Respiratory syncytial virus (RSV) is a single stranded RNA paramyxovirus, which
is the same family as para-influenza, measles and rubella.
Although in most case symptoms resemble the common cold, RSV can cause a severe
or life threatening disease, especially in younger infants. Infection does not confer
immunity however and continual re-infection throughout life is common. RSV is also
increasingly recognised as a major contributor to excess winter mortality in the
elderly in temperate climates, such as the UK. RSV outbreaks occur on a yearly basis
(in the UK with a striking seasonality at the turn of the year).
Highly contagious, RSV transmission occurs by contact with infectious secretions
via hand contamination and self-inoculation of the eyes, nose or mouth or contact
with large droplets or aerosols or fomites.
Surveillance in Scotland
Surveillance information is based on the numbers of laboratory reports to HPS, which
come for the most part from hospitalised patients.
Trends in Scotland (1995-2000)
RSV outbreaks have occurred repeatedly at the turn of the year in all recent winter
seasons. The numbers of cases reported normally rise sharply to over 600 in the
first 4 weeks of the new year and fall just as quickly thereafter. The 1999/2000
season was a particularly severe outbreak with over 800 cases per month at its peak.
Incidence and Risk
As the most common respiratory pathogen in infants and young children, RSV affects
virtually all children by the age of 2 years. Most at risk of complications are
very young infants, those with predisposing conditions and the elderly. Nosocomial
outbreaks in paediatric areas or nurseries can be a major problem.
Of the two available protective agents, Synagis (a monoclonal antibody) is the most
effective and is hospital administered monthly, by intramuscular (IM) injections.
With treatment with this drug being extremely expensive, prevention is recommended
only for very young infants and children at high risk from the disease.