Respiratory Syncytial Virus was first detected as a Coryza Virus causing symptomsof the common cold in chimpanzees in the fifties. In 1957 the virus was found inchildren and over the years to come it was established as the most common viruscausing Respiratory Tract Illness in the western world.
It is now known as a non-segmented single stranded RNA belonging to theParamyxoviridae. RSV causes illness in people of all ages, with symptoms varyingfrom light URTI to severe illness and death, depending on age and predisposition,following a classic epidemical pattern with peaks in wintertime.
Children 2-4 months are at the greatest risk of developing bronchiolitis, withsymptoms of URTI followed after 2-3-days by LRTI with wheeze, tachypnoe, forcedrespiration and fever. Some develop a tendency for apnoe and may need respiratorysupport, some may die. Premature children, cildren with chronic lung disease(formerly BPD), congenital heart disease and immunodeficiency are at a particularrisk of becoming very ill. Some of these may develop pneumonia rather than bronchiolitis.
The basic principle for treating RSV bronchiolitis has been basic support with air,fluids and mechanical ventilation when needed. Nebulisated salbutamol and racemicadrenalin are also indicated, alongside ribavirin for children with immunosuppresionand congenital heart disease. IGIV or Palivizumab may be given prophylactic.
A connection between RSV bronchiolitis and future airway disease is established.Many studies try to reveal the connection: is it a immunological predisposition? Anallergic predisposition? A structural error? A conclution remains to be found.