Respiratory syncytial virus - Revision history

Aidan at 15:29, 9 February 2026

2026-02-09T15:29:22Z

← Older revision		Revision as of 15:29, 9 February 2026
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	== Background ==		== Background ==
	=== Microbiology ===		=== Microbiology ===
	* ~~Single~~-~~stranded,~~ ~~enveloped~~ RNA virus in the [[Family::Pneumoviridae]] ~~subfamily of the Paramyxoviridae~~ family		* Enveloped [[Baltimore classification::(-)ssRNA virus\|Negative-sense single-stranded RNA virus]] in the [[Family::Pneumoviridae]] family
	* Two antigenic groups, A and B		* Two antigenic groups, A and B

Aidan: /* Outcomes and sequelae */

2023-01-09T19:19:36Z

Outcomes and sequelae

← Older revision		Revision as of 19:19, 9 January 2023
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	* Hypoxia necessitates hospitalization, and may fluctuate, and can also have apnea		* Hypoxia necessitates hospitalization, and may fluctuate, and can also have apnea

	==== Outcomes and ~~sequelae~~ ====		==== Outcomes and Sequelae ====
	* Cough may last for 4 or more weeks, despite resolution of the infection		* Cough may last for 4 or more weeks, despite resolution of the infection
	* Recurrent infections are common		* Recurrent infections are common

Aidan at 12:45, 14 August 2020

2020-08-14T12:45:10Z

← Older revision		Revision as of 12:45, 14 August 2020
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	== Background ==		== Background ==
	=== Microbiology ===		=== Microbiology ===
	* Single-stranded, enveloped RNA virus in the Pneumoviridae subfamily of the Paramyxoviridae family		* Single-stranded, enveloped RNA virus in the [[Family::Pneumoviridae]] subfamily of the Paramyxoviridae family
	* Two antigenic groups, A and B		* Two antigenic groups, A and B

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	** Can be considered in patients up to 24 months old if they are still on home oxygen, have had a prolonged hospitalization for severe pulmonary disease or are severely immunocompromised		** Can be considered in patients up to 24 months old if they are still on home oxygen, have had a prolonged hospitalization for severe pulmonary disease or are severely immunocompromised

	[[Category:~~RNA viruses~~]]		[[Category:Pneumoviridae]]

Aidan: Text replacement - "([Ss])olid-organ" to "$1olid organ"

2020-08-07T00:35:00Z

Text replacement - "([Ss])olid-organ" to "$1olid organ"

← Older revision		Revision as of 00:35, 7 August 2020
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	* More common in people who work with children and military recruits living in barracks		* More common in people who work with children and military recruits living in barracks
	* Highest risk for severe disease includes the elderly, patients with COPD, and immunocompromised patients		* Highest risk for severe disease includes the elderly, patients with COPD, and immunocompromised patients
	* Immunocompromised patients include solid-organ and hematologic transplant patients and those on chemotherapy		* Immunocompromised patients include solid organ and hematologic transplant patients and those on chemotherapy
	** Much higher mortality		** Much higher mortality
	** '''[[Bronchiolitis obliterans syndrome]]''' can be a complication in lung transplant patients with RSV pneumonia		** '''[[Bronchiolitis obliterans syndrome]]''' can be a complication in lung transplant patients with RSV pneumonia
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	** Monitor for development of bacterial superinfection		** Monitor for development of bacterial superinfection
	* Hospitalized children may benefit from inhaled [[Is treated by::ribavirin]], though the benefit is unclear		* Hospitalized children may benefit from inhaled [[Is treated by::ribavirin]], though the benefit is unclear
	* In high-risk patients with hematologic malignancies, hematologic transplants, or solid-organ transplants, treat with [[Is treated by::ribavirin]]		* In high-risk patients with hematologic malignancies, hematologic transplants, or solid organ transplants, treat with [[Is treated by::ribavirin]]
	* In the highest-risk group of patients, those with allogeneic stem cell transplantation who present with pneumonia, add [[Is treated by::IVIg]]		* In the highest-risk group of patients, those with allogeneic stem cell transplantation who present with pneumonia, add [[Is treated by::IVIg]]

Aidan: /* Clinical Manifestations */

2020-08-05T13:56:15Z

Clinical Manifestations

← Older revision		Revision as of 13:56, 5 August 2020
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	== Clinical Manifestations ==		== Clinical Manifestations ==
	* Incubation period of 3 to 5 days (up to 8)		* Incubation period of [[Usual incubation period::3 to 5 days]] ([[Incubation period range::up to 8 days]])

	=== Children ===		=== Children ===

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-19T13:45:44Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 13:45, 19 July 2020
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	* Infection does not generate persistent immunity		* Infection does not generate persistent immunity

	== Clinical ~~Presentation~~ ==		== Clinical Manifestations ==
	* Incubation period of 3 to 5 days (up to 8)		* Incubation period of 3 to 5 days (up to 8)

Aidan: /* Prevention */ added criterion

2019-11-07T16:42:49Z

Prevention: added criterion

← Older revision		Revision as of 16:42, 7 November 2019
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	** Preterm infants born before 30+0 weeks’ GA who are <6 months of age at the start of RSV season, it is reasonable (but not essential) to offer palivizumab		** Preterm infants born before 30+0 weeks’ GA who are <6 months of age at the start of RSV season, it is reasonable (but not essential) to offer palivizumab
	** Infants in remote communities who would require air transportation for hospitalization born before 36+0 weeks’ GA and <6 months of age at the start of RSV season should be offered palivizumab		** Infants in remote communities who would require air transportation for hospitalization born before 36+0 weeks’ GA and <6 months of age at the start of RSV season should be offered palivizumab
			** Can be considered in patients up to 24 months old if they are still on home oxygen, have had a prolonged hospitalization for severe pulmonary disease or are severely immunocompromised

	[[Category:RNA viruses]]		[[Category:RNA viruses]]

Aidan: /* Adults */ typo

2019-11-07T11:32:07Z

Adults: typo

← Older revision		Revision as of 11:32, 7 November 2019
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	* Immunocompromised patients include solid-organ and hematologic transplant patients and those on chemotherapy		* Immunocompromised patients include solid-organ and hematologic transplant patients and those on chemotherapy
	** Much higher mortality		** Much higher mortality
	88 '''[[Bronchiolitis obliterans syndrome]]''' can be a complication in lung transplant patients with RSV pneumonia		** '''[[Bronchiolitis obliterans syndrome]]''' can be a complication in lung transplant patients with RSV pneumonia

	== Diagnosis ==		== Diagnosis ==

Aidan: /* = Outcomes and sequelae */ typo

2019-11-07T11:31:56Z

= Outcomes and sequelae: typo

← Older revision		Revision as of 11:31, 7 November 2019
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	* Hypoxia necessitates hospitalization, and may fluctuate, and can also have apnea		* Hypoxia necessitates hospitalization, and may fluctuate, and can also have apnea

	==== Outcomes and sequelae ===		==== Outcomes and sequelae ====
	* Cough may last for 4 or more weeks, despite resolution of the infection		* Cough may last for 4 or more weeks, despite resolution of the infection
	* Recurrent infections are common		* Recurrent infections are common

Aidan: Major revision

2019-11-07T11:31:45Z

Major revision

← Older revision		Revision as of 11:31, 7 November 2019
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			== Background ==
			=== Microbiology ===
			* Single-stranded, enveloped RNA virus in the Pneumoviridae subfamily of the Paramyxoviridae family
			* Two antigenic groups, A and B

			=== Epidemiology ===
			* Worldwide distribution
			* In Canada and US, more common in late fall to early spring, but can occur at any time
			* Most common cause of bronchiolitis in children
			* Spread via droplets, either person-to-person or via fomites
			** Typically inoculated into respiratory or ocular mucosa rather than inhaled
			* Infection does not generate persistent immunity

			== Clinical Presentation ==
			* Incubation period of 3 to 5 days (up to 8)

			=== Children ===
			* Generally starts with an upper respiratory tract infection ± fevers and [[otitis media]]
			* Then can progress to [[bronchiolitis]], [[pneumonia]], [[tracheobronchitis]], and, rarely, [[croup]]
			** Highest risk for lower respiratory infections are with the first infection, age less than 6 months, and underlying cardiac or lung disease
			** Highest risk for requiring hospitalization is premature infants and those with chronic lung disease, congenital heart disease, immunosuppression, and neuromuscular disease
			* Wheezing and increased work of breathing are common and cough becomes prominent
			* Bronchiolitis may involve inspiratory and expiratory obstruction
			* Hypoxia necessitates hospitalization, and may fluctuate, and can also have apnea

			==== Outcomes and sequelae ===
			* Cough may last for 4 or more weeks, despite resolution of the infection
			* Recurrent infections are common
			* May have persistent wheezing into adolescence

			=== Adults ===
			* More common in people who work with children and military recruits living in barracks
			* Highest risk for severe disease includes the elderly, patients with COPD, and immunocompromised patients
			* Immunocompromised patients include solid-organ and hematologic transplant patients and those on chemotherapy
			** Much higher mortality
			88 '''[[Bronchiolitis obliterans syndrome]]''' can be a complication in lung transplant patients with RSV pneumonia

			== Diagnosis ==
			* Most often with PCR
			* Serology not generally helpful

	== Management ==		== Management ==
			* Supportive care
	* In high-risk patients, can treat with [[Is treated by::ribavirin]] ± [[Is treated by::IVIg]]
			** Can use puffers and steroids for bronchiolitis with wheezing, but not clear that they are helpful in children
			** Monitor for development of bacterial superinfection
			* Hospitalized children may benefit from inhaled [[Is treated by::ribavirin]], though the benefit is unclear
			* In high-risk patients with hematologic malignancies, hematologic transplants, or solid-organ transplants, treat with [[Is treated by::ribavirin]]
			* In the highest-risk group of patients, those with allogeneic stem cell transplantation who present with pneumonia, add [[Is treated by::IVIg]]

			=== Prevention ===
			* [[Palivizumab]] is indicated for some high risk groups of infants in order to prevent severe disease[[CiteRef::robinson2015pr]]
			** Children with hemodynamically significant CHD or CLD if they are <12 months of age at the start of RSV season
			** Preterm infants born before 30+0 weeks’ GA who are <6 months of age at the start of RSV season, it is reasonable (but not essential) to offer palivizumab
			** Infants in remote communities who would require air transportation for hospitalization born before 36+0 weeks’ GA and <6 months of age at the start of RSV season should be offered palivizumab

	[[Category:RNA viruses]]		[[Category:RNA viruses]]