RS virus

RSvirus, also known as RSV (Respiratory Syncytial Virus), is among the most common aetiological agents causing respiratory diseases in infants and young children. Infection with the virus is widespread - it is estimated that nearly 95% of children will be exposed to RS virus before the age of two.

The RS virus belongs to the family known as Paramyxoviridae. Viruses in this family are characterised by the fact that they have single-stranded RNA in their genome located in a protein envelope. RS viruses have special surface proteins that facilitate virus entry into the cell and subsequent penetration of the host cell. Glycoproteins located on the surface of the envelope have strong immunogenic properties. So far, scientists have distinguished two types of RS virus - type A and type B.

Route of infection

For the majority of viruses, RS infection occurs via the droplet route - most commonly through contact with a sick person. Infection can also occur through contact with objects that have been contaminated with secretions from the respiratory tract of the sick person. The route of infection through which the viruses enter is the nasal mucosa and most likely the conjunctiva. Virus incubation is 2-8 days. Excretion of the virus with the faeces takes about 8 days, although immunocompromised people can excrete the virus with their faeces for up to 4 weeks, according to scientific publications. Premature babies and children suffering from heart defects or cystic fibrosis are the most vulnerable to the side effects of exposure to the virus. The most severe cases described have been reported in children before the age of six months. Interestingly, severe cases have also been observed in children whose bodies synthesised high levels of antibodies following administration of the inactivated vaccine. It is therefore possible that RS virus infection has an immunological basis. Virus cultures under laboratory conditions are unfortunately characterised by relatively long waiting times for test results, and are therefore not commonly used in many diagnostic laboratories. Importantly, RS virus infection in young children does not always result in an increase in IgG titres, hence a titer test is not always authoritative in this case.

High-risk groups

Groups at high risk of contracting the disease after contact with RS virus include :

premature babies,
children with low birth weight,
children with bronchopulmonary dysplasia, congenital heart disease or immunodeficiency.

Clinical manifestations

Clinical signs of RS virus infection in infants and young children include :

dyspnoea,
wheezing,
progressive cyanosis,
periods of apnoea,
drowsiness,
irritability,
vomiting.

Treatment options

The treatment modality depends primarily on the age of the patient. In premature babies born before 32 weeks of gestation, lower respiratory tract infection is extremely dangerous, usually ending in hospitalisation in intensive care.

photo: panthermedia

Diagnosis

RS virus diagnostic tests are best performed during the illness season, i.e. from October to April, and in patients with sudden symptoms suggestive of infection. RSV testing involves culturing the virus and testing its genetic material. If the test is positive, it means that the patient is infected with RS virus. A positive culture or test of the genetic material of the virus can confirm the presence of the virus in the environment. Importantly - a positive result will not unequivocally indicate to the doctor what type of symptoms the patient will experience. A positive test result indicates unequivocally that the patient is ill and treatment therapy should be implemented. A negative test result may mean that the patient is not infected with RS or that the sample was not collected correctly. Methods used in laboratory diagnosis for RSV detection include immunofluorescence, immunoenzymatic techniques, determination of viral RNA by PCT in epithelial cells collected from the upper respiratory tract or nasopharyngeal/tracheal lavage.

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Who is entitled to reimbursement from the National Health Fund

The prophylaxis promoted by the National Health Fund assumes that premature babies and children at risk, for the prevention of RS infection, should receive 5 doses of palivizumab at monthly intervals, starting in October. Immunization with palivizumab is carried out once, and the eligibility criteria for children for immunotherapy are :

children before the age of 1 year, born between 28 and 32 weeks of gestation,
children with bronchopulmonary dysplasia,
children with certain heart defects.

Prophylaxis

The RS virus is present in Poland from November to April, hence it is recommended that children in the risk group receive 5 doses of the preparation that protects them against the disease. Unfortunately, at the moment, in spite of the fact that the extended programme for prevention of RS virus infection has been in operation since 1 March this year, there are no funds for financing immunization preparations and protecting children against the disease. According to media reports, at present, despite statutory reimbursement, immunization is only provided to children in three provinces - Świętokrzyskie, Kujawsko-pomorskie and Lubelskie.

Prophylaxis is therefore a key means of defence against infection. It is recommended to avoid human clusters, increase the frequency of hand washing, frequent airing of rooms, taking care of hygiene.

way4cure.com

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