Clinical features

The virus infects ciliated airway epithelial cells in the respiratory tract and type II pneumocytes (1).

Presentation of the infection varies depending on the patient's age and previous health status (1).

In infants:

• lower respiratory diseases, primarily, pneumonia, bronchiolitis and tracheobronchitis occurs in 25-40% of cases
  • these children will present with cough (98%), rhinorrhoea, low-grade fever (75%), cough, wheezing (65 to 78%) laboured respirations (73 to 95%), occasionally hypoxia and mild systemic symptoms
• in severe cases - tachypnoea, dyspnoea, frank hypoxia, cyanosis and apnoea may develop (2)
• wheezing and crackles may be heard on auscultation
• there may be an accompanying skin rash
• ear infections may also occur in children (3)

In adults:

• symptoms resemble those of the common cold - sore throat, cough and rhinorrhea - with malaise, headache and fever
• severe pneumonia may result, especially in the elderly or the immunocompromised

Reference:

• (1) Moore EC, Barber J, Tripp RA.Respiratory syncytial virus (RSV) attachment and nonstructural proteins modify the type I interferon response associated with suppressor of cytokine signaling (SOCS) proteins and IFN-stimulated gene-15 (ISG15). Virol J. 2008;5:116.
• (2) Dawson-Caswell M, Muncie HL Jr. Respiratory syncytial virus infection in children. Am Fam Physician. 2011;83(2):141-6.
• (3) Immunisation Against Infectious Disease - "The Green Book". Chapter 27. Respiratory syncytial virus (January 2013)