Respiratory syncytial infection in children

Respiratory syncytial infection (RS infection) is an acute viral disease with moderate symptoms of intoxication, predominantly affecting the lower respiratory tract, and frequent development of bronchiolitis and interstitial pneumonia in young children.

Epidemiology of respiratory syncytial infection

Respiratory syncytial infection is widespread and is registered all year round, but outbreaks occur more often in winter and spring. The source of infection is patients and, rarely, virus carriers. Patients excrete the virus for 10-14 days. The infection is transmitted exclusively by airborne droplets through direct contact. Transmission of infection through third parties and household items is unlikely. The susceptibility of different age groups to respiratory syncytial infection is not the same. Children under 4 months of age are relatively insensitive, since many of them have specific antibodies received from their mother. The only exception is premature babies, they do not have passive immunity and are therefore susceptible to RS infection from the first days of life. The greatest susceptibility to respiratory syncytial infection is noted at the age of 4-5 months to 3 years. At this age, all children have time to get sick with respiratory syncytial infection (especially in children's groups). In those who have recovered, specific IgA antibodies appear in the serum and discharge from the nasal mucosa. Secretory antibodies are an important factor of immunity in respiratory syncytial infection. Since acquired immunity is unstable, children may again become ill with respiratory syncytial infection upon repeated encounters with the respiratory syncytial virus. Such diseases proceed in a latent manner, but maintain the tension of specific immunity. Consequently, with the complete disappearance of specific antibodies against the respiratory syncytial virus, a manifest form of the disease occurs, and against the background of residual immunity - an latent, or inapparent, infection.

Causes of respiratory syncytial infection

The virus contains RNA, differs from other paramyxoviruses by its high polymorphism, the average particle diameter is 120-200 nm, and it is unstable in the external environment. There are 2 serovars of the virus that have a common complement-fixing antigen. The virus develops well in primary and transplantable cell lines (HeLa, Нер-2 cells, etc.), where syncytium and pseudogiant cells are formed. Unlike other paramyxoviruses, respiratory syncytial viruses have neither hemagglutinin nor neuraminidase.

Causes and pathogenesis of respiratory syncytial infection

Classification

There are mild, moderate and severe forms of respiratory syncytial infection, the course can be smooth, without complications, and with complications. In mild form, body temperature is normal or subfebrile. Symptoms of intoxication are not expressed. The disease proceeds as a catarrh of the upper respiratory tract.

In moderate cases, the body temperature is 38-39.5 °C, and the symptoms of intoxication are moderate. Bronchiolitis with respiratory failure of grades I-II is observed:

Symptoms of respiratory syncytial infection

The incubation period lasts from 3 to 7 days. Clinical manifestations of the disease depend on the age of the children.

In older children, respiratory syncytial infection usually proceeds mildly, as an acute catarrh of the upper respiratory tract, often without an increase in body temperature or with a subfebrile temperature. The general condition worsens slightly, a slight headache, slight chills, and fatigue are noted. The leading clinical symptom is a cough, usually dry, persistent, and prolonged. Breathing is rapid, with difficulty exhaling, sometimes with attacks of suffocation. Children sometimes complain of pain behind the breastbone. Upon examination, their general condition is satisfactory. Pallor and slight pastosity of the face, injection of the scleral vessels, and scanty nasal discharge are noted. The mucous membrane of the pharynx is slightly hyperemic or unchanged. Breathing is harsh, scattered dry and moist rales are heard. In some cases, the liver is enlarged. The course of the disease is up to 2-3 weeks.

Symptoms of respiratory syncytial infection

Diagnosis of respiratory syncytial infection

Respiratory syncytial infection is diagnosed based on the characteristic clinical picture of bronchiolitis with obstructive syndrome, severe oxygen deficiency at low or normal body temperature, in the appropriate epidemic situation - the occurrence of a mass uniform disease mainly among young children.

Treatment of respiratory syncytial infection

In most cases, treatment is carried out at home. Arbidol, children's anaferon, kagocel, gepon or other immunocorrective agents are prescribed, as well as bed rest, a gentle full diet, symptomatic agents, as with other ARVI. In case of obstructive syndrome, euphyllin with diphenhydramine or other antihistamines are given. Mucaltin, a mixture with marshmallow, thermopsis, sodium bicarbonate are indicated. In severe cases, hospitalization is necessary. In case of a combination of obstructive syndrome and pneumonia, antibiotics are prescribed.

Diagnosis and treatment of respiratory syncytial infection

Prevention

Early isolation of the patient, ventilation of the premises, wet cleaning with disinfectants are important. Specific prevention has not been developed. All children who have had contact with patients can be sprayed with interferon in the nose.

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