RSV - Understanding the Virus

The Pathogen

RS virus is an RNA virus of the Pneumoviridae family (genus Orthopneumovirus), which has a bilayer lipid envelope in which glycoproteins are present, consisting of a fusion and an adhesion (G) protein. In general, two groups of the RS virus are distinguished: A and B. These two groups differ in the antigenic structure of the G protein. Both groups of the virus strain circulate simultaneously, but RSV A predominates in most years.

The respiratory syncytial virus is a worldwide pathogen of acute upper and lower respiratory tract diseases and affects both young and adult patients. However, it is considered a common cause of respiratory infections in infants, especially in premature infants and young children. In terms of its seasonality and symptoms, RSV infection is particularly similar to common influenza.

For more information on respiratory syncytial virus, visit the official website of the UK Health Security Agency. Learn more here.

Transmission Route

The most common transmission of infection is via droplet infection from an infected and contagious person to another contact person. The nasal mucous membranes and conjunctiva are the main entry points.

Indirect transmission via surfaces, objects and contaminated hands cannot be ruled out as a route of transmission either. In respiratory secretions, the RS virus can survive on the hands for 20 minutes. It lasts up to 45 minutes on paper towels and cotton gowns, while it can survive for several hours on disposable gloves, stethoscopes and plastic surfaces. Therefore, medical staff in particular can contribute to a rapid, even nosocomial spread as soon as hygiene measures are incomplete.

Incubation Period & Contagiousness

The incubation period is 2-8 days. As early as one day after infection and even before the onset of symptoms, it is possible for RSV-infected persons to be infectious. As a rule, infected persons are considered contagious for 3 to 8 days. In immunocompetent patients, the symptoms usually subside within a week. Premature babies, newborns, immunodeficient or immunosuppressed patients, on the other hand, can excrete the respiratory syncytial virus for several weeks, in rare cases even for months.

Clinical Symptoms of Respiratory Syncytial Virus (RSV) Infection

Depending on the severity of the infection, the virus can show symptoms of a common respiratory tract infection up to a lower respiratory tract disease requiring ventilation but can also be asymptomatic in individual cases. Primary infections with the virus show clear clinical symptoms in most cases. Especially in infants in the first months of life, the infection manifests as bronchitis, pneumonia or tracheobronchitis.

• Flu-like symptoms like cold, fever & sore throat
• Coughing and wheezing, up to shortness of breath
• Accelerated breathing (with involvement of the lower respiratory tract)
• Rattling noises when breathing
• Cold and pale skin

Diagnostics

As with many other infectious diseases, anamnesis including clinical symptoms and age also plays a vital role in RSV diagnostics. In particular, the physical examination (illumination of the nasopharynx and ears, palpation of the lymph nodes in the neck and listening to the lungs with a stethoscope) can provide further clues to the severity of the infection.

However, to be able to reliably diagnose an infection with respiratory syncytial virus (RSV), it is necessary to detect the pathogen. Since detection should take place promptly in order to effectively prevent nosocomial RSV infections and to be able to initiate therapeutic measures as quickly as possible, it is recommended that a immunographic rapid test is performed. The rapid test provides  results within a few minutes. Thus, a preliminary diagnosis can quickly be made at the doctor's surgery. To confirm this result, detection of the pathogen by PCR/NAT is recommended. In our shop, you will find rapid RSV tests from various manufacturers for the detection of RSV virus antigens in swab samples within only 10 to 15 minutes.