What education should be provided to patients about Respiratory Syncytial Virus (RSV) infection?

Patient Education About Respiratory Syncytial Virus (RSV)

Hand hygiene is the most important preventive measure for RSV transmission, with proper handwashing before and after contact with infected individuals or contaminated surfaces being essential for reducing spread. 1

Understanding RSV

• RSV is a highly contagious respiratory virus that causes mild to severe respiratory illness
• It's the leading cause of lower respiratory tract infections in children under one year 2
• RSV can affect people of all ages, but is particularly dangerous for:
  • Infants and young children
  • Older adults
  • Immunocompromised individuals
  • Those with underlying cardiopulmonary conditions

Transmission and Prevention

How RSV Spreads

• Direct contact with respiratory secretions
• Contaminated surfaces (fomites)
• RSV can remain viable on surfaces for several hours 1
• RSV can be detected in air samples up to 22 feet from an infected patient 1

Key Prevention Strategies

1. Hand Hygiene

   • Wash hands frequently with soap and water or use alcohol-based hand sanitizers 1
   • Hand decontamination before and after contact with patients or respiratory secretions
   • Hand washing is particularly important after touching potentially contaminated surfaces

2. Respiratory Etiquette

   • Cover mouth and nose when coughing or sneezing
   • Use tissues to contain respiratory secretions and dispose of properly
   • Wear a mask if experiencing respiratory symptoms

3. Environmental Cleaning

   • Regularly clean and disinfect frequently touched surfaces
   • Pay special attention to toys, tabletops, and other objects that may be contaminated

4. Avoid Exposure

   • Keep high-risk individuals away from people with cold symptoms
   • Avoid crowded places during RSV season (typically December-March) 1
   • Limit visits from young children to high-risk patients 3

5. Tobacco Smoke Avoidance

   • Infants should not be exposed to passive smoking as it increases RSV risk 1
   • Passive smoking increases the risk of RSV infection with a reported odds ratio of 3.87 1

6. Breastfeeding

   • Recommended to decrease a child's risk of having lower respiratory tract disease 1

Recognizing RSV Symptoms

• Fever
• Runny nose
• Cough
• Wheezing
• Difficulty breathing
• Poor feeding (in infants)
• In severe cases: bronchiolitis or pneumonia 2

Treatment and Management

• No specific treatment for RSV infection; supportive care is the mainstay 2
• Most children recover within 1-2 weeks
• For severe cases:
  • Oxygen therapy may be required
  • Hospitalization may be necessary, especially for high-risk individuals

Preventive Medications

For high-risk infants, preventive options may include:

• Palivizumab (Synagis):

  • Monthly injections during RSV season for eligible high-risk infants 4
  • Indicated for:
    • Premature infants (≤35 weeks gestational age) who are 6 months or younger at RSV season start
    • Children with bronchopulmonary dysplasia requiring medical treatment in the previous 6 months and ≤24 months of age
    • Children with hemodynamically significant congenital heart disease ≤24 months of age 4

• Newer preventive options are emerging, including long-acting monoclonal antibodies and vaccines that may provide season-long protection with fewer doses 5

When to Seek Medical Care

Advise patients to seek medical attention if:

• Breathing becomes difficult or rapid
• Skin, lips, or nail beds appear bluish
• Signs of dehydration (decreased urination, dry mouth)
• Symptoms worsen or do not improve
• High fever develops

Special Considerations for Healthcare Settings

• Isolation or cohorting of RSV-positive patients when possible 1
• Use of gloves and gowns when handling infected patients 1
• Strict hand decontamination and education of staff and families 1

By following these preventive measures and recognizing when to seek medical care, patients can help reduce the spread of RSV and minimize its impact on vulnerable populations.