efficacy of 82.6%, were to be presented at IDWeek 2022.
  • A one-dose RSV medication called nirsevimab has been approved by the European Commission, according to pharmaceutical companies Sanofi and AstraZeneca. It is an antibody created in a lab to guard newborns against RSV at their initial encounter.
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Swara Keni

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