What is respiratory syncytial virus

The virus respiratory syncytial (RSV) is the main cause of infection of the lower respiratory tract in the newborn babies and children under two years. It is especially related with bronchiolitis, a respiratory infection which can be very serious in younger babies.
It's a virus that is present in all countries, but circulates in the environment during coldest of the year, giving rise to typical winter respiratory infections: colds, bronchitis, bronchiolitis and pneumonia.
The respiratory system is like a tree: the trunk is airway main (trachea), which is divided into increasingly thinner branches (bronchi and Bronchioles) to lead to small twigs that end up in sacs called alveoli (the leaves of the tree), that is where the gas exchange occurs during respiration, allowing oxygen to pass into the blood.
In adults and older children, RSV infection is usually mild catarrhal symptoms, due to upper respiratory tract: low-grade fever, clear mucus, general discomfort and some cough, which are resolved in a few days and without complications.
In children under two years, and especially in infants younger than three months although it may also manifest itself only as a mild cold, yet more risk that the picture progresses and affects the lower respiratory tract resulting in the dreaded bronchiolitis. Bronchiolitis is what we call this the first respiratory infection where there is involvement of the lower respiratory tract. RSV Infection produces an inflammation of the Bronchioles (hence the name) and, consequently, there is a difficulty in the proper gas exchange.

Symptoms and diagnosis of respiratory syncytial virus

Practically all children under two years of age have been affected at some point by the virus respiratory syncytial (RSV); in the majority of cases the symptoms of RSV are mild and they resolve without complications, but there are certain risk groups that may take more serious:

• Babies under three months of age, and especially newborn babies less than a month old.
• Premature babies.
• Family smoking environment.
• Infants not fed with breast milk.
• Children with some other underlying disease: heart disease, immunodeficiency, cystic fibrosis...

Bronchiolitis starts as a slight catarrh picture that gets worse within 2-3 days: there are bouts of coughing, fever and shortness of breath and the typical presence of wheezing in the chest, known in medicine as wheezing. This is because the passage of air through the Bronchioles narrowed due to information produces a characteristic whistle, which is easily heard with the stethoscope, which is key to the diagnosis of the disease.
Due to the difficulty for the passage of air, the baby begins to breathe faster to try to compensate for the lack of oxygen (which is known as tachypnea), appearing in the typical signs of respiratory distress exploration: sinking of ribs with breathing (retractions) and use of accessory breathing muscles. If serious and progressive respiratory failure may appear bluish discoloration of the skin (cyanosis) due to the lack of oxygen.

Diagnosis of respiratory syncytial virus infection

All VRS infections begin as a catarrhal picture, so the most important is to differentiate whether infection is only high-way or there is also involvement of the lower airway, i.e. If it is progressing towards a bronchiolitis. For this purpose, the diagnosis of respiratory syncytial virus is clinical and pediatrician will be carried out during the clinical examination of the baby; the presence of wheezing (wheezing in the chest) and other signs of respiratory distress are which indicate the diagnosis.

Treatment of respiratory syncytial virus infection

There is no specific treatment for the bronchiolitis caused by respiratory virus syncytial (RSV), since to be a viral infection is not treated with antibiotics. To control your symptoms, your pediatrician will explain to parents a series of guidelines, such as:

• Maintain a position semiincorporada in the cradle, to help the baby breathe better.
• Split outlets, offering less volume, but more frequently, so that children do not get tired. It is essential to maintain breastfeeding for its protective effect, and an abundant moisturizing.
• Nasal Wash with normal saline, to facilitate the expulsion of mucus and breathing.

In the majority of cases, the respiratory syncytial virus infection does not require income and can be managed at home, showing a gradual improvement of the patient from the third or fourth day of evolution. In total, the picture tends to last between a week and ten days, although residual cough can keep even weeks.
In the case of the newborn babies, very young infants, or those who present much difficulty breathing with need to administer oxygen, will require hospital admission. If evolution is unfavourable may require intubation and mechanical ventilation by means of artificial respiration, but in the majority of cases the RSV infection heal without sequelae.
Although the evolution is usually favorable, babies who have a bronchiolitis VRS are more likely to have during childhood bronchial hyper-reactivity, i.e., episodes of wheezing with colds, which usually send before reaching adolescence.

Prevention of respiratory syncytial virus infection

The virus respiratory syncytial (RSV) it is very contagious and is transmitted mainly through respiratory secretions by air (coughing, sneezing...) and contaminated surfaces.
Due to its high contagiousness, every winter tend to have epidemics in day-care centres, since they are small rooms in which children share a same environment.
Frequent handwashing and not sharing utensils for eating and drinking are fundamental guidelines to prevent contagion, although many times it is difficult to avoid.
Some basic measures to prevent respiratory syncytial virus infection are:

• Hand hygiene: is the fundamental measure.
• Avoid tobacco smoke.
• Encourage breastfeeding, more so even in infants who are born during the epidemic (winter months).
• Avoid contact of the newborn infants with people who have colds symptoms, or make that they wash their always hands before touching your baby.
• Avoid the nursery in the months of the epidemic, if it is that family could afford it.

There is no vaccine against RSV - they seem to have found an effective vaccine, but is still in experimental phase - even though babies are considered (especially the large premature) risk group, can receive monthly during the epidemic a monthly dose of an antibody that blocks the VRS, and thus prevents its spread (Palivizumab).

Article contributed for educational purposes