RSV Flashcards
What is your opening statement for RSV?
RSV is a nationally notifiable, vaccine-preventable disease caused by one of two RSV subtypes. It is transmitted primarily through respiratory droplets and the typical clinical presentation is bronchiolitis in children and pneumonia in adults. The maternal RSV vaccine (Abrysvo) is free under the NIP while nirsevimab (Beyfortus) is state/territory funded.
Is RSV nationally notifiable?
Yes
What is the RSV infectious agent?
RNA virus with two major subtypes (RSV A, RSV B)
What are the clinical features of RSV?
- Fever
- Rhinorrhoea
- Sore throat
- Cough
- Otitis media
Babies under 6mo: wheezing, dyspnoea, irritability, poor feeding
What are the complications of RSV?
- Pneumonia
- Acute respiratory distress
- CCF
- Myocarditis (rarely)
- Seizures / encephalopathy (< 1%)
- Exacerbation of chronic conditions
What is the public health importance of RSV?
Leading cause of LRTI in young children and older adults.
Aboriginal/Torres Strait Islader children - 2x rate of RSV-associated hospitalisations.
Epidemiology: when do seasonal outbreaks of RSV occur?
Autumn and winter
(peaks April and July)
Epidemiology: what proportion of children have had RSV infection by 2 years?
Almost all children.
How is RSV transmitted?
Person-person transmission through respiratory droplets, direct contact with secretions or fomites.
What is the incubation period of RSV?
2-8 days
What is the infectious period of RSV?
Before symptoms start until recovery (usually up to 10 days)
Priority populations: which groups are at greater risk for severe illness?
- Babies and young children (< 5 yrs), especially preterm
- Older adults (> 65 years)
- Aboriginal / Torres Strait Islander people
- Immunocompromised
- Chronic disease
Priority populations: who are at greater risk of becoming infected?
- Close and prolonged contact (e.g. living in same house)
- Infants from infected siblings
- Live or work in settings at increase risk of spread
Priority populations: which settings are at increased risk of spread?
- Early childhood care centres
- Schools
- Residential care facilities
Who is RSV vaccination recommended for?
- Pregnant (to protect newborns)
- Aged > 75
- Chronic conditions
- Aboriginal / Torres Strait Islanders > 60 yrs
Who are RSV monoclonal antibodies recommended for?
- Young infants whose mother / birthing parent did not receive RSV vaccine in pregnancy or who were vaccination < 2 weeks before delivery
- Young infants increased risk of severe RSV disease (regardless of mother / birthing parent vaccination status)
- Young children with medical risk factors for severe RSV disease in second RSV season
Apart from vaccination, how can RSV be prevented?
- Hand hygiene
- Respiratory hygiene
- Cleaning frequently touched objects and surfaces
- People with acute resp symptoms to stay home and avoid gatherings, settings high-risk for spread
How is RSV diagnosed?
Nasopharyngeal PCR
RATs also available but not as sensitive as PCR.
What is the clinical management of RSV?
Normally self-limiting and most people recover in 1-2 weeks.
What is the surveillance case definition for RSV?
- Isolation by culture
- PCR
- Antigen detection
- Seroconversion
What is the public health management of cases?
No public health investigation or response required.
What is the public health management of contacts?
Not required for individual cases.
What is the response to an RSV outbreak?
Generally focuses on high-risk settings.
- Encourage vaccination
- Tailor health education / messaging
- Isolating / grouping people with RSV symptoms
- Increasing infection control - hand hygiene, PPE, surface cleaning, laundering/throwing out soiled articles
Which special situations and high-risk settings might require extra infection and control actions?
- RACF
- Other residential settings e.g. disability facilities
- Healthcare facilities
- Early childhood care centres
