Respiratory Syncytial Virus

It is also transmitted when an infected person touches their eyes or nose and touches another person or contacting surface.
RSV infection can spread within families, and outbreaks have occurred in schools and day care centers. According to Goldrick, "The incubation period for RSV infection is typically four to six days but may be as short as two or as long as eight days. children may shed the virus for two to three weeks" (54). Infection usually results in a mild cough and cold like symptoms as the virus infects the upper respiratory tract. When the infection spreads to the lower respiratory tract, it can result in difficult breathing, wheezing, bronchiolitis, and pneumonia.
Diagnosis is based on observing the symptoms and may be confirmed by isolation and examination of RSV secretions, sputum or throat swabs. "Rapid diagnosis may be made by immunofluorescence techniques, enzyme immunoassays, or rapid chromatographic immunoassays" (Pruitt 63). If a patient tests positive for RSV, it should delay inappropriate antibiotic therapy.
Mild infections may resolve without the need for treatment. However, severe infections, especially in children and infants, "may require hospitalization to provide supplemental oxygen, humidified air, and hydration by intravenous fluids" (Goldenring). Nebulised and subcutaneous adrenaline have been effective in improving oxygenation and have shown positive clinical signs as compared to a placebo (Stack 80). However, according to Stack, "There is no convincing evidence to recommend the use of bronchodilators, corticosteroids or antibiotics" (80). Ribavirin, an anti-viral agent, may help prevent ventilation in this group of patients when administered through nebulisation. Breathing an oxygen and helium mixture (helox) may relieve the burden of heavy breathing in the patient (Pruitt 64). The RSV patient should be isolated in a private room and with equipment dedicated to the infected person. To aid in the prevention of the spread of RSV, prevent people who exhibit symptoms of respiratory infection from "visiting pediatric, immuno-compromised, or cardiac patients" (Pruitt 64).
RSV infection rarely causes death in infants and young children who seek early treatment. In older children and adults, the symptoms are usually mild and recovery is complete. However, according to Goldenring, "There is evidence suggesting an increased incidence of asthma in children who have developed RSV bronchiolitis". The mechanism is unknown as to whether a predisposition to asthma also presented a predisposition for developing bronchiolitis as a child or if the RSV induced bronchiolitis predisposed the child for asthma (Goldenring).
Works Cited
Goldenring, John. "Respiratory Syncytial Virus (RSV)." Medical Encyclopedia. 23 Aug. 2005. American Accreditation HealthCare Commission. 8 Apr. 2007 .
Goldrick, Barbara A. "Respiratory Syncytial Virus: Children Aren’t the Only Ones at Risk." American Journal of Nursing 104.11 (2004): 54-56. EBSCO. 8 Apr. 2007.
Pruitt, Bill. "Keeping Respiratory Synctial Virus at Bay." Nursing 35.11 (2005): 62-64. EBSCO. 8 Apr. 2007.
Stack, C. G. Essentials of Pediatric Intensive Care. London, GBR: Greenwich Medical Media Limited,