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RSV Testing

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Formal name: Respiratory Syncytial Virus

At a Glance

Why Get Tested?

To determine whether an infant, an elderly person, or an immunocompromised person has respiratory syncytial virus (RSV); to help determine whether or not RSV season has started in your community

When to Get Tested?

When it is RSV season (late fall through early spring) and your doctor wants to determine whether your runny nose, congestion, coughing and/or difficulty breathing are due to RSV or to other causes

Sample Required?

Usually a nasal aspirate or nasal wash; occasionally a nasopharyngeal (NP) swab

Test Preparation Needed?

None

The Test Sample

What is being tested?

RSV testing detects the presence of respiratory syncytial virus (RSV) in nasal secretions. RSV is a common viral respiratory infection that tends to be seasonal, causing community epidemics in young children, older adults, and in the immunocompromised. Outbreaks typically begin in November or December and disappear in early spring. In these high-risk groups, RSV can cause pneumonia and bronchiolitis.

According to the Centers for Disease Control and Prevention (CDC), RSV is the most common cause of pneumonia and bronchiolitis in the U.S. in children under 1 year of age. Almost all children have been infected with the virus by the time they are 2 years old, but less than 2% of these infections are severe enough to require hospitalization. This small percentage still translates to about 75,000 to 125,000 hospitalized children each year, most of them under 6 months old. Their symptoms may include severe coughing, difficulty breathing, and high fevers.

RSV can also be an important cause of respiratory illness in the elderly and in those who are immunocompromised. The World Health Organization (WHO) estimates that globally there may be as many as 64 million cases of RSV infection each year and as many as 160,000 RSV-related deaths.

RSV testing detects virus that is being shed in the respiratory/nasal secretions of an infected person. Since detectable amounts of virus are usually only shed for the first few days of an infection, most testing must be done during this time period. There are several methods to test for the virus, but rapid RSV antigen testing is by far the most popular. Rapid RSV antigen tests are frequently performed on-site, in the doctor's office or the emergency room, with most results available within an hour. In some cases, the sample may be collected and sent to a laboratory for a more sensitive testing method. Results of these RSV tests are usually available the same day.

Occasionally, a doctor will order a viral culture (to grow the RSV virus) or a test to detect the virus's genetic material. These tests have the advantage of identifying not only the RSV virus but also other respiratory viruses that may be present. The main disadvantages of these tests are that they are not available in every laboratory and that the results take longer than the rapid RSV test. This makes them less clinically useful for evaluating an individual, but they can be useful for documenting that RSV or another virus, such as influenza, has reached a community and for identifying outbreaks in particular populations, such as a nursing home, school, or neighborhood.

How is the sample collected for testing?

Sample collection technique is critical in RSV testing. The best and most frequently used sample is a nasal aspirate or wash. A syringe is used to push a small amount of sterile saline into the nose, then gentle suction is applied (for the aspirate) or the resulting fluid is collected into a cup (for a wash).

Sometimes, a nasopharyngeal (NP) swab is used, although it is not preferred because of decreased virus quantity in the sample. The NP swab is collected by having a person tip their head back, then a Dacron swab (like a long Q-tip) is gently inserted into one of the nostrils until resistance is met (about 1 to 2 inches in), then rotated several times and withdrawn. This is not painful, but it may tickle a bit and cause the person's eyes to tear.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

The Test

Common Questions

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Article Sources

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

(© 2012). Respiratory Syncytial Virus. American Lung Association [On-line information]. Available online at http://www.lungusa.org/lung-disease/respiratory-syncytial-virus/ through http://www.lungusa.org. Accessed January 2012.

Mayo Clinic staff (2011 July 29). Respiratory syncytial virus (RSV) Mayo Clinic [On-line information]. Available online at http://www.mayoclinic.com/health/respiratory-syncytial-virus/DS00414/METHOD=print through http://www.mayoclinic.com. Accessed January 2012.

Delgado, J. et. al. (Updated 2011 October). Respiratory Syncytial Virus – RSV. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/RSV.html through http://www.arupconsult.com. Accessed January 2012.

Krilov, L. (Updated 2011 June 14). Respiratory Syncytial Virus (RSV) Infection. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/971488-overview through http://emedicine.medscape.com. Accessed January 2012.

Dugdale, D. (Updated 2011 February 19). RSV antibody test. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003348.htm. Accessed January 2012.

(Updated 2011 October 31). Learn about Respiratory Syncytial Virus. CDC Features [On-line information]. Available online at http://www.cdc.gov/Features/RSV/ through http://www.cdc.gov. Accessed January 2012.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO. (pp 826-827).

(2003 April). "Flu" Season Explodes into "Respiratory Virus" Season. Stanford University Medical Center, LAB Letter [On-line newsletter]. PDF available for download at http://www.stanfordhospital.com/pdf/labLetterApril2003.pdf through http://www.stanfordhospital.com.

(2003 November 28, Reviewed). Respiratory Syncytial Virus. CDC, National Center for Infectious Diseases, Respiratory and Enteric Viruses Branch [On-line information]. Available online at http://www.cdc.gov/ncidod/dvrd/revb/respiratory/rsvfeat.htm through http://www.cdc.gov.

Izenberg, N. (2003 July, Reviewed). Respiratory Syncytial Virus. KidsHealth for Parents, Nemours Foundation [On-line information]. Available online at http://kidshealth.org/parent/infections/lung/rsv.html through http://kidshealth.org.

(2003 January 7). CDC Finds Annual Flu Deaths Higher Than Previously Estimated. CDC Media Relations [On-line Press Release]. Available online at http://www.cdc.gov/od/oc/media/pressrel/r030107.htm through http://www.cdc.gov.

Graham, P. (2003 October 30, Updated). Respiratory syncytial virus (RSV). MedlinePlus Health Information, Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001564.htm.

Polak, M. (2004 April 13). Respiratory Syncytial Virus (RSV): Overview, Treatment, and Prevention Strategies. Medscape, From Newborn & Infant Nursing Reviews [On-line journal]. Available online at http://www.medscape.com/viewarticle/472399?src=search through http://www.medscape.com.

Estrada, B. (2004 January 05). Pediatric Bulletin, What's New in RSV. Medscape, Infect Med 20(11):522, 2003. [On-line journal]. Available online at http://www.medscape.com/viewarticle/465432?src=search through http://www.medscape.com.

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(2003 May). BD Directigen RSV. Becton, Dickinson and Company (BD) [Test Package Insert].

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Rauch, D. (2007 July 26, Updated). Respiratory syncytial virus (RSV). MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001564.htm. Accessed on 7-29-08.

Mozingo, T. (2008, Winter). RSV When It's More Than Just a Cold. Healthy Children, American Academy of Pediatrics [On-line information]. PDF available for download at http://www.aap.org/family/healthychildren/08winter/HC-winter08-rsv.pdf through http://www.aap.org. Accessed on 7-29-08.

Mayo Clinic Staff (2007 August 1). Respiratory syncytial virus. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/health/respiratory-syncytial-virus/DS00414 through http://www.mayoclinic.com. Accessed on 7-29-08.

(© 2007). Respiratory Syncytial Virus. American Lung Association [On-line information]. Available online at http://www.lungusa.org/site/apps/nlnet/content3.aspx?c=dvLUK9O0E&b=2060721&content_id={AC999AD1-9FB2-4310-A642-FD850C2E82AC}&notoc=1 through http://www.lungusa.org. Accessed on 7-29-08.

(© 2007). Respiratory Syncytial Virus Fact Sheet. American Lung Association [On-line information]. Available online at http://www.lungusa.org/site/apps/nlnet/content3.aspx?c=dvLUK9O0E&b=2060721&content_id={DEA9A6D1-58D5-4E47-8F36-6E0AAB65B977}&notoc=1 through http://www.lungusa.org. Accessed on 7-29-08.

(2008). Respiratory Syncytial Virus. American Lung Association Lung Disease Data: 2008 [On-line information]. PDF available for download at http://www.lungusa.org/atf/cf/%7B7a8d42c2-fcca-4604-8ade-7f5d5e762256%7D/ALA_LDD08_RSV_FINAL.PDF through http://www.lungusa.org. Accessed on 7-29-08.

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