RSV, Virus

RSV Diagnosis and Supportive Care

Testing for RSV is key for diagnosis1,2

RSV, Patient

Diagnosis in primary care is usually based on symptoms and local epidemiology3
RSV is under-diagnosed and under-reported in adults, in part because:

  • Symptoms of RSV may be indistinguishable from those of other respiratory infections1
  • Laboratory diagnosis of viral respiratory infections in adults is not routine practice4a

Different laboratory tests are available to confirm RSV infection:1,2

RSV, PCR, Testing

RNA detection by RT-PCR1,2

  • Excellent sensitivity and specificity
  • Useful for older children and adults with lower viral loads in respiratory secretions
RSV, Antigen, Testing

Antigen detection by ELISA or immunofluorescence1,2

  • Most reliable in young children in whom these tests have sensitivity of around 80–90%
  • Less useful in older children and adults due to low viral loads
RSV, Testing

Culture isolation1,2

  • Time consuming (3–5 days) and requires skilled personnel
  • Generally reliable in young children
  • Less useful in older children and adults (due to lower viral loads)

Currently no specific treatments for RSV are available for adults5

The mainstay of therapy for acute infection is supportive care5-7

RSV, Virus

Mild infection

Most RSV infections resolve without clinical complications within 1 or 2 weeks5,7

Maintenance of hydration and managing symptoms with over-the-counter medications5

RSV, Virus

Severe infection

Supplemental oxygen or mechanical ventilation5-7

Maintenance of hydration, using nasogastric or intravenous fluids when needed7,8

(Bronchodilators, corticosteroids and antibiotics are not routinely recommended7,8)

Abbreviations

AE, adverse effect; ELISA, enzyme-linked immunosorbent assay; FDA, Food and Drug Administration; LRTI, lower respiratory tract infection; PCR, Polymerase chain reaction rRT-PCR, real-time reverse-transcription PCR; RSV, respiratory syncytial virus

References

  1. Henrickson KJ, Hall CB. Pediatr Infect Dis J 2007;26:S36–S40
  2. CDC, 2020. RSV – Information for healthcare professionals. https://www.cdc.gov/rsv/clinical/index.html Accessed August 2022
  3. Mayo Clinic, 2021. RSV diagnosis and treatment. https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/diagnosis-treatment/drc-20353104?p=1 Accessed August 2022
  4. Branche AR, Falsey AR. Drugs Aging 2015;32:261–269
  5. Lee N et al. J Infect Dis 2019;220:969–979
  6. CDC. RSV – Prevention. https://www.cdc.gov/rsv/about/prevention.html Accessed August 2022
  7. CDC. RSV – Symptoms and care. https://www.cdc.gov/rsv/about/symptoms.html Accessed August 2022
  8. Nam HH, Ison MG. BMJ 2019;366:l5021
  9. Smith DK et al. Am Fam Physician 2017;95:94–99
  10. Ralston SL et al. Pediatrics 2014;134:e1474–e1502
  11. FDA. Respiratory syncytial virus infection: developing antiviral drugs for prophylaxis and treatment. https://www.fda.gov/media/108437/download Accessed August 2022