Winter/spring outbreaks in children under 5. They get it from their parents and older siblings (PubMed).
Adults is usually reinfection with pre-existing immunity so disease is milder than kids but still nasty as URI's go with a 9 day illness, lower shedding and often is exacerbating underlying disease.
Often shows up when testing for influenza; sputum and nasal are both good specimen.
Incubation time is around 5 days, it is spread by direct contact.
Can cause nursing home outbreaks with 90% attack rates and may kill 11,000 elderly a year. Bacterial superinfection occurs a third of the time.
In the transplant patient it often progresses and patient often dies. Cold symptoms and sinusitis are hints.
Aerosolized ribavirin. VERY expensive. But does decrease mortality in the transplant patient. Giving aerosolized is also a real pain, but could always try po or iv in no inhaled option.
There is also IVIG and a monoclonal RSV antibody, Palivizumab, used in kids.
On the bright side, this disease is disappearing thanks to global warming (PubMed). Always look on the bright side of life.
Relevant links to my Medscape blog
Last Update: 04/07/18.