Respiratory syncytial virus (RSV) is an RNA virus from the Pneumoviridae family (genus Orthopneumovirus) and causes diseases of the respiratory tract.

RSV is widespread worldwide.

Humans are the only relevant reservoir for human RSV.

Transmission occurs primarily through droplet infection. Indirect transmission via hands, objects and surfaces contaminated with the virus is also possible.

Two to eight days (average five days).

RSV infection can be asymptomatic, cause uncomplicated respiratory illness or, in severe cases, lead to lower respiratory tract disease requiring ventilation.

The following people are at particularly high risk of severe RSV infection: children under five years of age, especially infants under 6 months of age, adults over 65 years of age and other certain groups of people in poor health, such as cancer patients and people living with HIV.

Symptoms of RSV infection usually include: runny nose, reduced appetite, coughing, sneezing, fever and a high-pitched, whistling lung sound when breathing. These symptoms do not all occur at once, but in different phases. In very young infants, RSV infection can manifest itself in irritability, reduced activity and difficulty breathing.

Almost all children go through an RSV infection in their first two years of life. The first infection in infants and young children can cause severe inflammation of the bronchial tubes (bronchiolitis), which in some cases is fatal." [3]

RSV infection does not protect against reinfection, which can occur at any age.

The administration of antiviral drugs is not routinely recommended to treat RSV infection. Most RSV infections heal on their own after one to two weeks. Consuming enough fluids is recommended to counteract a lack of fluids (dehydration). Antipyretics or painkillers can relieve symptoms. Important: Do not give aspirin to small children.

In severe cases, patients may need to be hospitalised due to breathing difficulties or dehydration.

In very severe cases, patients may need oxygen, infusions (if eating and drinking is not possible) or a ventilator.

In Austria, there is currently no approved RSV vaccine for the active immunisation of children. However, two options are available to passively immunise children against RSV: either by administration of monoclonal antibodies or vaccination of pregnant women (24th to 36th SSW).

From autumn 2023, two vaccines to prevent lower respiratory tract diseases caused by RSV will be available in Austria for adults aged 60 and older. Vaccination is approved and recommended from the age of 60.

Details on vaccination at: Vaccination schedule Austria (sozialministerium.at)

In Austria, the RSV season usually starts in November and lasts until April. Most cases are reported during these months. During the rest of the year, only isolated cases occur.

The SARI dashboard shows Austrian inpatient hospital admissions with severe acute respiratory infections, which include RSV.

The monoclonal antibodies for passive immunisation of children that are currently available in Austria are currently only approved under special conditions and are subject to a fee. With 2024, the market launch of another monoclonal antibody is expected, which is approved for all infants during their first RSV season.

From autumn 2023, the vaccine Abrysvo will also be available, which is also approved for passive protection of newborns by vaccinating pregnant women (24th to 36th week) so that the protective antibodies can be transferred to the child. Pregnant women between the 24th and 36th week of pregnancy can be vaccinated once with Abrysvo if they wish, in accordance with the approval, preferably between September and March.

The two vaccines available for adult vaccination from the age of 60 are Arexvy and Abrysvo.

Genome detections by PCR can detect RSV well, they are very specific, fast and work even if the sample contains only little viral material.

For antigen detection, immunochromatographic mostly enzyme immunoassay (EIA) based rapid tests are available. These rapid tests provide a result within 20 to 75 minutes. They are evaluated for persons up to 18 years of age. The sensitivity of EIA is in the range of 50-90% and its specificity is 75-100%, although the positive predictive value depends strongly on the age of the patient and the season. Immunofluorescence tests (IFT) are also used in laboratory diagnostics, which achieve a sensitivity and a specificity of over 90%. Out-of-season confirmation of the diagnosis by genome detection is important.

Antibody detections are of secondary importance compared to direct pathogen detections. In the case of RSV infection, antibodies are only formed in low concentrations. In order to detect a rise in titer, two sera must be examined at least 2-4 weeks apart. Antibody detection is therefore mainly suitable for retrospective confirmation of the diagnosis and for surveillance and research purposes.

For the diagnosis of RSV, PCR tests, for the detection of viral genome, or antigen tests, for the detection of antigens, are nowadays mostly performed on the basis of swabs from the nasopharynx.

You can find the responsible reference centre under the following link:
https://www.sozialministerium.at/Themen/Gesundheit/Uebertragbare-Krankheiten/Statistiken-und-Fallzahlen.html