RSV: an update on prevention and management

Abstract

Respiratory syncytial virus (RSV) is a common cause of respiratory tract infections in infants and young children, and adults over 60 years of age. Infants born prematurely, adults aged over 75 years, individuals with medical conditions such as chronic cardiac or respiratory disease, or obesity, and Aboriginal and Torres Strait Islander people are at increased risk of severe RSV disease. As the management of RSV disease is mainly supportive, routine testing for RSV in people with a respiratory illness is not recommended. In high-risk populations and individuals presenting with severe illness, respiratory virus testing should prioritise influenza and COVID-19, as there are specific antiviral drugs for these diseases. Recent approval of RSV vaccines and a new long-acting RSV monoclonal antibody has created opportunities to minimise adverse outcomes associated with RSV infection. Protection against severe RSV disease in infants can be achieved through vaccination of their mother between weeks 28 and 36 of pregnancy, or by administering an RSV monoclonal antibody after delivery. There is currently no RSV vaccine approved for neonates or infants. For older adults, at the time of writing there are 2 approved RSV vaccines available.

Keywords: RSV vaccines; nirsevimab; respiratory syncytial virus; respiratory tract infections.