RSV Information for Providers

Health care providers in New York State, especially those who care for pediatric patients, should stay up to date with RSV testing and recommendations for treatment and care.

Clinical Laboratory Testing

According to CDC, clinical symptoms of RSV are nonspecific and can overlap with other viral respiratory infections, as well as some bacterial infections. Several types of laboratory tests are available for confirming RSV infection. These tests may be performed on upper and lower respiratory specimens.

The most commonly used types of RSV clinical laboratory tests are:

  • Real-time reverse transcriptase-polymerase chain reaction (rRT-PCR), which is more sensitive than culture and antigen testing
  • Antigen testing, which is highly sensitive in children but not sensitive in adults

Less commonly used tests include:

  • Viral culture
  • Serology, which is usually only used for research and surveillance studies

Some tests can differentiate between RSV subtypes (A and B), but the clinical significance of these subtypes is unclear. Consult your laboratorian for information on what type of respiratory specimen is most appropriate to use.

For Infants and Young Children

Both rRT-PCR and antigen detection tests are effective methods for diagnosing RSV infection in infants and young children. The RSV sensitivity of antigen detection tests generally ranges from 80% to 90% in this age group. Health care providers should consult experienced laboratorians for more information on interpretation of results.

For Older Children, Adolescents, and Adults

Health care providers should use highly sensitive rRT-PCR assays when testing older children and adults for RSV. rRT-PCR assays are now commercially available for RSV. The sensitivity of these assays often exceeds the sensitivity of virus isolation and antigen detection methods. Antigen tests are not sensitive for older children and adults because they may have lower viral loads in their respiratory specimens. Health care providers should consult experienced laboratorians for more information on interpretation of results.

Prophylaxis and High-Risk Infants and Young Children

Palivizumab (Synagis) is a monoclonal antibody recommended by the American Academy of Pediatrics (AAP) to be administered to high-risk infants and young children likely to benefit from immunoprophylaxis based on gestational age and certain underlying medical conditions. It is given in monthly intramuscular injections during the RSV season, which generally occurs during fall, winter, and spring in most locations in the United States.

For the latest palivizumab guidance, please consult the AAP policy statement.

RSV Provider Resources: