What is respiratory syncytial virus?

The respiratory syncytial virus, also known as RS virus or RSV for short, is a virus that leads to fusions of cells in the respiratory tract, i.e. the respiratory tract. The pathogen is very similar to the influenza virus and is spread all over the world . The respiratory syncytial virus causes seasonally clustered outbreaks of the disease. Most people fall ill, in Europe, between November and April. However, the most frequent outbreaks occur in January and February.

Who is most commonly affected by respiratory syncytial virus?

All people, regardless of age, can get sick due to RS virus, but young children are particularly often affected. About 50-70% of all children become infected with RS virus in the first year of life. Almost all children have had an RSV infection at least once after the second year of life.

In addition, an infection with this virus is the most common reason why babies or even infants have to be treated in hospital due to illnesses in the respiratory tract . Premature babies and small babies are particularly at risk. The disease can take a severe course in them. In premature babies who suffer from lung damage or heart defects, an infection with the virus is even fatal in one out of 100 cases .

In adults, however, an infection with the respiratory syncytial virus usually leads to an uncomplicated and mild infection of the upper respiratory tract. Many infected people do not show any symptoms at all, which is why an infection with the virus often remains undetected in adults. In pregnant women, the virus can be transmitted from mother to unborn child.

How is respiratory syncytial virus transmitted?

The RSV is highly contagious. People who become infected with the virus can infect other people just one day later. This means even before the first symptoms are noticeable. This is because the incubation period is two to eight days.

The RS virus is transmitted by:

Droplet infection:

When sneezing, coughing or talking, tiny droplets of saliva containing the virus are released into the environment. If these droplets come into contact with the nasal mucosa or the eye conjunctiva of someone who is still healthy, there is a very high risk that they too will fall ill.

Smear infection:

Transmission is also possible through smear infection via contaminated clothing or toys. According to experts, the virus can survive on hands for about 20 minutes, on clothes for about 45 minutes and on plastic surfaces even for several hours.

What are the symptoms of respiratory syncytial virus?

The symptoms of an infection with RSV vary from person to person . People who have no other illnesses often have no symptoms at all. In other cases, there are symptoms similar to a cold, such as:

• Slightly elevated body temperature,
• Runny nose,
• Dry cough,
• Sore throat.

If RSV bronchiolitis occurs in babies and small children, which in addition to the upper respiratory tract also affects the lower respiratory tract, or more precisely, the branches of the bronchial tree, the following symptoms occur:

• High fever,
• Accelerated breathing,
• Audible wheezing and rattling when breathing,
• Coughing with sputum,
• Difficulty breathing, including use of accessory muscles,
• Shortness of breath,
• Cold, dry and pale skin,
• Blue discolouration of mucous membranes and/or skin due to lack of oxygen,
• In children under 18 months, sunken fontanel.

As accompanying symptoms, lack of strength, lack of appetite, refusal to drink and a general feeling of illness are often mentioned. In general, the entire clinical picture of such bronchiolitis is reminiscent of whooping cough.

How is respiratory syncytial virus diagnosed?

If a child suffers from flu-like symptoms, high fever and/or shortness of breath, a paediatrician should always be consulted. RSV is only very difficult to distinguish from other viral respiratory diseases. Not only the clinical examination helps the doctor to make a diagnosis , but above all a detailed description of the symptoms and the age of the patient.

After the doctor has carried out a clinical examination with auscultation, a laboratory examination is usually ordered . In a smear of the nasopharyngeal secretion, RS viruses can be detected beyond doubt. Only in exceptional cases is it possible to detect antibodies in the blood because the body only produces a few antibodies against the virus.

How is respiratory syncytial virus treated?

There is currently no causal therapy against the RSV, therefore only the symptoms can be treated. The following measures are usually recommended by a doctor, :

• Sufficient intake of fluids,
• Keeping the upper body elevated makes it easier to breathe,
• Nasal drops or nasal rinses with saline,
• Calf compresses,
• Inhalation.

For high fever, ibuprofen or paracetamol are usually prescribed. For severe rhinitis, a decongestant nasal spray can provide relief . The use of bronchodilators, for example salbutamol, should provide relief from breathing by widening the airways. These are delivered directly to the place where they are needed with the help of an inhaler.

In severe cases, adrenaline is administered via an inhaler. The administration of cortisone only makes sense systemically, i.e. as a tablet, because cortisone administered as inhalation has no effect on the RS virus . If the level of oxygen in the blood of the affected person becomes too low, ventilation becomes necessary. This is done in a hospital via a respirator mask.

How can respiratory syncytial virus be prevented?

The most efficient and important measures consist of careful hygiene, in public life, but also within the family. The following measures can help contain the spread of RSV.

• Wash your hands regularly, or even better, disinfect them.
• Cough and sneeze only into the crook of the elbow and not into the hands.
• Children's toys should be cleaned regularly.
• Children with the disease should not visit community facilities such as day-care centres or schools.
• Smoking should be avoided, especially around children.

There is no active vaccination against RSV, but there is a passive vaccination for children with risk factors. Specifically, such vaccination is recommended for the following children:

• Premature infants born before 35 weeks gestation.
• Premature children with lung diseases or heart defects.
• Children under the age of two who have a lung disease or heart defect.