Peak incidence in December-April; 18% incidence under age 5 yr, cause 20% of hospitalizations and ER visits in that age group (Nejm 2009;360:588). Big problem in immunocompromised (Nejm 1986;315:77), premature infants, term infants <1 mo, and ones w cardiopulmonary disease under age 2 yr
Also as common as influenza in the elderly w similar morbidity and mortality (Nejm 2005;352:1749, 1810)
Otitis media (Nejm 1999;340:260)
r/o influenza, parainfluenza virus (Nejm 2001;344:1917), metapneumovirus (Nejm 2004;350:443), asthma, adenovirus, and cystic fibrosis if recurs
Rx:Prevent w isolation, which decreases nosocomial spread (Nejm 1987;317:329). Monoclonal antibody, palivizumab q 1 mo (Med Let 2001;43:13) may decrease incidence in high-risk infants. Eventually vaccination (Nejm 2001;344:1917;1999;340:312) when available someday
of disease (Nejm 2003;349:82): supportive w O2; iv fluids, maybe nasal suction; bronchodilators no benefit (Nejm 2003;349:27, 82), but maybe oral dexamethasone and nebulized epinephrine if bronchiolitis and not sure about RSV status significantly reduces hosp admissions (Nejm 2009;360:2079)