Respiratory syncytial virus, or RSV, is a respiratory virus that infects the lungs and breathing passages. Although it can affect anyone, RSV is generally considered as the most frequent cause of lower respiratory tract infections in infants and young children. Each year about 125,000 infants are hospitalized with RSV in the United States. For more information on this infection, please visit: http://www.cdc.gov/rsv/.
- AAP Interim Guidance for Use of Palivizumab Prophylaxis (9/23/2021)
- Updated AAP Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus
- AAP Guidance on the Prevention of RSV in High Risk Infants (from Red Book)
- RSV Information for Healthcare Professionals (CDC)
General RSV Information
RSV, or respiratory syncytial virus, is a very common cause of respiratory infections in infants and children. In the US, RSV season occurs most often in the winter, while it can occur year round in tropical climates. RSV typically starts like other viral upper respiratory infections, but can evolve to more severe lower respiratory infection or viral pneumonia – seen most commonly with primary infection in infants. RSV can cause infection repeatedly over the first few winters of life, as well as cause URI’s in older persons, but recurrent RSV infection is usually mild. RSV lower respiratory infection sometimes results in transient dyspnea requiring support with oxygen and IV fluids in some infants. It can result in severe disease with respiratory failure in a few infants, especially those with chronic lung disease from prematurity, or with hemodynamically significant congenital heart disease.
Though there is not an effective vaccine to prevent RSV infection at present, there are means to create passive immunity with the use of anti-RSV antibodies. These methods have evolved over the years from high titer anti-RSV IVIG to monoclonal anti-RSV antibody given IM. This prophylaxis is given to high risk infants monthly during the time they are most at risk for severe RSV disease. In 2009, The AAP refined guidelines for prevention of RSV in high risk infants.
In the US, RSV season usually starts in mid-November, and prophylaxis is usually started November 1st. However, it is important to note that the start of RSV season can vary based on geographic location and may not be consistent across seasons – as is often the case in Texas. In many regions in the state, RSV activity starts in October - making October 1st a reasonable date to start prophylaxis in parts of Texas. Variation in the timing of the RSV season may be related to temperature and humidity.
Parent Resource - AAP HealthyChildren.org: RSV: When It's More Than Just a Cold
To get more info or register for RSV alerts, please visit www.rsvtexas.org. The most recent Texas data can be found at https://www.dshs.texas.gov/IDCU/disease/rsv/Data.doc.
Please direct questions or suggestions to Dr. Manju Gaglani, MBBS, FAAP, FIDSA, FPIDS, McLane Children’s Baylor Scott & White Health, 254-935-5047, firstname.lastname@example.org, or Alix Bronner, Texas Pediatric Society, email@example.com, 512-370-1509.